Abstract Committee Review

The Lewicke Block Test is a thoughtful and clinically valuable refinement of the Coleman and Chesnut principles. It provides a simple, reproducible way to distinguish toe-driven versus hindfoot-driven varus in patients with spastic equinovarus deformity.

The concept is biomechanically sound and clinically relevant, especially for neuro-rehabilitation, guiding treatment decisions such as targeted botulinum toxin injection, orthotic adjustment, and surgical planning.

I commend the authors for emphasizing practicality and interdisciplinary applicability. However, to elevate scientific rigor, the following brief points should be addressed:

1. Quantitative validation – Add pilot or referenced data using gait analysis or pedobarography to correlate visual correction with measurable alignment changes.

2. Define “correction” – Clarify whether the observed hindfoot realignment is qualitative or quantified by angular assessment.

3. Clinical implication – Explicitly connect test outcomes to intervention strategy (toe flexor vs. hindfoot procedures).

4. Limitations – Briefly note the absence of imaging validation and inter-rater reliability testing.

Overall, this is an excellent, practical contribution that enhances diagnostic accuracy and decision-making in spastic foot deformity management. I recommend acceptance with minor revisions to improve precision and reproducibility.

Thanks a lot for the feedback and valuable comments. Here is, in the attached document, a revised version of our abstract. We also responded to reviewers’ comments below, in blue:

1. Quantitative validation – Add pilot or referenced data using gait analysis or pedobarography to correlate visual correction with measurable alignment changes.
   1. We added a case for which the block test was validated by pedobarography.
2. Define “correction” – Clarify whether the observed hindfoot realignment is qualitative or quantified by angular assessment.

1. 1. The correction is qualitative. We clarified in the test.

1. Clinical implication – Explicitly connect test outcomes to intervention strategy (toe flexor vs. hindfoot procedures).

1. 1. We gave specific examples in the Discussion section.

1. Limitations – Briefly note the absence of imaging validation and inter-rater reliability testing.

1. 1. We added a paragraph on limitations in the Discussion section.