assessment and treatment of spastic equinovarus foot after stroke guidance from the montgodinne interdisciplinary group objective to present interdisciplinary practical guidance for the assessment and treatment of spastic equinovarus foot after strokeresults clinical examination and diagnostic nerve block with anaesthetics determine the relative role of the factors leading to spastic equinovarus foot after stroke calf spasticity triceps surae achilles tendon complex shortening and dorsiflexor muscles weakness andor imbalance diagnostic nerve block is a mandatory step in determining the causes of and the most appropriate treatments for spastic equinovarus foot based on interdisciplinary discussion and according to a patientoriented goal approach a medical andor surgical treatment plan is proposed in association with a rehabilitation programme spasticity is treated with botulinum toxin or phenolalcohol chemodenervation and neurotomy shortening is treated by stretching and muscletendon lengthening and weakness is treated by anklefoot orthosis functional electrical stimulation and tendon transfer these treatments are frequently combinedconclusion based on 20 years of interdisciplinary expertise of management of the spastic foot guidance was established to clarify a complex problem in order to help clinicians treat spastic equinovarus foot this work should be the first step in a more global international consensus