Dropfoot orthoses - what are the alternatives?
Drop foot is a very common gait difficulty in people who have survived a Cerebrovascular Accident (CVA). It consists of the difficulty of lifting the toes off the ground when walking, due to the lack of activation of the muscles involved in this action. This represents a high risk of a fall for the person with consequences that can be serious, such as fractures. Although dropfoot is one of the most complex difficulties to address in rehabilitation, there are alternatives that can meet people's motor requirements.
Usually, an Ankle Foot Orthosis (AFO) is used for the treatment of dropfoot, a device that stabilises the ankle joint in the anterior-posterior and medial-lateral directions while modulating the movements of the subtalar joint, i.e. it fixes the ankle and the sole of the affected foot to prevent it from dragging during walking. OTPs provide lateral stability to the ankle and promote a safe gait for the user, greatly reducing the risk of falls associated with dropfoot, which can have serious consequences that will hinder recovery.
In short, OTPs mechanically elevate the foot but also block any possible movement of the foot, thus preventing the possibility of activating the affected musculature. The passive treatment offered by OTPs does not promote active use of the neuromuscular systems and also limits the range of motion of the ankle. In addition, some models of OTPs can be uncomfortable, bulky and, if poorly fitted, can lead to pressure areas and tissue breakdown.
Neuro-rehabilitation oriented technology
Technology is now available that offers a safe alternative for dropfoot rehabilitation, such as Functional Electrical Stimulation (FES) neuro orthoses. These FES aids aim to optimise walking by activating the nerve pathways of paralysed muscles and freeing the person from the physical restrictions of common OTPs. This electrostimulation of paralysed muscles decreases atrophy and walking fatigue, a common side effect of the use of OTPs.
The WalkFES neuro orthosis consists of a small, lightweight band that is placed under the knee of the affected leg to restore the nerve signals necessary for the foot and leg muscles paralysed by the stroke to contract again at the precise moment of walking, thanks to the integration of an intelligent motion sensor that detects the exact moment when the person starts the gait cycle, generating a smoother, more natural and safer walking movement even over longer distances. Unlike an OTP, WalkFES devices are able to deliver functionality and at the same time enhance the activation of the musculature involved in the foot movement.
Why WalkFES?
- Because information from the outside entering our system from sensory organs in the joints, muscles, tendons and skin, as well as the direct effect of stimulation of our peripheral nerves act on the nervous system and foster new synaptic connections.
- Because the active involvement of muscles in the gait task leads to a substantial increase in the excitability of the cerebral cortex, compared to training without muscle activation.
- Because a large body of medical evidence supports the use of FES technologies for gait rehabilitation of people with hemiparesis.
- Because it does not require orthopaedic or special footwear for use.
- Because FES technology is recommended by the UK's NHS health system for the treatment of dropfoot.
Want to see for yourself the benefits of using WalkFES for dropfoot rehabilitation? You can request an evaluation by calling 22233 4007 or writing to contact@trainfes.com.
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