What is Dropped Foot?
If you have sustained an incomplete Spinal Cord Injury (SCI), Multiple Sclerosis (MS) or a stroke, you may have a impaired function and mobility. One of the crucial tasks would be to re-gain and improve the walking pattern.
You may struggle to clear a surface due to a drop foot which may cause a higher risk of falls and further injury. Having a foot drop can make walking more effortful and tiring due to the altered walking pattern.
Why have you got a drop foot?
Your injury or impairment may result in weakness to the muscle (called Tibialis anterior) at the front of the shin is not strong enough to lift your foot while walking. Fortunately, we live in the time where technique has progressed and more devices are available to assist.
How can I improve it?
The first option is using a plastic splint AFO (Ankle foot orthotics). Your specialist neuro physiotherapist will be able to assess you and recommend one of many mobility providers. The second option is FES.
FES for Dropped Foot
FES is functional electrical stimulation which is used in a few devices:
- The Medical Physics Department at Salisbury District Hospital produced The ODSTOCK DROP FOOT STIMULATOR (ODFS). Two small electric pads are placed over nerve supply for lower leg. The foot switcher in a shoe on the other side is targeted by body weight bearing and electric stimulation is delivered into particular muscles. Both electrodes and switch foot are connected with wires to the operating unit. For convenience a client may keep it on the belt and pressing the button on or off according needs.
The improved device is called PACE. It works on the same principle but has added more features so we can use it not only for walking. Different mode can be set up to perform a specific functional task like sit to stand or weight bearing with electrical stimulation into particular muscle or muscle groups. The exercise mode can be used for certain periods of time to help aid the strengthening of your weaker shin muscle. Your treating specialist neuro Physiotherapist can help to set up the specific strengthening programmes for you. - BIONESS and WALKAID have launched wireless products which there are more practical for clients and don/doff could be managed after practising easily by one hand only. There is also less risk for wires disconnection with device as well as a client safety and preventing of falls/ tripping over wires.
- BIONESS contains a specially shaped cuff where two electrodes are placed inside of cuff. The cuff placement is just below the knee. The switch foot is placed inside of a shoe on the other leg. The cuff and switch foot are wirelessly communicating with the small rectangular device approximately 2 x 3 inches. You can keep it on the strap around the neck.
- WALKAID has the similar cuff placed below the knee. The stimulation is triggered by a built in sensor. The sensor scans the position of your leg when swinging.
STIMWELL Med 4 units by Ottobock is the other unit that allows for 4 channels to be used and up to 10 programmes can be created that can be used by you outside of therapy sessions. The device allows for EMG triggered FES which can be used to help re-educate very weak muscles if flickers or very small movements are present. This also helps to re-educate tight muscles for example, the EMG triggered FES can be used on tight calf muscles to teach you how to relax your calf muscle before the stimulation to the front of your shin is delivered. Sit to stand programmes for both legs can be created using the 4 channels.
A comprehensive assessment with your treating specialist neuro physio in clinic will determine which device would be most suitable for your use.