Drop foot is a frequently treated condition that can be caused by conditions such as TBI/stroke, nerve damage, ligament and tendon damage, neurological conditions, and other degenerative diseases. These conditions may result in either a partial or complete inability to dorsi flex (lift) the foot, a movement that is crucial to allow for toe clearance during the swing phase of walking. The inability to lift the foot as the leg swings through when walking, increases the risk of falling. Drop foot also increases the energy used to walk as it forces the person to compensate by changing how they walk.
Drop foot splints- Ankle Foot Orthosis (AFO)
This group of individuals often have other complications and the last thing one wants is for them to fall. If they do not successfully manage to compensate for the dropped foot, they are at a high risk of the foot catching on the ground causing them to trip and fall. Foot slap, the inability to slow down the rate of the foot going down to the ground as the person goes from heel strike to midstance is another common problem for people that have drop foot. Foot slap also forces the individual to compensate and increases energy expenditure during walking.
The type of device selected to treat drop foot depends on the need of the individual and the severity of the muscle and nerve impairment. There are several orthotic treatment options available, each providing a varied amount of control and support. The selected device can be either a simple or complex off the shelf (OTS) splint or it can be custom manufactured to meet patient specific requirements.
Off the Shelf Drop Foot Bracing/Splinting
The Aircast Podalib is a simple, easy to use soft OTS orthosis that provides ankle dorsiflexion by means of elasticated bands that attaches to the soft comfortable cuff that wraps around the ankle. The two straps, hook onto the shoe or, for barefoot walking, to the foot strap. These straps connect the shoe to the ankle. This design provides the required ankle dorsiflexion which in turns provides toe clearance while walking. The quick closure buckles allow for ease of adjustment by the user.
- Mild to moderate Drop foot
- Neurological weakness or paralysis of the foot-lifting muscles.
- Tendonitis of foot dorsiflexors
Plastic Off the Shelf Ankle Foot Orthosis (AFO)
This light weight off the shelf plastic ankle foot orthosis is particularly well suited for short term intervention during the early phase stages of a drop foot incident whilst the rehab team assess the severity of the neurological fall-out and resultant muscle weakness. This AFO is an effective option to treat temporary dorsi flexor weakness or if the individual only walks short distances. The AFO helps in lifting the foot and reduces the risk of stumbling and falling.
With this dorsiflexion assist orthosis, the foot is held in a neutral foot/ankle position during the swings phase of walking, and it allows passive, flexible plantar flexion as the users heel lands on the ground. The ankle foot orthosis is thermoformable, which means it can be reshaped for individual adaptation to the patient if required.
This device is generally used as a short-term solution during early rehabilitation. Once a full evaluation is done, a suitable orthosis can be provided according to the individuals specific needs and requirements.
- Ease of availability and cost-effective brace for temporary use
- Well suited for early patient mobilisation.
Carbon Fibre Drop Foot Orthoses
A wide variety of carbon fibre type AFO options are available to aid with drop foot. These are selected to meet the specific needs of the individual.
Carbon fibre AFO’s provide the user with a dynamic and physiological gait pattern allowing for a more natural gait. These devices provide benefit by:
- Providing energy storage and release—energy efficient gait
- Allow for a natural heel strike
- Allow for an even step length and increased walking speed
- Control the rate of plantar flexion which limits foot slap
- Allow for a smooth roll-over from heel strike to propulsion
- Highly effective in providing toe clearance during swing phase
- Can be used as a ground reaction orthosis to provide knee extension control
Trubomed Xtern AFO:
The Turbomed Xtern AFO is a unique addition to the drop foot splint family. It is an externally applied AFO which means that it does not take up any space inside the shoe and it can easily be fitted on different shoes by simply sliding it onto the attachment piece that is secured directly onto selected shoes. It is often prescribed when patients require a more dynamic orthosis.
Conditions that often require the use of a drop foot AFO include but are not limited to:
- Dorsiflexion weakness
- Cerebral Vascular Accidents (CVA, Stroke) with limited fallout
- Guillian-Barre Syndrome
- Motor Neuron Disease (MND)
- Multiple Sclerosis (MS)
Custom bracing is designed in cases where specific requirements cannot be achieved by means of an off the shelf brace, or the complexity of the ankle alignment or structure requires a custom design and fit. Chin and Partners has a fully equipped manufacturing facility where our professionals and technicians build these specialised orthoses.
Indication for Custom made AFO but not limited to:
- Cerebral Vascular accidents (CVA, Stoke)
- Traumatic Brain Injuries (TBI)
- Spinal Cord Injuries
- Traumatic injuries
- Nerve impingement
- Muscle Dystrophy (MD)
- Multiple Sclerosis (MS)
- Guillian-Barre Syndrome.
Material choice: We select from a wide variety of materials and component to manufacture an AFO to provide optimal function and stability to meet the patients specific requirements and needs. Selection is based on the functionality, stability, and durability required from the orthosis. An AFO can be made from various plastics such as polypropylene, low-density polyethylene (LDPE), co-polymers or a combination of these materials to address flexibility and strength requirements in the design. Carbon fibre is used where maximum strength and durability is required, while maintaining a thin, lightweight Ankle-Foot-Orthosis (AFO). The material selection also ensures ease of don and doffing (putting on and taking off) the device. This custom designed and manufactured orthosis will allow for a close to natural gait pattern by providing the required support.
Component selection; This has a major influence on the orthotic prescription as it affects the function of the Ankle-Foot-Orthosis (AFO). These joints include but are not limited to free moving joints, mild to moderate dorsiflexion assist as well as stance phase resistant joints.
Free moving joints allow for forward tibial proregression when walking. Dorsiflexion assistive joints allow for adequate toe clearance during the swing phase. Adjustable stance phase resistant joints provide ground reaction forces during the stance phase and these have a further influence on knee control.
We at Chin and partners use components from various suppliers such as Ottobock, Fior & Gentz and Becker to name a few to ensure the best results in treating and addressing patient specific needs and requirements.