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DROP FOOT AND TREATMENTS

DROP FOOT AND TREATMENTS YOUNGMEE PARK
DROP FOOT AND TREATMENTS YOUNGMEE PARK

YOUNGMEE PARK

W HAT IS FOOT DROP  Foot drop / Drop foot  the inability to

WHAT IS FOOT DROP

Foot drop / Drop foot

the inability to lift the front part of the foot

not a disease

a symptom of some other medical problems

a sign of an underlying neurological, muscular or

anatomical problem

can happen to one foot or both feet at the same

time The ability to foot-lift is an essential part of the swing phase of the gait cycle

or both feet at the same time  The ability to foot-lift is an essential part

THE GAIT CYCLE

T HE G AIT C YCLE

CAUSES

Nerve injury

most common compression of the nerve nerve can be injured during THR or TKR

Brain or spinal cord disorders Neurological conditions stroke, multiple sclerosis (MS) cerebral palsy, Charcot-Marie-Tooth disease

Muscle disorders muscular dystrophy, polio amyotrophic lateral sclerosis (Lou Gehrig's disease)

disease  Muscle disorders muscular dystrophy, polio amyotrophic lateral sclerosis ( Lou Gehrig's disease )

MUSCLES & NERVE

o

Dorsiflexor

anterior tibialis

extensor hallucis longus extensor digitorum longus

o

Peroneal Nerve

ERVE o Dorsiflexor anterior tibialis extensor hallucis longus extensor digitorum longus o Peroneal Nerve
ERVE o Dorsiflexor anterior tibialis extensor hallucis longus extensor digitorum longus o Peroneal Nerve

SYMPTOMS

High steppage gait

An exaggerated, swinging hip motion

tingling, numbness & slight pain in the foot

Difficulty performing certain activities that require the

use of the front of the foot

Muscle atrophy in the leg

Limp foot

performing certain activities that require the use of the front of the foot  Muscle atrophy

TREATMENT

depends on the specific cause of foot drop

Exercises

strengthen the muscles, maintain joint motion and help to improve gait

Ankle Foot Orthotics (AFO)

support the foot with light-weight leg braces and shoe inserts

Electrical Functional Stimulations

electrically stimulate the peroneal nerve during footfall

Surgery

repairs or decompresses a damaged nerve

fuses the foot and ankle joint or transfers tendons from stronger leg muscles

The goal of treating foot drop is to get patients back to a regular gait cycle.

tendons from stronger leg muscles The goal of treating foot drop is to get patients back

PHYSICAL THERAPY- EXERCISE

usually when the problem stems from weak muscles proper physical therapy exercises can strengthen ankle muscles and improve symptoms

 proper physical therapy exercises can strengthen ankle muscles and improve symptoms Toe Curls toe-to-heel rock

Toe Curls

 proper physical therapy exercises can strengthen ankle muscles and improve symptoms Toe Curls toe-to-heel rock

toe-to-heel rock

 proper physical therapy exercises can strengthen ankle muscles and improve symptoms Toe Curls toe-to-heel rock

PHYSICAL THERAPY- EXERCISE

Foot Stretch

Isometric Dorsiflexion

Foot Stretch
Foot Stretch

PHYSICAL THERAPY- EXERCISE

Foot Band

P HYSICAL T HERAPY - E XERCISE Foot Band Cycling

Cycling

P HYSICAL T HERAPY - E XERCISE Foot Band Cycling
P HYSICAL T HERAPY - E XERCISE Foot Band Cycling

ANKLE FOOT ORTHOTICS

The most common treatment

An insert in the shoe that holds the foot at 90 degrees

Stabilizes the ankle in stance and helps clear toes in swing

An insert in the shoe that holds the foot at 90 degrees  Stabilizes the ankle
An insert in the shoe that holds the foot at 90 degrees  Stabilizes the ankle
A NKLE F OOT O RTHOTICS  A variety of materials Plastic AFO : light

ANKLE FOOT ORTHOTICS

A variety of materials Plastic AFO : light weight off the shelf - short term use custom molded from a cast long term use or complicated case

risk of skin irritation

long term use or complicated case risk of skin irritation Metal and leather AFO : heavy

Metal and leather AFO : heavy

skin contact must be kept a minimum

good for fluctuating edema patients

FUNCTIONAL ELECTRICAL STIMULATION (FES)

Electrical stimulation to the nerves controls the dorsiflexor muscles.

it was first proposed as a treatment for foot drop in 1961

they send electronic pulses to fire the nerve response for the front of your foot to lift.

it's programmed to each individual separately

it provides normal range of motion to the foot and ankle during walking

stroke and multiple sclerosis patients with foot drop have had success with it

Contraindication :

pacemaker, uncontrolled epilepsy, pregnancy, broken skin

with foot drop have had success with it • Contraindication : pacemaker, uncontrolled epilepsy, pregnancy, broken

WALKAIDE

W ALK A IDE  utilizes patented tilt sensor technology Initiating stimulation when the leg is

utilizes patented tilt sensor technology

Initiating stimulation when the leg is tilted back Terminating stimulation when the leg is tilted forward.

creates a more natural and efficient walking pattern.

back Terminating stimulation when the leg is tilted forward .  creates a more natural and
back Terminating stimulation when the leg is tilted forward .  creates a more natural and

FES VS. AFO

Functional electrical stimulation

Ankle-foot-orthotics

small

big and heavy

wear almost any type of shoe

needs special shoes to fit

active muscle contraction

passive to correct the gait

reconstruction neural pathway

can’t help reconstruct neural

pathway

doesn’t work for people who have problems with nerves in the feet

Cosmetically unappealing

more normal walking pattern

hold the foot at 90 degrees

$$$$

$$ - $$$

the feet Cosmetically unappealing more normal walking pattern hold the foot at 90 degrees $$$$ $$

There are many causes and treatments

for foot drop, and each individual

patient requires different procedures depending on their specific cause and

conditions. Clinicians must work to find

optimum treatments for each patient to

ensure the best outcomes.

cause and conditions. Clinicians must work to find optimum treatments for each patient to ensure the

QUICK QUIZ

Name the nerve that controls the muscles that lift

the foot.

Name of the abnormal gait when the foot is raised high to avoid catching a drooping foot

Name two of the exercises for a foot drop injury

Contraindication for FES

high to avoid catching a drooping foot  Name two of the exercises for a foot

QUESTIONS?

Q UESTIONS ?

FASCINATING FOOT AND ANKLE FACTS

1.

25% of the bones in your body are in your feet.

2.

The average person takes 8,000 to 10,000 steps per day

3.

The average person will walk over 100,000 miles

in their life, or more than 4 trips around world.

4.

Women have four times as many foot and ankle problems as men ill fitting high-heeled footwear is commonly the problem.

5.

More than 75% of people will experience foot

and ankle problem in their lifetime.

is commonly the problem. 5. More than 75% of people will experience foot and ankle problem

REFERENCES

Bullen , D. ( n.d .). Tools To Treat Foot Drop on ADVANCE for Physical Therapy & Rehab Medicine. ADVANCE for Physical Therapy & Rehab Medicine. Retrieved February 28, 2013, from http://physical- therapy.advanceweb.com/Features/Articles/Tools - To - Treat - Foot - Drop.aspx

Farley, J., & CPO/L. (n.d.). Controlling drop foot: Beyond standard AFOs | Lower Extremity Review Magazine. Lower Extremity Review Magazine - biomechanics, foot orthotics, knee pain, insoles, diabetic footwear, ankle braces. Retrieved February 26, 2013, from http://lowerextremityreview.com/article/controlling-drop- foot-beyond-standard-afos

focus on foot drop. (n.d.). physical-therapy.advanceweb.com. Retrieved February

28, 2013, from physical-therapy.advanceweb.com/SharedResources

Foot Drop: Causes, Symptoms, and Treatment. (n.d.). WebMD - Better information.

Better health

Retrieved February 28, 2013, from http://www.webmd.com/a-to-z-

WalkAide: Dynamic Foot Drop Treatment . (n.d.). WalkAide: Dynamic Foot Drop

Treatment . Retrieved March 1, 2013, from http://www.walkaide.com/en- US/Pages/default.aspx

WalkAide: Dynamic Foot Drop Treatment . Retrieved March 1, 2013, from http://www.walkaide.com/en- US/Pages/default.aspx