Tapping your toes to your favorite tune. Walking to the refrigerator. Climbing stairs.

These are all everyday activities that most people take for granted - until they can’t and find themselves in a health crisis due to injury or disease. Unfortunately, for some of your patients suffering from stroke, multiple sclerosis, ALS, or brain and spinal cord trauma, accomplishing these simple, everyday tasks is painful or even impossible.

Those challenges can result from foot drop, which is a general term for a condition in which someone cannot raise the front part of their feet. Foot drop is caused when changes in muscle tone in the foot decrease coordination and strength, resulting in an inability to flex the ankle or lift the forefoot.

This gait abnormality is caused by poor nerve communication to the muscles used to flex the ankle. Patients notice that their toes point downward as they swing their feet from one step to another. This prevents a natural heel-to-toe stepping motion and could cause balance issues when maneuvering stairs, curbs, and uneven surfaces. 

A seemingly minor thing like not being able to tap your toes seems inconsequential, but if left untreated, it can lead to injury to the foot or leg, increased fall risk, or postural deformity.

Foot drop can cause the foot to “drop” or drag when an individual is walking. The inability to effectively lift the foot off the ground can be a significant safety concern because when the toes drag, it is easy to trip over items on the ground.

People with foot drop adopt compensatory movements to compensate for poor foot control, such as excessively lifting at the hip or over-flexing the knee. This pattern can lead to pain or impairments in other body areas.

Many individuals with foot drop experience numbness in the affected foot, making it challenging to feel small changes when walking on uneven surfaces, increasing the possibility of a fall.

Foot Drop Management and Treatment

Since foot drop isn’t a disease but a symptom of an underlying condition, if the cause is effectively treated, foot drop might improve or could even disappear. But, there are instances when foot drop can’t be effectively treated and it can be permanent.

Aside from several treatment options we’ll address below, there are some simple but practical measures your patient can take to help keep them safe as they deal with foot drop.

Because foot drop increases the risk of tripping and falling, they should take these precautions around the house:

• Keep all floors clear of clutter.
• Avoid using throw rugs.
• Move cords away from walkways.
• Ensure that rooms and stairways are well-lit.
• Place fluorescent tape on the top and bottom steps of stairways.

Foot drop treatment depends on the cause of the condition and the severity of the disability. Some standard treatment methods that are sometimes used in combination with each other include: 

Physical therapy

Physical therapy may help in recovery from foot drop. Specific exercises can strengthen the leg muscles and improve flexibility. Choosing a physical therapist with knowledge of foot drop and its causes can be beneficial.

Surgery

If patients are looking for a more immediate treatment that orthotics or physical therapy only provide over time, several surgical solutions may help, including:

• Tendon transfer. This involves transferring a tendon that goes to a different part of the foot and directing it to the top of the foot to replace the tibialis anterior.
• Ankle fusion. This surgery fuses the foot and ankle to remove the burden from the surrounding muscles.
• Nerve graft or transfer. This procedure repairs damaged nerves by replacing them with healthy nerves.

Ankle-Foot Orthotics

One commonly used device is the ankle foot orthosis (AFO), which keeps the foot at a 90-degree angle to the lower leg to support it. We work with various physicians to help choose the perfect AFO for each patient. Everyone is different, so everyone  won’t benefit from  the same foot drop brace.
Factors that should be considered when choosing an AFO brace for foot drop treatment include:

• Rigid or soft. Rigid braces are more supportive, while softer braces are more comfortable and less likely to cause skin integrity issues.
• Hinged or solid. Hinged braces allow individuals to continue using their ankle muscles, while solid braces fully support the foot and ankle.
• Custom-made or prefabricated. While custom-made options are personalized and adapted to your patient’s specific needs and body structure, prefabricated options may be more appropriate if they are only short-term.
• Easily concealed or outwardly visible. Sometimes patients want their AFO brace to be as discreet as possible.
• Cost-effective or more expensive. Costs of AFOs vary greatly depending on insurance coverage and the type of AFO needed.

Benefits of our PRAFO® Orthosis

Anatomical Concepts offers various AFO devices to help patients manage lower extremity pain, increase mobility and improve recovery results. Our flagship AFO product is the PRAFO® orthosis, a fully adjustable, custom-fitted AFO that can help manage many of the ankle/foot anomalies your diabetic foot drop patients deal with.

The PRAFO® orthosis has proven to support the foot and ankle effectively, allowing ulcers to heal while your patient undergoes diabetic rehabilitation.  

The PRAFO® is designed with many adjustable features beneficial for both ambulatory and non-ambulatory patients. Its custom-contoured aluminum heel connector bar controls dorsi-plantar flexion by allowing infinite, measurable adjustments. The securely fastened walking base provides a shoe-type surface for mobile patients. Its calf and foot segments can be custom-modified to accommodate patients.  

Other design highlights and benefits of the PRAFO® are:  

• Height adjustment capability is available to all PRAFO® families of orthoses 
• Foot length adjustment capability is available to all PRAFO® families of orthoses 
• The aluminum heel connecting bar can be custom contoured to accommodate the patient’s foot/ankle position 
• Available in Adult standard Kodel liner # 650SKT, Pediatric standard # 550SKG, and Infant standard # 450RKG  
• Controls dorsi-plantar flexion 
• Liner options (Kodel®, Fleece, Terry Cloth, Polyurethane Foam or Pad & Strap) with various color choices are available 
• The line also includes optional accessories that complement secondary needs

Visit the product page to learn how you can incorporate the PRAFO® into your patient’s treatment plan. If you’re a patient suffering from foot drop, ask for ACI by name when speaking with your doctor.