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    afos

    as i was stretching jack out a few nights ago i noticed he is getting worse and worse foot drop. it also seems to be making his spasms worse. he has a rx. for afos, i was wondering though he wants a certain kind that he saw up at the expo. but i really dont think they would be that great for correcting foot drop. now what i was wondering is, does anyone wear ankle lentgh afo's for sitting and switch to calf length braces for standing?

    also what pro's cons are there for using only ankle height afos? i am thinking he will hate teh high afos and not wear them. but i also know his ankle turns when standing so he needs the support.

    #2
    If using properly fit wheelchair foot support and shoes in the wheelchair, AFOs should not be needed.

    Calf-length AFOs are the best, as they distribute the pressure along the entire calf. Ankle length AFOs are not very effective, and are much more likely to cause skin breakdown on the calf or Achilles tendon. AFOs should be used for standing or walking if there is instability of the ankle that causes lateral movement, foot in or out turning, or toe drag (when walking).

    AFOs are for prevention of footdrop, not treatment. The main treatment is aggressive stretching, standing, and sometimes surgery (heel cord lengthening). Both ROM and daily standing (with proper foot positioning) should prevent foot drop in all both those with the worse spasticity.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #3
      What is the definition of foot drop?

      I have an incomplete SCI in which i can walk all day long, but i have a weak left foot and my toes will not move upward, though i can move my weak ankle some enough to clear good enough to walk. I do have foot slap if i walk fast.

      I have been told this is foot drop. Is that right?

      I can face a wall with one foot out and stretch the cord just fine.

      I do also have a calf-high AFO in which i hate. I just rather walk a little slower, but i don't think this will prevent my foot from getting worse, I mean a sci doesn't keep making you loose function right?? Thats the way this post sounds.

      faster than a speeding ticket
      http://www.adamsmith.name

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        #4
        Technically, a footdrop is a fixed contracture of the foot at the ankle which prevents the foot from being flexed to neutral or beyond. Weakness of the dorsiflexor muscles can cause toe (foot) drag, which some people call foot drop, but it is not really an accurate term for this. If not stretched regularly, foot drag can lead to foot drop.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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          #5
          i have given up on the hope of him stretching himself out properly every day. he does not have it in him. he is very tight as compared to other sci members, which makes stretching way too difficult for himself. i stretch him when i can, but i am not always around. we are looking at getting a standing wheelchair hoping he will like it enough to use it while in the barn doing table work. so with this said what would you guys suggest? i am thinking about getting an insert on his footplate that makes him stretch out. anyone have such a device already made?

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            #6
            If the footplate is at the right angle, it should kind of force his heel into a stretch. At least that's the way mine is set up.

            I'm not deaf...I'm just ignoring you! [img]/forum/images/smilies/wink.gif[/img]
            "Legs are overrated. You can still get laid." - Kevin Girardi, "Joan of Arcadia"

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              #7
              paul he has a ti-lite and the angle can not be adjusted. any other suggestions?

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                #8
                I wear a product from Allied Medical (Alimed) called the Freedom Drop Foot brace. It is neoprene and attaches with velcro straps. I can put this on with one functioning hand. The brace almost looks like an ankle wrap, provides me support, yet allows my ankle to flex in a more natural way. This brace has been a great find for me.

                Bob, c5/c6 inc. walking

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                  #9
                  Hmmm...nope, no other ideas here, unless you just want to attach something to the footplate to change the angle. I have a TiLite too and mine is angle adjustable.

                  I'm not deaf...I'm just ignoring you! [img]/forum/images/smilies/wink.gif[/img]
                  "Legs are overrated. You can still get laid." - Kevin Girardi, "Joan of Arcadia"

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                    #10
                    rwm, do you use the Freedom Drop Foot brace for walking or at other times? It sounds interesting if it is more comfortable than "regular" AFOs. Thanks.

                    T12 Incomplete - Walking with Walker, Oct 2003
                    T12 Incomplete - Walking with Crutches, Injured in Oct 2003

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                      #11
                      MikeC,
                      Yes I wear the Freedom Drop Foot brace walking and at all times during the day. The brace has been very comfortable for me even with constant neuropathic foot pain. The design is essentially a sneaker insole with neoprene straps attached to the sides. One just wraps the straps around your ankle and the brace is on. Its been good to me so far, coming up on 10 months wearing it.

                      Bob c/5-6 inc. walking

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                        #12
                        Hubby uses kind of "spaceboots" at night (we give them plenty of names, I'm not sure of their right name - if you need to see them, I can email you a pic or come over to see them ;-) LOL). They are suppose to prevent the foot drop that happens to him at night (he sleeps on his back). During the day, when he is in his w/c he just mostly wears basketball tennis shoes. He doesn't stretch it enough (I do it whenever I can), so there is a little bit of foot drop going on too. I've been trying to get him back to standing - he uses KAFO's, but I have a feeling that after 3.5 years and 60 lbs gain they don't really fit him well. So I'm trying to push him to get a new ones...
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