NEUROLOGICAL PHYSIOTHERAPY

Drop Foot

Foot drop / Drop foot

Foot drop is a term used to describe weakness or loss of power to the muscles that pull up the ankle and toes. As a result when walking the foot tends to scuff the ground and a slapping sound can be heard. The risk of tripping or falling increases if floor clearance isn’t achieved. A telltale sign is scuff marks on the front and outside of the shoe as it rubs along the ground.

Drop Foot

Causes of Foot Drop

Foot drop is usually due to a neurological disorder. It maybe due to central neurological condition ( brain and spinal cord) or peripheral nerve injury (local nerve going to the muscle). Potential causes include the following:

  • Brain – stroke , Multiple sclerosis
  • Diabetes – can result in neuropathy often affecting both legs
  • Hereditary disorders – hereditary neuropathy
  • Lumbar spine or lower back eg disc protrusion onto the nerve
  • Peripheral nerve injury – in the case of foot drop the peroneal nerve is affected.

Drop-Foot-Phases

Typical Features of Foot Drop

The typical feature of a drop foot is scuffing of the foot when walking. Shoes are often worn down excessively at the front and outside.  Normally when walking the foot lifts up to avoid hitting the ground during swing phase. When landing (contact phase) the foot makes contact with the ground heel first and then the forefoot. However in the presence of a drop foot the walking pattern changes, the hip and knee bend up excessively during the swing phase to avoid tripping. The foot lands on the ground with the entire foot planted down all at once with a slapping sound. There is risk of going over on the ankle particularly when sensory awareness in the foot is impaired.

Walking on uneven ground eg forest paths, grass, cobbles, kerbs is more difficult due weakness and lack of ankle stability.

A foot drop maybe temporary or permanent depending on the condition. In many cases surgical intervention is not an option therefore conservative or non surgical management needs to be considered.

Physiotherapy Management

The primary focus is to optimise the potential for recovery and improve quality of walking. The initial step is to have a physiotherapy assessment. 

Assessment

This includes a detailed evaluation of:

  • Walking
  • Specific limb measurement
  • Balance control
  • Sensory awareness
  • Muscle strength
  • Flexibility

This provides a baseline level of function. It is carried out by our neurophysiotherapy team who specialise in neurological conditions. An integral part of management is the use of splints / orthosis and electrical stimulation.

Splints/ Orthotics

Splints or orthosis range from flexible to rigid, off the shelf to custom made, plastic to light weight carbon fibre, subtle to the more obvious. The most appropriate will depend on a number of factors including diagnosis, level of impairment, skin health and sensation. We have a range of devices that can be trialled to find the most suitable for you. 

Electrical Stimulation

Electrical stimulation, in conjunction with a strengthening regime, is used to stimulate the weakened muscles. We offer a loan scheme for home use.

The Bioness Foot-drop System.

One very sophisticated system and new to Ireland is The Ness L300 foot-drop system. This is a revolutionary medical device that can help improve walking pattern by lifting the foot allowing you to walk easily indoors and outdoors.  Using advanced technology this is a wireless system that senses when your foot is on or off the ground.  The device sends electrical impulses to the specific leg muscles, which helps to lift the foot and allows you to walk more easily.  It’s a comfortable device that can be worn under most clothing.  It can help people who suffer with a neurological condition where they have difficulty walking due to weakness or stiffness in the leg muscles.  The L300 foot-drop system is programmed by our clinicians to stimulate the appropriate muscles and nerves in the leg to provide a more natural walk. www.bioness.com

You can be assessed for suitability for this advice by one of our clinicians who have been specially trained in its use.

Please feel free to call 01 8829174  if you would like further information or to get advice on any of the above.

Ness-L300-for-Drop-Foot

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