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Foot Drop and AFO

Hi everyone. I have just been given an AFO by orthotics but it is really big and bulky and does not fit beneath my trousers as I was told it would. I find it quite embarrassing and very bulky but it does help my foot drop so I can see the benefits. I went for a meal last night and didn’t wear it and fell in the doors of the restaurant. I was mortified and now have a bruised hand as a result. I wondered if anyone knew of any supports/braces for helping with foot drop that are less intrusive and bulky. I see my physio on Wednesday so wondered if anyone had any suggestions I could ask her about. Thanks x

Have you considered a FES?

What’s that?

Hello Julie

There are a few options.

The easy, cheap, low-tech solution is a ‘Foot-up’, see Foot-Up® for Drop Foot - Drop Foot Support - Össur Webshop

The Foot-up works OK but the elastic does become stretched and ultimately they stop working so well. Saying that, I still sometimes use mine that I bought a long time ago.

Another cheap, similar devise is the ‘Boxia’, http://www.orliman.com/en/product/calf-support-for-the-boxia-drop-foot-ankle-brace/

Theoretically the Boxia works better than the foot-up, but it really only works when you’re wearing trainers. The way the elastic attaches to the shoe is by means of a metal hook. If your shoes aren’t padded enough at the front, the hook digs in and hurts.

Then there’s Functional Electrical Stimulation (FES). The commonest is made by https://www.odstockmedical.com/ This is what most people get if they are able to get FES on the NHS. Basically, the FES suit is a box work at the waist or the knee. It is connected to electrodes and a foot switch. The idea is that as you change your weight to start to use the affected foot, the electrodes stimulate the faulty nerve and your foot receives the nerve impulse needed to lift your foot.

The problem with FES is that it’s a bit of a postcode lottery as far as whether your local NHS trust will fund it for MS. And if you’re in an area where it’s not funded, it’s not cheap.

I’ve also tried a Neurodyn (http://www.beagleorthopaedic.com/products/foot-and-ankle/neurodyn-foot-lift-orthosis ) which I found very difficult to put on and didn’t seem very effective.

And a SAFO (Silicone Ankle Foot Orthosis): https://www.dorset-ortho.com/en/patient-services/safo/ These are custom made orthoses. The company make a plaster cast of your foot and then make a Silicone ‘boot’ to exactly fit your foot. They are bulky beasts and I have only one (very old) pair of shoes that I can get on the foot with an AFO. But they do work, I’ve used mine in swimming pools / hydrotherapy pools. These are not available on the NHS and cost about £800!

When you see your physiotherapist, I’d ask whether you can get FES in your area. If so, you need to be referred to the relevant company (possibly Odstock) by your GP. The FES company assess you to see if the device will work, then your GP has to apply for funding. Your physio should have some idea as to whether you can get FES.

Failing that, or even as well as the AFO you have and possibly a referral for FES, ask your physio if they can get you a Foot-up.

I personally use the FES most days for my little bit of walking (I can only walk a few metres with a walker), or use the Foot-up.

Hopefully this is useful information.

Sue

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Hello - I was using an orliman foot drop device, which worked really well. In order for it to work one had to wear any lace up shoes. You then put two hooks in the eyes of the shoes, which then hooked onto a piece of heavy duty elastic, which was then anchored to a velcro strip, which was attached to your lower foot. Very simple to use and very effective. Made a huge difference to me. If I need a replacement device or a new elastic (lasts roughly 4-6months) then I just phoned the orthotics department and they posted me a new one.

However, as I was hyper extending my knee I am now using a different and more cumbersome device. I had a cast made of my lower leg and ankle and now wear a brace on my leg/foot. It did take time to get used to it, but now I find it better than the device I was previously using, as I’m not hyper extending as much. It’s comfortable, as it was made to fit my leg. Oh yes! I did make a half hearted attempt at using an off the shelf brace, but it didn’t seem to work for me.The guy from orthotics seemed to really care about the brace he made for me, so I worked hard at getting used to wearing it and I’m glad I did. Might need to wear a full leg brace yet, as I still hyper extend, but not as much. Don’t relish the thought of a full leg brace.

At one point I tried the electrical nerve stimulator device. A physio had an old device which I used for a short spell. It was great when it worked, but at times the connections detached themselves and then i’d have to find a quiet spot to sort it. Also, the wires sometimes sneaked out and became visible. It did cross my mind that folk might think I was carrying a bomb. It might be worth trying this.

I tend to wear trousers all the time now, as I don’t like drawing attention to myself.

I’d recommend you try the orliman foot drop device, as i used it for around two years and it worked well. Just persevere to see what works best for you.

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Sue, I live in Scotland and the NHS provided me with a custom made silicone ankle foot orthosis. Seems I was very fortunate. It works, but is a bulky beast, which I can only use with certain shoes.

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A total postcode lottery. I paid for my own SAFO. And my own FES. The NHS have given me a rubbish Neurodyn, a Foot-up and a Boxia. It would be OK if I could walk, but for a while I was constantly hoping the equipment would make walking easier. Nothing has, so over the last few years I’ve spent a lot of money for not much gain.

The problem with the SAFO to me is that if I could get the SAFO into a shoe, the other shoe would be too big (for my SAFOless foot). So I have one ancient pair of shoes that actually work with the SAFO and the other foot!

Sue

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I used this for a while

but now use FES which halves the effort so double my range!

Good luck

Mick

I have used the SAFO for over 10 years now. It works great for me. No real problems with shoes either.

hope you find something that works for you.

derek