Foot Drop System

The options for foot-drop are:

Traditional Ankle Foot Orthosis (AFO). This is like the right hand picture Mick googled (why am I not surprised that he googled AFO?). They come in a whole range of designs and fabrics, from steel to nylon. You can get a referral to your NHS hospitals Orthotics Department from your neurologist.

Simple (cheap) nylon / elastic devices like the Foot-up made by Ossur (in Micks first photo) - see Foot-Up | Foot Drop Brace | Össur UK or the Boxia made by Orliman - see BOXIA A.F.O. DROP FOOT | Orliman Both of these devices cost about £50, but you can get them from your NHS physiotherapist too.

The Silicon Ankle Foot Orthosis (SAFO) is a custom made AFO. The company make a plaster cast of your foot and ankle and construct a perfectly formed silicon ‘boot’. The company who make them is Dorset Orthopaedics - see Prosthetic and orthotic rehabilitation | Dorset Orthopaedic These are not cheap, in the region of about £800, but they last a long time.

Then there’s Functional Electrical Stimulation (FES). There are several companies who make different varieties. Your local NHS service may pay for FES, but it depends on the Community Commissioning Group. Mine for example, Coastal West Sussex does not pay for FES for most people with MS, it has to be an exceptional case, and since we are all different, everyone is exceptional, therefore no one is. The most common FES (and the one most people have funded by the NHS) is Odstock in Salisbury - see https://www.odstockmedical.com/ The cost of the Odstock version is a strange arrangement whereby you pay £330 per appointment. Odstock provide all equipment and consumables for this, the set up is expensive as you have to have several appointments, but thereafter just one appointment per year.

Obviously, there are other FES systems available, for example the system Daisy is buying. The only problem I can see with buying a system is who supports you in its use? If your physiotherapy department doesn’t know how to, will the company who sells you the equipment support you with set up and ongoing issues?

I’ve tried most of these foot drop solutions. I have a SAFO, and Odstock FES, Foot-up and Boxia. I also tried a traditional AFO as well as a nylon ‘Neurodyn’ orthotic - http://www.beagleorthopaedic.com/products/foot-and-ankle/neurodyn-foot-lift-orthosis (useless!) Because I can’t walk much, I’m actually thinking about giving up on FES and sticking to basic Foot-up and Boxia types of solutions. They’re simple to use and cheap to replace.

Interestingly, Professor Giovannoni has just posted this on the Barts Blog: https://multiple-sclerosis-research.org/2019/04/foot-drop/ It’s a small study comparing traditional AFO with FES. It’s utimately inconclusive as there was a high drop out rate from both groups of users.

Sue