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New devices compensate for foot drop

Nerve stimulation can help many people walk normally again.

Stroke and other diseases can damage nerves that control motion, resulting in foot drop. People with this condition have difficulty controlling the affected foot when walking. Although a conventional below-the-knee leg brace can provide stability, it cannot help these people pick up their foot normally with each step. Harvard-affiliated Spaulding Rehabilitation Hospital offers two devices that can. Dr. Randie Black-Schaffer, medical director of the stroke program at Spaulding, says the devices are significantly helpful.

Walk aide

Walk Aide

Cuff stimulators help people pick up their foot normally after a stroke.

How they work

Both devices stimulate the peroneal nerve, which causes the dorsiflexor muscle to contract and pull the foot up. Both models house the stimulator in a cuff, which is easily strapped around the upper calf with Velcro and can be worn with any kind of shoe. Both devices must be fitted by a trained therapist.

Here’s where the two models differ: The WalkAide is entirely contained in the cuff. It utilizes tilt sensor technology, which stimulates the peroneal nerve when the angle of the lower leg changes as the foot is picked up to take a step. It adjusts to an individual’s unique walking pattern.

The Bioness L300 model has a sensor that attaches to the shoe, in addition to the cuff. It detects when the heel rises off the ground in preparation to take a step and signals the stimulator to raise the foot.

Few side effects

Although most people have no problems with peroneal nerve stimulation, some find it uncomfortable. In somepeople the peroneal nerve cannot be adequately stimulated with the surface electrode—a problem that can occur in people with large calves.

Because the devices are keyed to the gait cycle, they do not work well for some people with spasticity. Others find the $5,000–$7,000 cost prohibitive when not reimbursed by their insurance provider.

Nevertheless, peroneal nerve stimulators are helpful for many people with foot drop due to stroke or other central nervous system disorders.

“One of my patients wears his all day every day,” says Dr. Black-Schaffer.

Posted by: Dr.Health

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