Foot Drop Following Stroke. What are the Treatment Options?
NeuroRehab Team
Friday, July 15th, 2016
Electrical StimulationFoot Drop Brace
The National Institute of Neurological Disorders defines foot drop, also known as dropped foot or drop foot, as “the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot.” Consequentially, people who have foot drop scuff their toes along the ground; they may also bend their knees to lift their foot higher than usual to avoid the scuffing, which causes what is called a “steppage” gait.
What Causes Foot Drop?
Foot drop is caused by (1) damage to the long nerves or peroneal nerve which is in the front of the leg, (2) muscle damage or some abnormality in the anatomy or a combination, or (3) brain or spinal disorders.
1. Nerve injury. Most commonly, foot drop is caused by an injury to the peroneal nerve. The peroneal nerve is a branch of the sciatic nerve that wraps from the back of the knee to the front of the shin. Because it sits very close to the surface, it may be damaged easily.
An injury to the peroneal nerve may also be associated with pain or numbness along the shin or the top of the foot.
Some common ways the peroneal nerve is damaged or compressed include:
- sports injuries
- diabetes
- hip or knee replacement surgery
- spending long hours sitting cross-legged or squatting
- childbirth
- time spent in a leg cast
2. Muscle disorders. Conditions that cause the muscles to progressively weaken or deteriorate may cause foot drop. These include:
- muscular dystrophy
- amyotrophic lateral sclerosis (Lou Gehrig’s disease)
- polio
3. Brain or spinal disorders. Neurological conditions can contribute to foot drop. These include:
- stroke
- multiple sclerosis (MS)
- cerebral palsy
- Charcot-Marie-Tooth disease
Managing Foot Drop
Recovery depends on the cause of foot drop and how long you’ve had it. In some cases it can be permanent. There are steps you can take to help support your foot and improve walking ability.
Foot Drop Treatment Options Include:
- Therapy to strengthen your foot, ankle and lower leg muscles
- Wearing an ankle-foot orthosis to support your foot in a normal position
- Functional electrical stimulation can help lift the foot during mobility
- surgery to fuse the ankle or foot bones may be possible in severe or long-term cases
Ankle Foot Orthoses (AFO)
An ankle-foot orthosis (AFO) is worn on the lower part of the leg to help control the ankle and foot. It holds your foot and ankle in a straightened position to improve your walking.
Electrical Nerve Stimulation
In some cases, an electrical stimulation device can be used to improve walking ability. It can help you walk faster, with less effort and more confidence.
Two self-adhesive electrode patches are placed on the skin. One is placed close to the nerve supplying the muscle and the other over the centre of the muscle. Leads connect the electrodes to a battery-operated stimulator which is worn on a belt or kept in a pocket. The stimulator produces electrical impulses that stimulate the nerves to contract (shorten) the affected muscles.
Find Foot Drop Electrical Stimulation Devices
Surgery
Surgery may be an option in severe or long-term cases of foot drop that have caused permanent movement loss from muscle paralysis. The procedureusually involves transferring a tendon from the stronger leg muscles to the muscle that should be pulling your ankle upwards. Another type of surgery involves fusing the foot or ankle bones to help stabilise the ankle.
