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Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
For people with hemiplegia, one-handed techniques of self-care can be taught in the immediate phase. Once the affected limb has regained sufficient power to overcome gravity it may be used to assist with functional tasks. The best evidence for a benefit of physiotherapy after stroke is for task-orientated exercise training, especially if intensive and performed in the early phase.99 Team members, not limited to physiotherapy, should then encourage the patient to incorporate the techniques into their usual daily routine. An ankle–foot orthosis (AFO) may prevent foot drop hindering attempts at walking.100
Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
The lesion is usually neurapraxic with variable axonal involvement. Significant spontaneous improvement is seen within 3 to 6 months. Patients with more than 50% axonal injury show slower and incomplete recovery. Treatment is symptomatic with physical therapy and ankle-foot orthosis. Caesarian section should be considered in subsequent pregnancies to avoid further compromise (23,29). Rarely, idiopathic or inherited lumbosacral plexopathy akin to brachial neuritis may occur in postpartum period.
Surgical principles of amputations
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Arul Ramasamy, Aabid Sanaullah, Donatas Chlebinskas
The Chopart amputation involves the disarticulation of the foot at the level of the talonavicular and calcaneocuboid joint. This amputation level has some advantages compared to more proximal amputations:It does not provide much shortening of the limb.Postoperatively the patient can be fitted with an Ankle-Foot-Orthosis (AFO), allowing normal shoe wear.By maintaining the heel, distal weight-bearing is through tough weight-bearing skin.
Footwear characteristics and foot problems in community dwelling people with stroke: a cross-sectional observational study
Published in Disability and Rehabilitation, 2023
Dorit Kunkel, Louis Mamode, Malcolm Burnett, Ruth Pickering, Dan Bader, Margaret Donovan-Hall, Mark Cole, Ann Ashburn, Catherine Bowen
Although 70% of respondents in our previous survey [12] indicated that they felt their current indoor shoes “were right for them”, when assessed by a podiatrist we found that only 50% of the shoes worn by participants in the current study fitted well. A systematic review concluded that between 63 and 73% people wore poorly fitting shoes, highlighting that this is a very common problem [34]. Worryingly even bespoke shoes supplied and worn with a foot orthosis did not fit well in all cases. Evidence shows that shoe fit is important [34] and that correctly fitted ankle-foot orthosis can have a beneficial effect on gait post stroke [35]. It is argued that poorly fitted shoes might not allow the ankle foot orthosis to fulfil its intended purpose. Poorly fitting shoes have been linked to the development of foot problems including toe deformities, pain, skin lesions, hallux valgus, corns, and calluses [34].
Robot Assisted Ankle Neuro-Rehabilitation: State of the art and Future Challenges
Published in Expert Review of Neurotherapeutics, 2021
Shahid Hussain, Prashant K. Jamwal, Paulette V. Vliet, Nicholas A. T. Brown
A single DOF ankle-foot orthosis has been developed at Seoul National University (SNU) [39]. The robotic orthosis actuation works on the principle of Series Elastic Actuation (SEA) and an electric motor has been used in combination with Bowden cables to provide plantar/dorsiflexion to the ankle joint. The electric motor and the motor controller are mounted around the waist area of patients and the actuation is transferred to the ankle joint by using Bowden cables. The ankle-foot orthosis is designed for over ground rehabilitation [39]. A single DOF robotic exoskeleton for providing plantar flexion/dorsiflexion to the ankle joint of neurologically impaired patients during treadmill walking has also been developed at Northern Arizona University [40]. The robotic exoskeleton is also powered by SEA [41]. A single DOF ankle-foot orthosis SAFE, powered by SEA has also been recently proposed in the literature [42]. Using a similar working principle to SAFE, a robotic ankle exoskeleton powered by SEA has also been developed at the University of Washington for providing plantar/dorsiflexion for treadmill walking [43].
Trends and Technologies in Rehabilitation of Foot Drop: A Systematic Review
Published in Expert Review of Medical Devices, 2021
Fady Alnajjar, Riadh Zaier, Sumayya Khalid, Munkhjargal Gochoo
This systematic review summarizes the different types of robot-assisted rehabilitation devices available for foot drop correction and rehabilitation. It focuses on the latest researches and proposed devices for foot drop correction. The strategies widely used are ankle-foot orthosis devices. These can be platform-based or wearables. Recent researches have successfully attempted to develop RAFOs to improve the FD therapy paradigm drastically. Another method that is increasingly becoming popular and is being researched extensively is Functional Electrical Stimulator. This article reviews the trends of rehabilitation and assistive devices developed and proposed in the last 5 years, focuses on both RAFOs and FES devices. Due to variable study designs, inconsistent quality of studies and small sample sizes, this systematic review results must be interpreted with an open mind. In our shortlisted studies, the articles can be classified as RAFOs and FES based articles. Based on this review it is seen that RAFO and FES both improve the condition of FD in the patients. This review is done to assess and describe the currently available literature for efficacy of robotic devices and methods available for recovery or improvement in condition of patients suffering from FD due to stroke or other reasons, and to elaborate on the limitations and prospects of such devices to inspire future study designs.