Hi Andrea, The foot drop issue can be addressed with a number of AFO's
I find the toe off splint helpful (Glibert & Mellish UK)not just for the
contact phase issues but also in regard to propulsion. Also with the MS
issues in regard to muscle bulk it is easily adaptable in the shin area
to provide a snug fit.
The lateral instability problem needs to be addressed with a lateral
flare onto the rear foot or if as excessive as you describe extended
into the fore foot. Dependant on the degree of instability I would
probably try with 10-15mm lateral flare tapering into the 5mm around the
lateral aspect of the fifth met.
For me this is essential with instability issues and really involves the
shoe as part of the treatment process.
Hope this is useful.
Regards
Mark Gallagher
Department of Podiatry
University Hospital Birmingham NHS Trust
-----Original Message-----
From: A group for the academic discussion of current issues in podiatry
[mailto:[log in to unmask]] On Behalf Of Andrea and Danielle
Sent: 15 November 2004 03:59
To: [log in to unmask]
Subject: Foot Drop
Hi All
Just seeking some advice regarding a 65 year old lady suffering with
Multiple Sclerosis. She has significant foot drop and massive lateral
instability on her right side. AFO's have proved unsuccessful and
whilst
the devices I have prescribed have reduced the lateral instability there
has
been no overall improvement in her amount of foot drop. Muscle strength
is
very poor and whilst receiving rehabilitative physio, we are not
achieving
the kind of results I would like. Any ideas for the type of device i
could
use to assist this lady.
Kind Regards
Mr Andrea Castello
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