HealthFirst reporter Leslie Toldo tells us all about this new treatment for foot drop.
About 20 percent of stroke patients will suffer foot drop. It's the inability to raise the foot because of weakness or paralysis.
This cuff is helping the mother of a famous athlete keep up with her daughter.
Linda Krohn isn't reading just any magazine. Her daughter graces the cover. "This was her dream ever since she was 8."
She's the proud mom of Olympic gold medalist skier Lindsey Vonn.
"Lindsey is just one example of what hard work can do," Krohn said.
That work ethic runs in the family. but for years, Krohn's foot drop held her back. She had a stroke while giving birth to Lindsey. The nerves in her left foot and ankle never recovered. "This muscle doesn't get any nerve impulses from my brain at all. With a foot drop, I would catch my toe, so it's dangerous."
She has a smoother, faster step now, thanks to a device designed just for her.
"The peroneal nerve is the nerve that we're after here," explained prosthetics and orthotics expert Roger Wagner.
Computer software pinpoints Krohn's peroneal nerve. Those measurements are transmitted through Bluetooth technology into a control unit and cuff she wears while walking. Instead of a one-size-fits-all device, practitioners line up the electrodes exactly with Krohn's nerve. they deliver the electrical signal that tells her foot to pick up.
"The placement of the electrodes is unique to everyone," Wagner said.
Each patient has a tiny permanent mark telling them where her cuff should go. "It's very critical to get it exactly where it needs to be," Wagner stressed.
And it's helping Krohn be where she needs to be, which includes cheering on her champion daughter on the slopes, on screen and even on a cereal box.
"It's hard to believe she's my daughter," Krohn said.
Other than stroke, the cuff is approved to help people with foot drop as a result of multiple sclerosis, spinal cord injuries, traumatic brain injuries and cerebral palsy.
BACKGROUND: Foot drop describes the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot. People with foot drop often scuff their toes along the ground or bend their knees to lift their foot higher than usual to avoid the scuffing. Foot drop is a symptom of an underlying problem. Causes may include: neurodegenerative disorders of the brain that cause muscular problems, such as multiple sclerosis, stroke and cerebral palsy; motor neuron disorders such as polio, some forms of spinal muscular atrophy and Lou Gehrig's disease; injury to the nerve roots, such as in spinal stenosis; and peripheral nerve disorders.
The most common treatment is to support the foot with leg braces and shoe inserts. Exercise therapy can help strengthen the muscles, and maintaining joint motion also helps to improve gait. In cases with permanent loss of movement, surgery that fuses the foot and ankle joint or that transfers tendons from stronger leg muscles is occasionally performed.
ELECTRICAL STIMULATION: There's a new version of the WalkAide device that's helping patients strengthen their own muscles while obtaining a smoother gait at the same time. WalkAide uses sensor technology to analyze the movement of the leg and foot. Then, it sends electrical signals to the peroneal nerve, which runs along the outside of the lower leg and controls movement in the ankle and foot. The new addition includes the Bi-Flex cuff, which was designed using the feedback from patients. This new cuff holds the WalkAide control unit and is worn below the knee as the patient walks. The cuff is designed for each specific patient. The electrodes inside the cuff line exactly where the patient's peroneal nerve is located. This was a problem in the old, one-size-fits-all device. "Getting the electrical stimulation along the peroneal nerve is the whole shooting match. Without that, the system doesn't work, and, the placement of the electrodes is unique to everyone, so it can be a little further back on one person, a little higher or lower on another person, so having the device fitted exactly to each patient is very helpful in the effectiveness of the device," Roger Wagner, a practitioner with Hanger Prosthetics, told Ivanhoe.
The patient has a permanent mark on his or her leg that lines up the cuff and the electrodes. Patients say it's a big improvement. "Before with the old system, you had to move the cuff around until you got the electrodes in exactly the right spot for you, and sometimes, it would take an hour to get them in the right place," Linda Krohn told Ivanhoe.
COST: Medicare and Medicaid does cover the cost of the system for some indications including stroke, multiple sclerosis, cerebral palsy and traumatic brain injury. Without insurance, the device can cost about $8,000.
For more information:
Hanger Prosthetics & Orthotics
1- 877- 4HANGER
http://www.hanger.com
