Stopping Foot Drop - NewsChannel5.com | Nashville News, Weather & Sports

Stopping Foot Drop

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HOUSTON, Texas (Ivanhoe Newswire) - A potentially dangerous condition can strike people with head trauma, stroke, MS and other problems. It affects the feet and makes every step a struggle. Now, a "shocking" new device can help people stay on their feet and out of wheelchairs.

People walk an average of three to five thousand steps every day. For people like Charles, Linda and Denina, each step is literally a drag.

"I'll start dragging that right foot pretty good," Charles Hebert, a foot drop patient, told Ivanhoe.

"It's very frustrating," Linda Neiman, said.

"It's like picking up dead weight," Denina Gilliam, adds.

All three have foot drop. It is a condition caused by underlying neurological, muscular or anatomical problems that makes it difficult to walk. Methodist Hospital Doctor Jenny Lai said it puts patients at risk for nasty falls.

"They're coming in with head injuries or broken hips and that means often times the physician will say, maybe it's time for you to be in a chair," Jenny Lai, MD, a section chief and physical medicine and rehabilitation and the Methodist Hospital in Houston, explained.

For the first time, they tried the Bioness; it straps on the thighs and legs and sends electrical stimulation to muscles and nerves

"The device will help you to lift up your ankle and to move forward," Dr. Lai said.

Linda drags her left foot while she walks. With the Bioness, the drag is all but gone.

"When these things are stimulating, I don't feel the tightness in my muscles," Linda said.

Denina and Charles notice a difference too.

"I feel it bending, help bending the knee," Denina said.

"It wasn't like a miracle or anything, but it was easier," Charles said.

Doctor Lai said it can take up to eight sessions for patients to get the best results. While the patients didn't see life-changing results during their first session, they will give it another try.

"I definitely feel it's a plus," Linda said.

Doctor Lai said besides a foot splint or surgery there aren't many other treatments for foot drop. She said about 50 percent of private insurance companies cover the Bioness, but Medicare does not.

RESEARCH SUMMARY

BACKGROUND: Foot drop, sometimes called drop foot, is a general term for difficulty lifting the front part of the foot. If you have foot drop, you may drag the front of your foot on the ground when you walk. Foot drop isn't a disease. Rather, foot drop is a sign of an underlying neurological, muscular or anatomical problem. Sometimes foot drop is temporary. In other cases, foot drop is permanent.

(SOURCE: Mayo Clinic)

FOOT DROP SYMPTOMS: Foot drop makes it difficult to lift the front part of your foot, so it might drag on the floor when you walk. To counter this, you might raise your thigh when you walk, as if you were climbing stairs (steppage gait), to help your foot clear the floor. This odd gait might cause you to slap your foot down onto the floor with each step you take. In some cases, the skin on the top of your foot and toes may feel numb.

Foot drop typically affects only one foot. Depending on the underlying cause, however, it's possible for both feet to be affected. See a doctor if your toes drag on the floor when you walk.

(SOURCE: Mayo Clinic)

PUTTING YOURSELF AT RISK: The peroneal nerve controls the muscles that lift your foot. This nerve runs near the surface of your skin on the side of your knee closest to your hand. Activities that compress this nerve can increase your risk of foot drop.

Examples include:

Crossing your legs. People who habitually cross their legs can compress the peroneal nerve on their uppermost leg.

Prolonged kneeling. Occupations that involve prolonged squatting or kneeling — such as picking strawberries or laying floor tile — can result in foot drop.

Wearing a leg cast. Plaster casts that enclose the ankle and end just below the knee can exert pressure on the peroneal nerve.

(SOURCE: Mayo Clinic)

"ELECTRIFYING LEGS" WITH THE BIONESS: The Bioness comes in two models: The Bioness L300 Foot Drop System, which consists of a leg cuff and the L300 Plus, which includes a leg cuff and a thigh cuff. The system applies electrical stimulation in a precise sequence, which then activates the muscles and nerves to lift the foot and bend or extend the knee. The result is a more natural walking pattern (gait) combined with enhanced stability and confidence. The systems work wirelessly and are programmed by your clinician to work specifically for you.

The maker claims the Bioness systems:

Assist with a more natural walking pattern (gait)

Reeducate muscles

Reduce muscle loss

Maintain or improve range of motion

Increase local blood circulation

INTERVIEW

Dr. Jenny Lai, Section Chief at the Physical Medicine and Rehabilitation at The Methodist Hospital in Houston, talks about stopping foot drop.

Can you tell us about Bioness?

Dr. Jenny Lai: It's a functional electrical stimulation. What that means is it has electric current to stimulate your nerve. It allows the nonfunctional muscle to work and stimulate and move again, it can be in your ankle, thigh anywhere where the device can fit.


What is it used for?

Dr. Jenny Lai: Usually if you have a neurological status like a stroke, multiple sclerosis, traumatic brain injury or spinal cord injury, where your foot is not able to move, it takes a lot more energy to drag your feet around and take the feet forward. This device will help you to lift up your ankle and to move forward.

How long have you been using this therapy?

Dr. Jenny Lai: We've been using it in therapy for maybe a year or two years now. The thigh unit just recently came out, so along with the ankle unit and the thigh unit, we have found it very helpful for patients that were not walking well before.

What kind of results have you seen?

Dr. Jenny Lai: Great results. We've been seeing happy tears in the office. This allowed them to have a normal gait pattern. We have patients that have been falling with a lot frequency, they're stumbling over. What this device does is they help those patients who are still willing to go out to the community and who can walk around the house have a better lifestyle.

Does it get progressively better the more you use it?

Dr. Jenny Lai: Yes it does. The first time when they try it, they're just getting to learn how to use the device. Usually we allow them 6 sessions to 8 sessions so they can fine tune the device to fit their need. Some people just need a little help in kicking that muscle; some people need a lot of help. The therapist will help them to fine tune that machine to adjust to their needs. They also need to adjust their own needs, especially multiple sclerosis patients. Sometimes they'll have good days where they don't need as much, some days they'll have bad days and need more stimulation to get the muscles moving.

Who doesn't qualify for Bioness?

Dr. Jenny Lai: A person who has nerve damage preferably. Those patients may not have a good result from the stimulus. This device is good for you if your peripheral nerve is intact, so then the nerve and the muscles are intact. When we stimulate that nerve, the nerve will provide transmission electrical stimulation to the muscle. If you have a peripheral nerve injury it may not work as well, but we don't want to say no to our patients. Sometime you may have peripheral nerve injury but it's not complete.

What would cause a peripheral nerve injury?

Dr. Jenny Lai: Diabetes and trauma.

How long does it last and how do you maintain it?

Dr. Jenny Lai: The machine should last for years. To maintain it we have to recharge your battery, but so far the company has been very good.

Is it covered by insurance?

Dr. Jenny Lai: Currently we only have 50% of the private insurance companies that are willing to pay for this device. There's still 50% that are not willing to jump in and help their client just yet. Medicare currently is not also covering this device. We are hoping that in time that the policy will change to allow Medicare recipients to get this device, and also the 50% or more of the private companies to come in and help those in need to get this device so they can walk better.

What are the other treatments for foot drop?

Dr. Jenny Lai: Currently we only have static braces. It's almost like a splint. You splint your ankle so that it doesn't drop. I do not like that device because it doesn't allow the nerve to stimulate or allow the muscle to move, and the fear of immobilizing an ankle or a joint is that you may further enhance atrophy. This works on the opposite end. It continues to stimulate that nerve and continues to stimulate that muscle hopefully to prevent further atrophy.

What does the future hold?

Dr. Jenny Lai: I'm hoping in the near future that we will see more of these kind of devices out there in the community for patients to use not just on the leg but also on the arm.

How do you feel when you see someone testing it out for the first time or after a couple of times and seeing how it improves their lives?

Dr. Jenny Lai: I'm happy for them. I think you will see a lot of happy tears because if they continue to fall, that means they're in danger of hurting themselves. They're coming in with head injuries or broken hips and that means often times the physician will say maybe it's time for you to be in a chair. If this can prevent them from being in the chair or give them a few more years to be a walking candidate, then I think insurance company and Medicare should give them the chance to continue to walk as long as they wish to walk.

FOR MORE INFORMATION, PLEASE CONTACT:

George Kovacik
Media Relations
The Methodist Hospital System
(832) 667-5844
ggkovacik@tmhs.org

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