Bioness & Foot Drop

The inability to lift the front of your foot while walking, also known as ‘foot drop’, can be caused by several different injuries or disorders. It is seen commonly in individuals with MS, but may also occur in individuals with ALS, post-stroke, or nerve compression/spinal cord injury. Foot drop can occur in one or both feet and can be temporary or permanent depending on the underlying cause. With foot drop individuals often drag their foot when walking, causing a number of compensations such as hiking the hip/lifting the thigh up to help the foot clear the floor. This walking pattern may cause the individual’s foot to slap onto the floor when walking due to loss/decreased of control of the muscles slowly lowering the foot. This leads to instability, increased effort with walking and increases the chance of injuring the structures at the foot and ankle.

Research has shown that there are many ways physiotherapy can assist individuals who have foot drop. There are a number of options available for bracing the foot; the most common being an ankle foot orthosis (AFO), which holds the ankle at a 90-degree angle to the lower leg. The downside of AFO’s is that they often requiring a larger shoe to fit inside, and they do not promote actively working on the strength, range of motion, and nerve conduction required to potentially fix foot drop.

Functional electrical stimulation (FES) is another commonly used tool to facilitate muscle re-education, prevent muscle loss, maintain or increase joint range of motion, and/or increase local blood flow. In some cases, it can be used temporarily until these muscle groups are able to lift the foot while walking without any additional assistance. In other individuals it is a device that can be worn regularly to improve walking ability allowing individuals to manage at home or at work easier. FES is used by placing electrodes on the outside of the lower leg and applying a low-level electrical current which stimulates the nerves, causing a muscle contraction and the foot lifting off the floor. The device has a 360 gyroscope and accelerometer built in, allowing the wearer to walk at different speeds, on inclines, or even run with the device on.

At Nomad Therapies our physiotherapists are trained to work with the Bioness L300Go and L300Plus to provide functional electrical stimulation (FES) to the lower leg and to the thigh muscles if necessary. During your sessions, your physical therapist can use these device(s), alongside therapeutic exercise and gait training to help manage your foot drop, and correct non-optimal movement patterns for walking. The Saskatchewan Aids to Independent Living Program (SAIL), can provide financial assistance to individuals who would benefit from the regular use of a FES device for foot drop, allowing them to own their own device for use at home/work. Assessments/follow up from a Nomad PT, and referral from a specialist are required to apply for this funding; If you wish to know more information please contact our office at 306-382-2939.