Aids & Adaptations in Gait Rehab

• Aids and adaptations - from most to least supportive:

  • Overhead/ceiling track hoists
  • Standing hoists
  • Parallel bars
  • Frames (gutter, rollator, zimmer, delta etc…)
  • Crutches
  • 2 walking sticks
  • 1 walking stick
  • Furniture surfing
• Aids and adaptations - Orthotics

  • Large amount of variability in both the devices themselves and benefits they may have

  
• Aids and adaptations - Ankle Foot Orthoses (AFO’s)

  • Often used for patients with foot drop
  • Maintain a rigid or semi-rigid ankle position
  • Can be made of plastics, metal and carbon composites
  • Off the shelf or custom moulded
  • Hinged or rigid

  
• Aids and adaptations - Ankle Foot Orthoses (AFO’s) - Pros:

  • Assists toe clearance in swing phase
  • Initial contact with heel not toe or flat foot
  • Increase ankle stability in stance phase
• Aids and adaptations - Ankle Foot Orthoses (AFO’s) - Cons:

  • Restricts active toe-off
  • Can be uncomfortable if poorly fitting
  • Difficulty fitting into shoes
• Aids and adaptations – Functional Electrical Stimulation (FES)

  • Aims to produce muscle contractions which mimic normal voluntary gait movement
  • Electrical impulses applied to the common peroneal nerve
  • Can be applied either through the skin or with implanted electrodes
  • 2012 NICE guidelines support use for foot drop of central neurological origin