Footdrop

Some clients will experience footdrop, which affects their balance and gait pattern, increasing the risk of falls. Clients may consider foot-up braces or custom ankle-foot orthoses for ankle support. A commonly-prescribed foot-up brace is the Navigait foot-up brace , as it is lightweight, which is an important consideration for clients with ALS.

Recommend Navigait foot-up brace if:

• Client has dorsiflexion weakness with intact inversion and eversion ankle range with 4+ strength
• OR client is inappropriate for custom AFOs because hip flexors are weak (assessed by physiatrist)
• OR client is not walking on a regular basis/for moderate distances so custom AFOs do not make sense
• OR client cannot afford custom AFOs
• AND client is going to wear shoes with laces on a regular basis.

Recommend referral to physiatrist if:

• Client has dorsiflexion with significant inversion/eversion weakness
• Client may be recommended custom ankle-foot orthoses, which are covered by the Assistive Devices Program.

Referrals from ALS/Neuromuscular Clinic at Sunnybrook, are usually sent to Boundless Bracing . However, clients are able to visit any ADP-approved vendors for orthotic devices: https://www.ontario.ca/page/garments-pumps-and-braces#section-4

Resources

• https://www.ontario.ca/page/garments-pumps-and-braces
• https://www.youralsguide.com/ankle-foot-braces-for-als.html