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
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This is specialized equipment requiring experience to prescribe. You are encouraged to consult the neuromuscular clinic OT or PT treating your patient before ordering if you do not have significant experience in these specialized areas.