Neuroprosthetics

Custom Ankle Foot Orthoses (AFOs) are beneficial for treatment of many medical conditions and injuries. Another treatment option similar to custom AFO’s are Neuroprosthetics. Neuroprosthetics refers to devices which provide functional electrical stimulation to replace the lost use of a particular function.

Conditions appropriate for this treatment can be (but are not limited to):

Anatomy and Biomechanics of the Foot	There are 26 bones in the foot that create many joints. There are many muscles, tendons, ligaments and nerves in the foot. There are two ankle joints: Talocrural joint  Subtalar joint The foot can be broken into three parts: Rearfoot/hindfoot Midfoot Forefoot Arches of the foot: Medial longitudinal arch Lateral longitudinal arch Transverse metatarsal arch Areas Stimulated: Peroneal Nerve  Tibialis Anterior
Goals of Neuroprosthetic Treatment	Provide foot clearance in swing phase of gait (walking). Position foot for heel contact in stance  Produce a more energy efficient gait pattern
Neuroprosthetic Devices	There are a variety of Neuroprosthetic devices. Each system is unique and not all Certified Orthotists offer this technology since extra training is required in order to become a provider. Systems that are currently available are: WalkAide System Bioness L300 Odstock Pace
Neuroprosthetic Application	Each system typically consists of electrodes, cuff, and a control unit. Some systems have additional components. The set up process would include programming the timing of the electrical stimulation, sizing the cuff, and setting up the electrode placement.
Living with Neuroprosthetic (follow up)	The device may take some time to get used to the corrections. The device should not be painful;  however, it is not uncommon to feel some initial discomfort. The break-in period should not last more than two weeks. If you experience pain or irregular foot movement, please book an appointment with your Certified Orthotist for immediate attention. If the function of the device is inconsistent after two to four weeks please book a follow up appointment with your Certified Orthotist. It is always recommended to book a follow up appointment with your Certified Orthotist if you experience any changes in condition (pain, growth). The Certified Orthotist can determine what changes need to be made or make recommendations for alternative treatment. Neuroprosthetics are able to be reprogrammed and electrode placement adjusted. The Certified Orthotist can reassess and determine the course of treatment with you.
Funding for Custom Foot Orthotics	Currently the majority of users pay for the technology independently. Private insurance may pay for or a portion of the cost of the system. It is important to consult with your insurance company to determine the coverage that they provide.