My 23-year-old son suffered a severe hypoxic brain injury just over a year ago and is gaining some movement in his arms. I am worried, however, that he is not being treated at all for drop foot. I am concerned that this will impede his chances of walking again.
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Answer transcribed from Brightway's interview with Dr. Thomas Franz:
If the person is not up and able to walk or bear weight through the legs, it's a fairly simple thing to place splints on the person in bed and to hold the foot in a more neutral or normal position. Obviously, if you go to walk again and your Achilles tendon, which is the tendon in the back of the foot that connects your calf muscle, has become so tight and contracted that you can only stand on your tiptoes, that is going to impede the function.
Sometimes if the person is very spastic and the foot wants to forcibly push down, not just kind of flop because there's paralysis, the concern may be that splinting will cause a pressure sore that the person will push so hard against the splint that they will develop a wound. If that's the case, then there may need to be something done to reduce the tone so that the drop foot can be treated or prevented. However, if there's not spasticity and nobody is really thinking about the drop foot, then the individual asking this question would be correct. Bring it to the attention of nursing and the therapists working with their loved one to say “let's get a splint on here”.
There are probably dozens of splints available to prevent drop foot. They all have certain advantages, and some are very specifically meant to not develop pressure areas or to minimize the chance of a pressure area so that the person not only avoids the drop foot but also avoids a bedsore or a pressure sore. So yes, that should definitely be reviewed with the people caring for their loved one.