howdy folks I'm Bob schroer physical
therapist Brad I'm a physical therapist
we are the most famous physical
therapist on the Internet you know
opinion of course Bob today the title of
our program is fixing foot drop best
option when it won't get better we
actually were provided today with a
brace from sable yes ayyy B all whoo I
think it's a pretty cool company I never
heard of them until they contacted us
but they got a lot of cool products for
people who had strokes and other
disabilities and you'll take a look at
their website we'll put a link below by
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so what is it foot drop when we show
them first Brad what foot drop generally
is so often times that it concur after a
stroke but there's other reasons DS will
go over a lot of these but the primary
thing is the anterior tip muscle right
here gets weak for whatever reason and
when you come down and you heel strike
your foot just flops slaps down yeah so
if you hear someone walking down the
hallway with foot drop you'll hear oh
well you or you'll see this they're
lifting it and like you know they have
to lift up the leg really high to clear
right so they're compensating for that
loss of muscle well want you to lay down
once your bread and just put your foot
off the edge of the bed all right so
let's say this is the weak foot this is
the strong foot you know he holds up
here I pull on this and it's solid as a
rock
yeah you can turn this way and it goes
in it's solid goes this way it's solid
he pushes down it's solid now with foot
drop you know if I ask him to bring it
up this way he might have a little bit
he may be able to hold a little bit but
you know it pushes down or he may not
all right believe what we call flaccid
where there's no movement and often
along with that it's aversion to isn't
it quite sure that's so in other words
turning the foot out you ask some
weakness there and that gives way and
sometimes turning in gives way also and
generally there's usually some plantar
flexion but even some people there's not
either push it pushing down so there's
basically the four directions and and
he's especially gonna be weak going up
in this direction which is really
important with walking because when you
have foot drop you're more likely to
catch your toe
actually the surface or if there's a
slight crack in the sidewalk where
you're gonna cause a fall so it's really
important that you take care of it one
way or another it's very dangerous very
much as a higher risk for falling you're
you know the problem could be anywhere
along the body here it could be in the
brain after a stroke or and in that case
you may get some return back after the
swelling goes down
and also other times the other you want
other parts of the brain to try to help
out and take over so that's why
sometimes after a stroke it might be a
few months but you start to see some
improvement right you may have like the
muscles of the of the tools that pull
the toes up extend the toes they can
help compensate for some of that and to
your tip loss so the body is really
gonna try to work hard to correct itself
sometimes it does and sometimes it does
right and it could be anywhere along the
nerve pathway you might have a pinched
nerve in your back right your low back
could easily cause this problem where
you get that foot to not function
properly sometimes after hip surgery
sure you've seen people sometimes after
knee sometimes it's the peroneal nerve
sure can can give you problems sometimes
if you just sit like this too long and
put pressure on your on your peroneal
nerve you can actually get foot drop I
had foot drop one time in my I was
driving my car and I was sitting on my
wallet put pressure on my static nerve I
can imagine the size of that whoa I got
old papers in there that's all the money
and I couldn't push the brake I can't
feel really so so and there's other
things like muscular dystrophy work
should actually be in the muscle itself
but her I'm assuming that if you have
foot drop you know you're gonna have it
well and you probably know the reason
why you have it diabetes is also often a
very common one nursing but as you're
trying to do exercise to get it better
you can go ahead and use bracing to
prevent yourself from falling you can
also if you found out that you know what
it's just not going to get better this
is the time to consider a brace like
this all right now the old braces were
more of this nature Brad you're gonna
put this one on right here and I'll show
this one this is a pretty heavy-duty one
this is a poly propylene there's a poly
ethylene poly ethyl asters yeah and it's
got actually a hinged brace hinged ankle
put in there right and the you know it's
molded exactly to your foot but you can
imagine something like this is very
bulky difficult to put on there a little
bit difficult to put on and there's
really a high incidence of skin
breakdown on these because you gotta
have them just right or there's rubbing
right there a little warm in the summer
time this one here is not a custom one
but it no that's this is gonna be a
little more cheaper but often times this
is all you need to keep the foot from
dropping so this one's a little more
comprehensive custom fit this is for ya
just like you said just to stop the flow
the way this goes is simply goes like
this and you get a velcro strap to put
it on but I don't know if you've ever
wore one of these bread I put them on I
want to see how I feel like and they
don't feel good yeah so yeah it's one of
those things that if if you need one
it's better than having your foot drop
but this other option really I think is
I mean that's why we're showing it
because we don't show things we don't
appreciate and I think are worthwhile
right and we're we're not getting paid
for this and we're not getting a part of
if you buy one of these this is just we
think it's a good product for you so
we're supporting it this is called the
sable step I'm gonna get the name right
sable step foot drop race and
basically it's consists of this it's a
part that goes around the ankle and then
you have another section that actually
wears this it's not my shoe for it here
it is should we get up and show a little
yeah closer view that's a closer view
yeah so it comes with these eyelets Lani
tell me when I'm about the right
distance from you she has a restraining
order against us that's always my
favorite joke okay we're looking right
here if you can see Oh a side view like
this better maybe on this one right here
so you just you're gonna there's a screw
with a little washer and the eyelet and
you're gonna this is something you have
to have you know some good eyes are like
my kids get my reading glasses out to
get it on there but one just gets
attached it's very solid and it's gonna
do the job I would recommend taking the
shoelaces out of the shoe brand try to
do it without doing that of course don't
do that it's a lot easier to do it
without and and it comes with three size
screws you should know that and it may
vary depending on what shoe you have
which one's gonna work I first tried the
longest one and it was too long and it
there was too much sticking out here I
actually took the shortest one sure and
it worked there's three different
lengths depending on how thick the
fabric is of your shoe now if you don't
have an eyelet the eyelets on your shoe
if you don't have the holes right um you
actually can they they do sell a punch
that you could like so if you had a shoe
like where's my other shoe yeah like a
slip-on shoe or a Velcro slip it off
those leather yeah you can take punch
true and put the eyelet on there and and
and you'd still use this right so and
you know it looks special II you know
these are looking you know they look
nice it doesn't look really odd or
anything like that it no you cannot and
you know the other thing I just that
these are the people that qualify for
this by the way that should you know can
can possibly use this brace one when
you're standing up you should be able to
get your heel on the ground you don't
want it so tight that your your toes
actually raised up in other words you're
showing that right now
so yeah if your foot so tight you can't
get the foot on the ground so we're
looking at this gap right yeah you
should be able get your foot all the way
on the ground number two if you if you
only have one hand because of a stroke
you are gonna need someone to help you
put it on right and number three get
Loni go one more time down here if you
have a lot of what we call tone if you
have spasticity and it's like pulling
your foot this way this main s not
necessarily help you write your foot is
not able to range and if you have this
you know exactly what we're talking
about is tight it moves but it's always
tight and Tony is what we call that so I
already put the eyelets in here the
little hooks in there and we just slide
the shoe on here and so this is the the
mechanism and this is actually this
mechanism here is called the BOA
and I actually asked though the inventor
what molla stands for well this is a
whole separate company bola makes this
okay I think it's like a constrictor
because you'll see how it can it doesn't
it make sense to you how it constricts
like a boa constrictor
sure oh you don't even buy that sure but
it does it does it it pulls it right up
and you'll see it why don't you put it
on Bob so if you by the way also if you
have ankle sores or soreness around the
ankle you probably could not use this
because you'll see in a second so this
just has velcro and it comes with some
pads to Brad put the pads in there
already mm-hmm you may start without the
pads and then see how it feels and it
depends their handy-dandy the velcro so
you can put all they do anywhere you
want
I didn't realize so so this just goes
around and by the way you can fit this
to fit you exactly I didn't do this
right now but you can actually cut along
on different levels here and make it
small or so that it fits you really well
you don't have when you velcro it if you
have a skinny ankle you don't have that
extra thao hang you know right so I'm
gonna go ahead and put this around and I
actually I would probably would probably
make this smaller or cut it off a little
bit fit well sure if I was gonna use on
here I actually have a patient I want to
use this with so I don't want to cut it
off right now yes I need the in full
lengthen and there are no it's nice and
tight
so you have a little what's that a
little belt that goes around a strap
with a buckle a buckle and that's just
gonna help secure it yeah hold it in
place so you know right here we have
what do they call these spectral cord
there's a cord on here with you and
what's just the first step you have to
do is you actually take this dial and
you pull it out the man unlocks it and
that unlocks it right yeah yeah so now I
grabbed a lower cord there's two cords
here you grab the lower cord and it's
loose because that dial is open and I
take it and I just bring it down and I
loop it over the eyelets the hooks I
guess you'd call them huh yep and now I
push this back down and I tighten it up
it's not a little ratchet mechanism you
can hear it yeah it really kind of cool
it is and what you can do then is
actually decide how far up your foot you
want it to be right so I'm gonna take it
up quite far here now the shoelaces I
probably would have tied this normally I
would probably wasn't going yeah you
don't want to do that so you should have
them tied before you do this but I can't
believe that happened to us once again
we didn't rehearse 300 make mistakes
yeah all right so as I walk along here
in Aulani
you're gonna see it helps you know
without me having to put any effort at
all it helps hold the foot up right you
know and it's just really comfortable I
mean it because it's my own shoe and you
got your yeah your normal foot were see
you've got good traction you don't have
the bulkiness of an AFO what we call
these plastic supports you know being
around your ankle and getting in the way
and I'm guessing if I pulled my you know
if I had a pant leg to pull down and out
shorts I'm guessing you nobody even
noticed right yeah it's gonna be covered
up yeah so you know my sense is you're
gonna have more of a walk normal walking
pattern with this then you are with a
brace I agree so and we'll have to
report back to you after we try with a
real patient right real patient so okay
it'll work out really good boy it's
already late Brad yeah that one time
flies when you have them
thanks for watching
you