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NEW! Small L300 Foot Drop System Help Your Smaller Patients Recapture the Freedom of Mobility The award-winning L300 Foot Drop System is now available with a small leg cu to fi t individuals with a calf circumference of less than 12 inches, helping to improve gait, reeducate muscles and help them to walk more naturally. The Small L300 Foot Drop System is available as an upgrade to existing L300 programs or as part of a full L300 program which includes both the small and regular cu sizes. CONTACT US AT 800.211.9136 option 2 | BIONESS.COM Individual results vary. Patients are advised to consult with a qualifi ed physician to determine if these products are right for them. Contraindications, Adverse Reactions and Precautions are available on-line at www.bioness.com (also available in the NESS H200 Wireless/L300 Plus/L300 Clinician’s Guide). NESS ® , NESS H200 ® Wireless, NESS L300 ® , NESS L300 ® Plus, Intelli-Gait ® , Intelli-Sense Gait Sensor , Bioness, the Bioness Logo ® and LiveOn ® are trademarks of Bioness Inc. www.bioness.com | Rx Only © 2012 Bioness Inc. ADVANCE for Physical Therapy & Rehab Medicine 17
[Foot DRoP] for strengthening or used during gait training. Activation of the stimulation can be performed manually by the therapist or via a heel switch in the patient’s shoe. Weight bearing through the heel activates the switch. A neuroprothesis is an FES-based orthosis. The stimulation facilitates dorsiflexion while the prosthesis is worn. The stimulation is provided via surface electrodes over the muscle belly of the tibialis anterior. The result is a lifting of the toes as weight comes off the heel. The lift is maintained during swing phase. As weight moves onto the heel, the stimulation stops firing and the dorsiflexors relax. The amount and severity of gait deviations are reduced, as is energy expenditure. Several studies are showing a relationship between the use of FES and neuroprotheses to motor learning during gait. Continued practice of dorsiflexion with each step facilitates motor learning of the action. As the patient continues to walk, the practice continues. Over time, improvement is seen even when not using the stimulation. • Hands Free Therapy • Decrease Fear of Falling & Increase Productive Therapy While AFOs can be used for almost any patient, FES and neuroprotheses have some limitations. The patient must have adequate cognition to understand the purpose of the stimulation and provide feedback about the intensity. Fitting a neuroprothesis can be time consuming. Appropriate electrode placement must be determined on an individual basis. Not everyone tolerates the sensation of electricity. Some people have allergic reactions to the electrodes. Compared to AFOs and FES alone, the cost is significantly greater and may not be covered by insurance. Treatment for foot drop resulting from cerebral palsy is different. Some children rely on their extensor tone for ambulation. Inhibiting it via an AFO would decrease their functional abilities. Continued growth of the child means AFOs must be refabricated to keep up with changes in structure size and shape. Tendonrelease surgery is sometimes performed to increase ROM of the ankle. Although the surgery is delayed as long as possible, it is often repeated as the child grows. n Allowing Patients To Take The Next STEP... “SOLO-STEP has given our facility an added edge to take on more challenging cases safely for both the patient and therapist.” -Michel Vincent - PT/MOMT “This is the single best application of movement available in all of our eight clinics and has improved compliance.” -Mark McDonald - PT-OCS Ideal for amputees, bariatrics, pediatrics, geriatrics, neurological and vascular patients... to name a few! 18 ADVANCE for Physical Therapy & Rehab Medicine Learn More @ www.solostep.com Phone: (866) 631-1117 resources Graham, J. (2010). Foot drop: Explaining the causes, characteristics and treatment. British Journal of Neuroscience Nursing, 6(4), 168-172. The Pathokinesology Service and the Physical Therapy Department of Rancho Los Amigos National Rehab Center. Observational gait analysis. (2001). Los Amigos Research and Education Institute Inc. Downey, CA. Perry, J., & Burnfield, J. (2010). Gait analysis: Normal and pathological function, 2nd edition. Thorofare, NJ: Slack Incorporated. Sackley, C., Disler, P., Turner-Stokes, L., Wade, D., Brittle, N., & Hoppitt, T. (2009). Rehabilitation interventions for foot drop in neuromuscular disease (review). The Cochrane Library. Toni Patt is an ADVANCE blogger based in the Houston area. www.advanceweb.com/pt For more information on foot drop, please visit www. advanceweb.com/PT PATENTED
Page 1 and 2: Our digital editions give you two u
Page 3 and 4: Don’t win an iPad... Cross ss Cou
Page 5 and 6: contents ADVANCE FoR PHYsICAl tHERA
Page 7 and 8: [MORe ARTiCleS] 9 Management Focus:
Page 9 and 10: [EDiToR’S ViEw] 8National Rehabil
Page 11 and 12: [MANAgEMENt FoCus] sticky notes wit
Page 13 and 14: [CoVER stoRY] ruNNiNg righT how To
Page 15 and 16: [CoVER stoRY] that patients adhere
Page 17: [Foot DRoP] Positive steps Understa
Page 21 and 22: [lAsER tHERAPY] laser and living ti
Page 23 and 24: [lAsER tHERAPY] Therapeutic Laser S
Page 25 and 26: [BACK PAIN] Pain Epidemic Physical
Page 27 and 28: [INFECtIoN CoNtRol] soft-surface Co
Page 29 and 30: [AquAtIC tHERAPY] Confidence gain W
Page 31 and 32: 30 ADVANCE for Physical Therapy & R
Page 33 and 34: [CoVER stoRY] running continued fro
Page 35 and 36: [CE DIRECTORY] • • Summer Webin
Page 37 and 38: Register Online at www.usa.edu or C
Page 39 and 40: [CE DIRECTORY] Attention Therapists
Page 41 and 42: [CE DIRECTORY] AUG. 12, 2012 NEWPOR
Page 43 and 44: [CE DIRECTORY] group discounts. Con
Page 45 and 46: [CE DIRECTORY] with disabilities. T
Page 47 and 48: [CE DIRECTORY] program producing LA
Page 49 and 50: EMPLOYMENT OPPORTUNITIES New York,
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