From foot drop to functional walking
How can we support people with upper motor neuron lesions and foot drop to walk with greater safety, efficiency and function?
In this episode of the BTB Rehab Podcast, we explore the role of two commonly used strategies in gait rehabilitation: functional electrical stimulation (FES) and the ankle-foot orthosis (AFO).
Rather than asking which option is universally better, we focus on a more clinically relevant question: how do we decide which approach is most appropriate for each person?
What you’ll learn
- What foot drop associated with upper motor neuron lesions involves;
- How FES and AFOs support gait;
- The main differences between these two approaches;
- The potential advantages and limitations of each option;
- Which clinical and functional factors should guide decision-making;
- Why the person’s goals, preferences and context matter;
- When combining FES and AFO may be considered;
- Why scientific evidence needs to be integrated with individualised clinical assessment.
Clinical relevance
Especially useful for clinicians working with:
- Neurological gait rehabilitation;
- People with foot drop following upper motor neuron lesions;
- Functional electrical stimulation and ankle-foot orthoses;
- Clinical decision-making in rehabilitation;
- Situations where safety, walking efficiency and functional goals need to be balanced;
- Cases in which the most appropriate intervention is not determined by technology alone.
📌 Take-home message
FES and AFO are not competing solutions in every situation.
The most appropriate choice depends on the person’s clinical presentation, walking goals, functional needs, response to the intervention, preferences and everyday context.
The key is not simply to stimulate or support, but to use the available evidence and clinical reasoning to help each person achieve more functional walking.
Apply this in your clinical practice
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