Name of the Procedure:

Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint (L2210)

Summary

This procedure involves attaching a device to the lower extremity (leg) that assists with dorsiflexion (upward movement) of the foot and resists plantar flexion (downward movement). It is often used to aid individuals with neuromuscular disorders or conditions that lead to foot drop.

Purpose

The main purpose of this procedure is to help individuals who have difficulty lifting the front part of their foot due to conditions such as stroke, multiple sclerosis, or cerebral palsy. This assistive device supports foot movement, improves mobility, and helps prevent tripping and falls.

Indications

• Foot drop or difficulty with dorsiflexion
• Neuromuscular disorders
• Post-stroke rehabilitation
• Multiple sclerosis
• Cerebral palsy
• Other neurological impairments affecting foot movement

Preparation

• Consult with a healthcare provider to determine suitability.
• No specific fasting or medication adjustments are typically required.
• A comprehensive physical examination and gait analysis may be conducted to assess the extent of foot drop and mobility issues.

Procedure Description

1. The patient is assessed to determine the appropriate type and size of the assistive device.
2. The device is custom-fitted to the patient's lower extremity.
3. The healthcare provider demonstrates how to properly wear and use the device.
4. Adjustments may be made to ensure the device provides the correct level of dorsiflexion assist and plantar flexion resistance.
5. The patient may be asked to walk with the device to ensure proper functionality and comfort.

Duration

The fitting and adjustment process typically takes around 1 to 2 hours.

Setting

This procedure is usually performed in an outpatient clinic or a rehabilitation center.

Personnel

• Orthotist or prosthetist
• Physical therapist
• Occasionally, a physician or neurologist may be involved for initial assessment.

Risks and Complications

• Skin irritation or pressure sores from the device
• Discomfort or pain if the device is not properly fitted
• Rarely, muscle fatigue or strain if the device overcompensates for foot movement

Benefits

• Improved mobility and walking ability
• Reduced risk of tripping and falls
• Enhanced independence in daily activities
• Benefits can be realized immediately after proper fitting and use of the device

Recovery

• Minimal recovery time is needed as this is a non-invasive procedure.
• Patients may require some time to get accustomed to the device.
• Follow-up appointments may be necessary to make adjustments and ensure optimal performance.

Alternatives

• Use of ankle-foot orthoses (AFOs) or other types of braces
• Physical therapy focusing on strengthening and improving foot movement
• Functional electrical stimulation (FES) devices
• Surgery, in severe cases

Each alternative has its pros and cons, and the choice depends on the individual's specific condition and needs.

Patient Experience

Patients might experience some initial discomfort as they adapt to the device. Physical therapists will provide guidance on exercises and tips for integrating the device into daily life. Pain management and comfort measures, such as padding and proper fitting, are essential to ensure a positive experience.