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Assistive Technology for beating foot drop

Following stroke, a foot drop gait is common, affecting 20 to 30 per cent of stroke survivors (Peishun et al., 2021). We know that for decades, the standard of care has involved Ankle-Foot Orthoses (AFOs)—passive, rigid braces that stabilises the ankle but rather fails to promote active muscle engagement. However, a new frontier of technology, including advanced neuro-prosthetics, wearable exoskeletons, and smart orthoses, is revolutionising how we treat foot drop, shifting the focus from passive compensation to active rehabilitation.

Functional Electrical Stimulation (FES) has been a significant advancement over traditional AFOs. Recent research is focused on creating smarter, more adaptive FES systems. Novel algorithms now use information from muscle synergy patterns—the coordinated activation of multiple muscles—to optimize stimulation delivery and create a more natural gait. Implantable FES systems, with electrodes placed directly on the nerve, offer an even more discreet and comfortable experience by eliminating the need for surface electrodes.

The rise of the Internet of Things (IoT) and smart sensor technology is creating new possibilities for personalised and home-based rehabilitation. Instead of static plastic, modern orthoses can incorporate sensors to provide real-time feedback on walking patterns.

* Real-Time Feedback: In-shoe sensors can track gait metrics like pressure distribution and foot inclination, providing immediate feedback to both the user and clinician.

* Tele-rehabilitation: Mobile apps linked to smart devices allow for remote monitoring, personalized guidance, and progress tracking, empowering patients to continue therapy at home.

* Aesthetic and Comfort-Focused Design: Innovations like the “HDC Shoe” prioritise aesthetics and discretion, overcoming a major barrier to patient acceptance of traditional, bulky AFOs.

Technology is fundamentally changing the prognosis for stroke survivors with foot drop. As research moves from single-technology solutions to hybrid systems, integrating robotics, FES, and AI, we are moving closer to a future where rehabilitation is truly personalised.


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