during walking to clear the ground. The problem is that dorsiflexion is not occurring. The standard response seems to be get them a AFO to lock the foot at 90 degrees. I didn't see any attempt to determine why the dorsiflexion was not occurring.
I can see numerous different reasons and I am not medically trained.
1. The motor cortex area that controlled the Tibialis anterior muscle was damaged and in the penumbra.
2. The motor cortex area that controlled the Tibialis anterior muscle is dead.
3. The pre-motor cortex was in the penumbra.
4. The pre-motor cortex is dead.
5. The executive control was in the penumbra.
6. The executive control area is dead.
I don't know my math very well but I think this leads to 6! 6 factoral or 6* 5* 4 * 3 * 2 * 1 = 720 possible variations as to the cause of dropfoot.
Correction: I asked a PhD friend about this and his reply was;
And we have a one-size-fits-all AFO for this.
The standard seems to be a rigid plastic AFO, sometimes with a built-in hinge.
I received one of these for two reasons, allowing my toes to clear the floor and stop the eversion of my foot.
Currently have quit using the AFO from 1 year ago. The use of it was preventing me from getting a decent heel strike and was not allowing me to build up any muscle strength in my ankle muscles.
I think that there should be a protocol for each underlying diagnosis. In my case I can dosiflex in any position but doing it while walking does not work very well. My diagnosis is that since my pre-motor cortex is dead it was not coordinating the firing of all the muscles of walking. Do not take any of this as medical advice.
Peter Levine has a good description of what you are missing by using an AFO to compensate.