Can An Emerging Brace Facilitate A Stable Gait?

Start Page: 79
Author(s): 
Danielle Chicano, Contributing Editor

Physicians looking for an ankle foot orthotic (AFO) that may help reduce the risk of falls and improve balance for the older population may want to consider using a new kind of brace.

   The Moore Balance Brace is all about making it easy for older people and those who are at a higher risk of falling to wear an AFO, explains the manufacturer Arizona AFO.

   According to the company, clinical indications for the brace include vestibular disorder, chronic ankle instability, ankle arthritis, stroke imbalance, drop foot and diabetic peripheral neuropathy. The Moore Balance Brace also aids in reducing the body’s postural sway, helps stabilize the foot and ankle, and improves foot clearance to reduce tripping, according to Arizona AFO.

   Victoria Melhuish, DPM, FACFAS, concurs that she has found Moore Balance Brace particularly effective for patients with diabetic peripheral neuropathy in addition to preventing falls in her patients.

   “I look for fall risk with all my patients new and old. Some are ready for the Moore Balance Brace AFO. Others only want to use some sort of foot orthotics,” explains Dr. Melhuish, “(The brace is) well tolerated and increases the speed and steadiness of gait. For some patients at risk for falls, this change is very fast and as soon as they are fitted, the visual changes are visible right away.”

   In comparison to similar products, the Moore Balance Brace is lightweight, sleek and flexible, which improves patient adherence, explains Arizona AFO.

   “When you don’t need strong support of foot pronation, this is a much better AFO to use. The device is much smaller and easier to fit onto the foot than any other hinged or non-hinged AFO currently on the market,” adds Dr. Melhuish, who is in practice in Gardnerville, Nev.

   On the other hand, Dr. Melhuish notes that if a patient has excessive foot pronation, this lightweight device may not control foot mechanics well. Also, if patients are still able to push off with their forefoot, they would “tend to fight the device,” explains Dr. Melhuish.

   Both the manufacturer and Dr. Melhuish maintain that although the device is smaller than most, it is important to ensure it fits properly inside the patient’s shoe. One should not leave it to the patient alone to figure out what type of shoe to use, notes Arizona AFO. The company says the brace is not indicated for use in a house shoe, slipper or with no shoes at all.

   Dr. Melhuish says the brace increases shoe size slightly, noting patients usually require half a shoe size larger. Additionally, she notes that those patients with thinner, more sensitive skin may experience irritation from the top of the brace.

   “I have adjusted this (irritation) in my office by adding a padding rolled over this edge,” explains Dr. Melhuish.

   Dr. Melhuish notes that on average she currently prescribes the Moore Balance Brace to patients three to four times per month.

   “For those patients who have already changed their gait to an apropulsive gait, I find that they are good candidates for this device,” adds Dr. Melhuish.

   Ms. Chicano is a freelance writer who lives in Philadelphia.

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