17 March 2023
This male patient was diagnosed with Charcot-Marie-Tooth (CMT) about ten years ago by the Chelsea and Westminster Hospital, though as he recognises the condition had been apparent for some time as he had been tripping and falling more and more frequently.
CMT is a group of inherited conditions that damage the peripheral nerves. It is the most common inherited neurological condition in the world, affecting an estimated 1 in 2,500 people. The main symptoms are muscle weakness in the feet, ankles and legs; foot drop is common. The Chelsea and Westminster Hospital prescribed bespoke boots and then standard AFOs (Ankle Foot Orthosis).
Progressively his condition got worse as the AFOs wore out but during and after the pandemic he found it was not easy to get NHS appointments. At the same time, he found out that he had Parkinson’s disease too. This had an additional impact as he suffered from a common symptom of the condition, referred to as ‘freezing’ where a person is not able to move forward for several minutes. At least this symptom can be ameliorated by the drugs prescribed for the disease.
Frustrated by the NHS our patient searched the internet for alternative sources of clinical help; It was with this background that he came for his first consultation at LOC.
The Neuro Swing AFO has a unilateral ankle joint that is designed to be held within a carbon fibre construction. The joint has two springs, posterior and anterior. The springs can be altered in three ways. Resistance in the springs can be reduced or increased and the range of movement can be altered as can the alignment of the ankle.
As far as LOC is concerned one of the essential aspects of this initial consultation is to find out what the patient’s own goals and aspirations are. It turned out that our patient was a keen walker (probably developed during lockdown) and was walking about 10,000 steps a day regularly. He was assessed by Jack Choong, senior orthotist at LOC, who recommended a pair of Neuro Swing AFOs.
The Neuro Swing has an adjustable ankle joint system with two springs: posterior and anterior. Resistance in the springs can be reduced or increased and the range of movement can be altered as can the alignment of the ankle. The objective is to return the patient’s gait to as near normal as possible.
The Neuro Swing AFOs were fitted in October. “I particularly liked the way that these feel as though they are actually moulded to my feet and ankles. I have much greater stability and no longer feel I need my walking stick unless I am in a crowded area. Jack has been friendly and helpful throughout this process; he understands my needs. And I am impressed that review appointments are built into the service that LOC provides.”
Senior orthotist Jack Choong comments "Our normal walking pattern is one of the smoothest and most efficient ways to progress which puts less stress on our joints and muscles. Not only have this patient's Neuro Swings helped achieve this, they have also restored his walking confidence and balance, with improved comfort."
For more guidance and advice about CMT, go to Charcot-Marie-Tooth UK.