Charcot Marie Tooth disease

Causes

CMT is caused by gene mutations that affect the normal function of the peripheral nerves. Sometimes these mutations damage the nerves themselves, others damage the myelin sheath which is the protective coating that surrounds the nerve. Both result in weaker messages being sent out to one’s limb extremities and back.

Symptoms

In the most common kinds of CMT, symptoms usually begin before the age of 20. They may include:

  • Foot drop
  • Foot deformity (high arched feet)
  • Curled toes (hammer toes)
  • Loss of muscle in lower leg
  • Numbness in the feet
  • Difficulty with balance
  • Later similar symptoms may also appear in the arms and hands

CMT is progressive however it does not affect life span.

Orthotic Treatments

Depending on the type and severity of an individual’s symptoms bespoke orthotics can help to alleviate some problems associated with the condition. AFOs provide corrective forces and support to achieve a normal walking gait and provide protection. For those with high arched feet or hammer toes specialist footwear may be prescribed.

Further information / Reading / Links

NHS website

Wikipedia

 

FAQs:

An AFO is an Ankle Foot Orthosis which as the name would suggest encompasses the ankle and foot. The objective is to control the position and movement of the ankle. AFOs are used to support weak limbs; they can also be used to immobilise the ankle and lower leg to correct foot drop. When set up correctly they can also have a great influence on the knee and hip joints. They are the most commonly used Orthoses.

The length of time that one needs to wear an AFO very much depends on the condition being treated. If it is a long-term condition like cerebral palsy or post-polio syndrome it is likely to be years as the condition cannot be cured. Your orthotist will advise you.

A patient’s comfort in their AFO is vital for compliance with the prescribed wearing regime.

So there are a number of steps the orthotist should take to ensure a comfortable fit: the patient’s heel should fit fully into the heel cup without excess space, the contours of the plantar surface of the AFO should match the patient’s foot, for children there needs to be up to half an inch growth room in the toe shelf length. At LOC we use our Gait Laboratories at our Kingston and Manchester clinics to fine-tune our bespoke orthotics.

A GRAFO is used to control instabilities in the lower limb by maintaining proper alignment of limbs and controlling their motion. It reaches around to the front of the knee extending down to the ankle. It works by altering a patient’s limb presentation to displace load and impact as well as offering further control to the knee.

The cost of an AFO is dependent on the type of AFO that has been prescribed and the material that it has been made with. Carbon fibre will be more expensive than metal or plastic for example. LOC’s bespoke AFOs cost can be found on our Orthotic Prices page.

The ability to drive while wearing an AFO is dependent on the condition being treated and the orthosis that has been prescribed. If wearing a hinged AFO, for example, you will be able to drive, but if wearing a knee brace, you won’t. Your orthotist will advise you.

The most flexible type of AFO is a Dynamic Ankle Foot Orthosis (DAFO).  It is thin and provides flexible support to the foot and ankle.

Both normal AFOs and DAFOs improve static balance (eg: while standing). Research among MS sufferers suggests that DAFOs aided balance while walking more than AFOs.

The simple answer is: yes they can. However one has to be sensible and look for wide-fitting trousers/jeans preferably of light and thin material.

Typically an AFO is stiff and rigid whereas a DAFO is thin, flexible and wraps around the patient’s entire foot. A DAFO provides support but also allows some range of normal movement.

A Supra Malleolar Orthosis SMO gets its name from the part of the body it encompasses. Thus an SMO supports the leg just above the ankle bone or malleoli. It allows dorsiflexion and plantar flexion(toes up and toes down) but eliminates mediolateral movement.

It typically takes a few weeks but is slightly dependent on the chosen materials and current availability.

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