Richie Drop Foot Stability System 

 

CLINICAL INDICATION:  Neurologic conditions resulting in foot drop or loss of posterior lower leg muscle strength

Features:

Carbon fiber ankle foot orthosis ( make this a link to description)

  - controls ankle joint dorsiflexion and load on the Achilles tendon

Custom functional foot orthosis (one pair)

 - controls rearfoot pronation

 - patented “Richie ArchLock™” lateral offloads the medial-central band of the plantar fascia 

Carbon fiber footplate with toe rocker

 - diminishes dorsiflexion of the MTP’s and engagement of the windlass

 

Mechanism: 

Traditional solid shell plastic AFO braces designed to treat drop foot provide support primarily during swing phase. (1-3)  A carbon fiber AFO brace with lateral strut can add an additional benefit of dynamic recoil during the third rocker to aid in push-off or propulsion.  (4-5)

 

Clinical Indications

In cases of foot drop caused by stroke or nerve injury, where there is no spasticity and the knee is stable, the Richie Dynamic Assist Brace would be recommended.  However, when there is some degree of posterior leg weakness or contracture as seen in Charcot Marie Tooth disease, the Richie AeroSpring Drop Foot Stability System can provide additional support and improved gait efficiency. 

Many neurologic conditions result in acquired foot deformity, so the addition of the custom balanced foot orthotic to the carbon fiber AFO allows this innovative Drop Foot Stability System to address all levels of the pathology.

The lightweight dynamic features of the Richie AeroSpring Drop Foot Stability System allows the otherwise healthy patient to engage in walking or running for exercise.  Dynamic carbon fiber AFO devices have shown ability to improve push off while optimizing energy expenditure during walking. (6-8)  The possibility for participation in sport or exercise would not be possible with most bulky sold shell AFO devices, but is now feasible with a carbon fiber brace system.

Contraindications

1. Severe instability of the knee.  Mild to moderate instability in the sagittal plane can be controlled with the Richie AeroSpring System

 

2. Severe ankle joint contracture with equinus.   The Richie AeroSpring System incorporates a carbon fiber brace with footplate aligned at 90 degrees.   Some compensation can be achieved by incorporating a heel wedge to balance equinus.

Reimbursement*:

Reimbursement for the carbon fiber AFO:
Billed under code L1932
Average reimbursement: $800
Reimbursement for the Pair of Foot Orthotic:
Billing code L3000
Average reimbursement: $400

Note:  Reimbursement varies among payors and region.  No guarantees or assurances for reimbursement are implied with this document.  Suppliers must contact each payor to verify coverage and reimbursement amounts. 


 

REFERENCES

1. Park JH, Chun MH, Ahn JS, et al. Comparison of gait analysis between anterior and posterior ankle foot orthosis in hemiplegic patients. Am J Phys Med Rehabil 2009; 88(8): 630–634.
2. Lehmann JF, Condon SM, Price R, et al. Gait abnormalities in hemiplegia: their correction by ankle-foot orthoses. Arch Phys Med Rehabil 1987; 68(11): 763–771.
3. Gok H, Kucukdeveci A, Altinkaynak H, et al. Effects of ankle-foot orthoses on hemiparetic gait. Clin Rehabil 2003; 17(2): 137–139.
4. Wolf S, Knie I, Rettig O, Fuchs A, Do ̈derlein L. Carbon spring AFOs for active push-off. Abstract of 10th GCMAS meeting April 6–9 2005, Portland.
5. DesloovereK,MolenaersG,VanGestelL,HuenaertsC,VanCampenh- out A, Callewaert B, et al. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study. Gait Posture 2006;24(2):142–51.
6. Bartonek A, Eriksson M, Gutierrez-Farewik EM. A new carbon fibre spring orthosis for children with plantarflexor weakness. Gait Posture 2007;25(4):652–6.
7. Bartonek A, Eriksson M, Gutierrez-Farewik EM. Effects of carbon fibre spring orthoses on gait in ambulatory children with motor disorders and plantarflexor weakness. Dev Med Child Neurol. 2007;49(8):615–20.
8. Danielsson A, Sunnerhagen KS. Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis. J Rehabil Med. 2004;36(4):165–68.