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Transverse Myelitis

Symptoms

Transverse myelitis (TM) is a rare neurological disorder, with around 300 new cases of the disease recorded in the UK every year. Transverse Myelitis may occur in isolation or with another illness. When TM occurs in isolation, it is believed to be caused by an abnormal activation of the immune system against the spinal cord. In contrast, around a third of patients also present with flu-like symptoms, including fever. The main symptoms of TM are muscle weakness, primarily in the legs, less commonly in the arms. However, the very first symptom is often pain in the lower back, combined with burning or tingling sensations in the legs.

Orthotic Treatments

Any orthotic treatment must go hand-in-hand with what is recommended to you by your neuro physiotherapist. Depending on an individual’s exact symptoms muscles can be activated by using Functional Electrical Stimulation (FES), while foot drop can be treated with bespoke Ankle Foot Orthoses (AFO).    

Further information & Support

The Transverse Myelitis Society offers both emotional and practical support, with Equipment Grants, Regional Support groups and a Neurophysio bursary scheme.      

Clinic Locations:

Kingston upon Thames (HQ) Bristol Cambridge Manchester    

FAQs:

What does AFO stand for?

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.

How long do you wear an AFO?

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.

How should an AFO fit?

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.

How does a ground reaction AFO work?

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.

How much do AFOs cost?

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.

Can you drive wearing an AFO?

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.

Can you get a flexible AFO?

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.

Do static or dynamic AFOs improve balance?

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.

Do AFOs fit under trousers?

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.

What is the difference between an AFO and a DAFO?

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.

What is an SMO orthotic?

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.

How long does it take for LOC to manufacture bespoke AFOs following an assessment?

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