EQUINE GAIT IN DROP FOOT.

It may be funny to learn that, a youth of twenty years, who can run fast, able to do squatting and many other exercises with hands and trunk several times at a stretch, is unable to stand still at ease like a normal man. He has to keep stepping or has to take small support with hand or finger to stand still, if not he would fall. This was the miserable condition of an Engineering student for one year. His parents were disappointed when their brilliant son fell bedridden with quadriplegia consequent to a terrible Axonal Guillain Barre Syndrome.

A proper timely medical and physiotherapeutical management turned them to be hopeful when he started walking, running and could do most of his activities after six months. He joined for his classes in his college. He had only one difficulty that he could not stand still in the laboratory while the tutor's demonstration was going on. He kept on stepping forward and back in the group ridiculously to maintain balance, creating a distraction for others. The tutor warned him to stand still during the demonstration and the friends ridiculed his funny movement. His difficulty was not understood by the tutor and friends as they found otherwise no problem in his other activities. He was depressed and discontinued the classes taking leave and came to the hospital for review. He was examined and found all his muscle groups were in normal power as per the Oxford scale except ankle joint. He had residual foot drop or drop foot which the tutor and friends failed to understand. The Electromyogram revealed that his foot drop was due to the axonal degeneration of the common peroneal nerve, which supplies to the muscles of the ankle joint. He was treated for a long period by electrical stimulation and exercises and now he is perfectly alright, married, and settled in the USA.

Foot drop is weakness or paralysis of muscles involved in lifting the front part of the foot. The most common cause of foot drop is injury, disease, or compression of the common peroneal nerve. People with foot drops may drag their toes while walking. They may also have to lift their knees higher than usual to avoid dragging ( Equine gait). Foot drop is found in diseases like Multiple sclerosis, Amyotrophic lateral sclerosis, Spinal muscular dystrophy, Polio, Cerebral palsy, Stroke, Alzheimer's disease, Parkinson's disease, Diabetes, GBS, etc. other than compressive and traumatic neuropathies.

Physiotherapy has a fundamental part in treating drop foot. It includes toe-curling, theratube or theraband exercises, stretching and strengthening exercises, electrical stimulation to muscles and nerves, etc. Exercises to stimulate and rewire the brain which makes an effective way to overcome foot drop in stroke cases.

In permanent foot drop conditions, tendon transfer surgery is useful. Ankle foot orthosis(AFO) and lightweight braces are used as inserts in shoes and special footwear to keep the foot raised while walking.

In comparison with myriad incurable neurological disorders, drop foot alone is not a very serious deficit on the journey of success of a human being.

Thank you.