EXPERIMENT: Can Ankle-Foot Orthoses (AFOs) reduce ankle-clonus?
CONCLUSION: Carbon-fibre AFOs are an excellent first-line treatment for ankle-clonus and should be tried before resorting to (ineffective) medication.
Initially I experimented with buying off Amazon an inexpensive polypropylene (that is, plastic) Ankle-Foot Orthosis for my right leg – a Prolite Standard AFO for Drop Foot. This was, frankly, an experiment to see whether lifting my dropped-foot might improve my walking. Only my right foot drops. Unexpectedly, the AFO seemed to reduce the uncontrollable jerking of my right leg (clonus).
Although I had not been clever enough to anticipate this, it made sense: By restricting the position my ankle could adopt, the ankle-clonus (one of the two types of unending reflex cycle I have, along with knee-clonus) was less likely to be triggered.
I found this a very interesting observation.
Given that I have bilateral clonus – in other words, it’s pretty well as bad in both legs – I immediately kicked off a new experiment by buying a matching second AFO for my left leg to see if wearing AFOs on both legs would help my clonus overall.
Wearing AFOs on both legs resulted in a tremendous reduction in my clonus – unlike the baclofen that I had already been prescribed. As a result, I could very slowly walk (albeit with mobility aids). However, after an hour or so, I found that they became uncomfortable.
I discussed my findings with my MND Network Coordinator. She mentioned that she knew that in Cornwall someone had found a partiular design of carbon-fibre AFO to be very comfortable. She referred me to a local NHS Orthotist who immediately ordered me two highly-engineered carbon-fibre AFOs – Trulife Matrix T Ankle-Foot Orthoses for my left and right legs. They would cost several hundred pounds each to buy privately but were completely free on the NHS.
They are comfortable and highly effective. I wear them all day. Which raises the rather obvious question as to why AFOs aren’t even recognised as a first-line intervention for ankle-clonus…