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Breaking out of the cast-like AFO: WalkAide and Bioness L300

October 9, 2013 12:14 am


AFO on Drew Podgorski stroke survivor

For two years after Drew’s stroke, he had to give up his sneaker addiction and was stuck wearing wide-fit New Balance tennis shoes to accommodate his cumbersome, cast-like AFO brace.

No more checkerboard Vans. No more Jordan’s. No more high-top Chucks in every color of the rainbow. And forget about walking barefoot and feeling his toes in the fresh grass.

Like Drew, many stroke survivors have drop foot, which is characterized by weakness or paralysis of the muscles involved in lifting the front part of the foot. Drop foot causes a stroke survivor to either drag the foot and toes or engage in a high-stepping walk called steppage gait, or both.

Drop foot causes stroke survivors to experience difficulty with the most simple daily activities. For instance, Drew often trips on uneven surfaces, causing him to take a tumble and sustain some pretty nasty cuts and bruises. Thank God that’s it, especially since he was on Coumadin blood thinner for a good two years. Hazards for Drew are area rugs, carpet, curbs, lifts from room to room or any surface that’s not completely flat. Steps can be difficult too, and slow.


AFO stroke

Doctors prescribed a cumbersome custom AFO brace to help support Drew’s foot, thus the bulky New Balance tennis shoes. It’s made of hard plastic and forms around the back of his calf behind the knee and goes all the way down underneath his heel, sort of like a cast. When he was first out of the hospital, the AFO brace went all the way up to his thigh and had springs and hardware at the joints to facilitate a little movement.

The hospitals will push these heavy braces because they’re custom-made and more expensive than lighter AFOs like the Toe-OFF.

Due to drop foot, Drew hikes the entire right side of his body upward, and his clenching shoulder leads as he lifts and pushes his brace-covered leg forward to take each step. If he walks barefoot, his toes will drag behind on the carpet. Walking on cement is out of the question, as his toes would scrape against the rough surface.

Walkaide system on patient

But there are other options. And these options are pretty fantastic, aside from having to electrocute yourself, even though that’s the beauty of it. These options are two electrical stimulation (e-stim) systems called WalkAide and Bioness L300. They wrap around the calf and send low-level electrical stimulation to activate nerves and muscles that lift the foot.

Basically, they shock your foot into lifting up so you can walk more naturally, with increased speed and improved balance.

Here are the websites for each:

Bioness L300 Foot Drop System 

Saebo Myotrac Infiniti (Drew never tried this one)


No more heavy AFOs or dragging your toes behind.

With WalkAide, you can even walk barefoot.

Bioness does not allow you to walk barefoot as there is a “heel strike” that goes in the bottom of your shoe and records your gait. Bioness also has a small remote control you must keep with you at all times.

Drew has tested both and we are in the process of trying to obtain the Walkaide for him.

Each are wonderful devices that restore some freedom to stroke survivors. But there are pros and cons to both. For instance, with Walkaide, you can walk barefoot and free of controls. But Walkaide is pre-programmed. So if your gait is slower or off for some reason, the Walkaide might lag behind and you could trip.

Bioness L300 responds to your gait, and accommodates your every step. But you cannot walk barefoot and you have to have the remote with you at all times.

There’s also a price to pay for these devices. And that price is between about $4,600  (Walkaide not including monthly electrodes of $70 per pack) to  up to $7,000 (Bioness).

Further complicating the matter is that the medical device companies that make Bioness and Walkaide, as well as private insurance and Medicare, make it nearly impossible to get them covered.

You can read more about our struggle with getting them covered, in the next post: The carrot and stick: Getting Medicare or insurance to cover your Bioness L300  or WalkAide for foot drop

Note: There may be some conditions that do not allow the use of these devices. A doctor must prescribe these devices to you.

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