Orthotic solutions for CMT patients
By Dave Kimzey, CO
Charcot-Marie-Tooth or CMT
Charcot-Marie-Tooth (or CMT) is an inherited peripheral neuropathy that causes weakness in the extremities. The ailment was discovered by three physicians, Jean-Martin Charcot, Pierre Marie, and Howard Henry Tooth. It usually affects the lower extremities first but will also affect the upper extremity as well. It has a number of unique characteristics that include:
- It has no ethnic or race boundary’s and is found worldwide.
- Approximately 2.6 million people are affected by this ailment.
- CMT is a slow progressive ailment with patients slowly loosing normal use of their extremities from the nerves degenerating and weakening muscles, because the nerves can no longer stimulate the muscles. Many patients lose some sensory nerve functions.
- Some of the symptoms associated with CMT are usually an extremely high arch in the feet or a Pes Cavus foot along with hammer and or clawing of the toes. In some cases however a collapsed arch occurs resulting in Pes Planus feet.
- Foot drop and an associate high-steppage gait are the typical features of this pathology.
Treatment for both the Pes Cavus and Pes Planus deformities usually involves custom made foot orthotics to support the longitudinal arch and relieve pressure of the ball of the foot along with the toes. In most of these cases an orthopedic extra depth shoe are also needed to accommodate the extreme longitudinal arch shapes.
Foot drop results when the muscles cannot lift the foot up when walking, resulting catching the toes during swing phase along with turning of the ankle. This can be very precarious for the patient and dangerous for falls resulting in other injuries. This can also lower the patient’s confidence in being independent from canes, walkers and even wheelchairs.
There is no one device or treatment that is a good solution for everyone. There are off the shelf devices that can be useful, along with a variety of styles of custom made braces. At HOPE we have combined several different ideas for Ankle Foot Orthotic (AFO) to help stabilize and support the knee, foot and ankle while still maintaining dynamic movement to allow for a more natural gait.
The role of your orthotist during the treatment of any bracing need, is to listen and work with your physician, therapist, and most importantly the patient, to assess the needs and goals of the individual.
Call Horizon Orthotic & Prosthetic Experience today for you free consultation!