Improve Foot Clearance in Neuro Patients with Ace Wrap

Written by Joey Masri, PT, DPT

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The consequences of a neurological event can be quite large, with areas such as cognitive skills, visual perception, and overall physical function all vulnerable to decrement. Physical therapists are in a great position to improve all of these areas and have a profound effect on an individual's quality of life. For purposes of this brief write-up, we will focus on the physical aspect - namely by addressing foot clearance issues in these individuals to improve gait mechanics.

That's where ace wrap comes in.

Ace wrap is not just reserved for immobilizing injured joints or holding hot/cold packs in place. It can also be a powerful tool in the world of neurorehabilitation in order to facilitate more effective sessions of gait training. 

In this video, I will demonstrate just how to make that possible by using ace wrap to improve foot clearance - a common issue following certain types of stroke or peroneal nerve injury:

This technique can be used until the patient demonstrates enough strength to do without it or while they await a more permanent and fitted orthotic.

INSTRUCTIONS:

1. With your ace wrap, begin by creating an anchor by wrapping around the patient's mid foot in a medial to lateral direction to encourage a supinated foot position.
    
2. From the medial side (inside part of the foot) diagonally work the wrap upwards to the lateral (outside) part of the patient's knee joint.
    
3. Create an anchor just below the patient's knee joint. Two anchors here should be good enough.
    
4. Work the wrap from the medial side of the knee joint diagonally back down to the lateral part of the foot.
    
5. Create additional anchors around the mid foot as you did in the first step and repeat the whole procedure. Once you get back up to your knee anchors, you may tuck any additional ace wrap away.

KEY POINTS:

• Do NOT wrap the patient's leg too tightly. You do not want to cut off their blood flow. A slight pulling on the ace wrap as you follow the procedure should be enough. Practice is STRONGLY encouraged!
• Monitor the skin for irritation, pulling of hair, or signs of allergy to the wrap material.
• Utilize appropriate assistance devices to aid in safe and effective gait training (walkers, canes, handheld assistance).

What are your thoughts on this? What other uses can you think of that utilize ace wrap? Please feel free to send us a message or comment below!

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