343: Bracing That Evolves With Recovery: Rethinking AFOs After Stroke With Kim De Roy, MSc. PT, CPO

What if the device we put on a patient's foot in the first weeks after stroke could change with them, instead of locking them into one decision for the next five years? In this episode, host Erin Gallardo, PT, DPT, NCS, talks with Kim De Roy, MSc. PT, CPO, CEO of Elevate Movement, whose career sits at the crossroads of physical therapy and orthotics and prosthetics. That path started when he became a below-knee amputee at 19. Kim shares why he thinks traditional bracing has been built to compensate rather than recover. He explains how to easily prevent contractures and equinovarus positioning from developing in the ICU while everyone is focused on survival. He also describes how reimbursement rules that allow one device for years leave outpatient therapists with few options. Erin and Kim discuss the Sstep, a textile drop foot sock with a dial-tensioned lift that works without a shoe, from positioning in bed to nighttime bathroom trips, a common time for falls. They also discuss the Swift, a custom carbon AFO whose adjustable calf cuff lets clinicians start with near-rigid stability and progress to a dynamic, energy-returning brace as the patient recovers. Along the way they cover why the first supported step matters so much for confidence, how a dynamic brace can help with sit-to-stand, a striking case where fear of falling seemed to drive upper extremity tone, and what the research suggests about early AFO use and dorsiflexor recovery. Kim closes with practical next steps for clinicians who want to bring this into their own workflow through their O&P provider. Learn more at elevatemovement.com and dropfoot.com.

Custom Carbon Fiber AFO Swift

•   Patients with a more spastic type of paralysis, struggling with equino-varus of the foot and ankle, knee instability, and hip weakness: https://www.youtube.com/watch?v=Y4nZZ1m8W8k
•   Patients already ambulating but struggling flaccid type paralysis with ankle instability, knee hyper extension, hip weakness, etc.… comparison to SpryStep: https://www.youtube.com/watch?v=1q5Ru1fIiZg&feature=youtu.be

Sstep Drop Foot Sock

•   Patient using the Sstep drop foot sock: https://www.youtube.com/watch?si=rboyrH2RpNQEX9D4&v=Y1bhTtw2qlI&feature=youtu.be

Elevate Movement - www.elevatemovement.com

Contact:

Kim@elevatemovement.com

Jenna@elevatemovement.com