Neuro-Muscular Solutions

+oapl trusts in patient engagement and involvement in their on-going orthotic management. Long-term users of orthotic devices require clinicians that are confident in their knowledge to be able to provide an orthotic solution to ensure the specific goals of the patient, family and referring specialist are met.  

+oapl's clinical team specialise in the prescription and fitting of orthoses designed specifically to manage the ongoing needs of our neuro-muscular patients


Our clinical team are proficient in managing a wide range of conditions including the following:


Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a condition of the central nervous system, interfering with nerve impulses within the brain, spinal cord and optic nerves. Problems with gait or difficulty in walking are among the most common symptoms
in MS.Gait problems are usually related to several factors:
  • Muscle weakness a common cause of gait difficulty. Patients may also have a foot drop which can cause them to stumble or trip. Weakness may often be compensated for by appropriate orthoses such as an AFO (ankle-foot orthosis).
  • Spasticity Muscle tightness or spasticity can also interfere with gait. This can generally be managed with specific orthoses as part of a treatment regime.
  • Balance problems generally result in a swaying  gait known as ataxia. Severe ataxia generally means the person would benefit from the support and stability an orthosis can provide.
  • Sensory Deficits such as severe numbness or loss of proprioreceptive sensation. Most gait problems can benefit to some extent from physical therapy which includes exercises and gait training with the use of appropriate orthotic devices.


Stroke (CVA)

Every stroke is different, with each person affected by stroke encountering different problems and having different needs. The way in which you might be affected depends on the location, in the brain, of the stroke as well as how extensive the stroke is. A stroke on the right side of the brain generally causes problems on the left side of the body. A stroke on the left side of the brain causes problems on the right side of the body. Some strokes can occur at the base of the brain and can cause problems with eating, breathing and moving.

A huge variety of orthoses can be utilised during recovery from stroke. Orthoses will be provided to encourage early mobilisation and enable safe transfers initially but may also form part of long term ongoing care. Orthotists will be part of the wider multi-disciplinary team that provide ongoing rehabilitation so  Stroke survivors who have residual impairment ,at the end of the formal rehabilitation phase of care, should be referred to appropriate orthotic services for assessment and continued management.


Each person's gait disorder needs to be evaluated on an individual basis by the entire allied health and medical team so that an appropriate therapy program developed to suit that individual.



Long after the initial bout of poliomyelitis, some people suffer from further symptoms including new weakness, joint and muscle pain and fatigue. These symptoms are known as the ‘late effects of polio’ or ‘post-polio syndrome’. Late effects of polio can develop years or decades after the initial bout of infection. The most common symptoms include:
  • decreasing strength and endurance
  • pain in muscles and joints
  • fatigue.

As part of the rehabilitation process patients may be referred to an orthotist for an assessment and management plan to minimise the symptoms of Post-Polio Syndrome. 


+oapl's tertiary qualified orthotists are skilled in the evaluation, design, fabrication and fitting of custom made devices that aim to reduce muscle fatigue, support the body and allow for improved mobility.


For further information:


Additional Information


WalkAide is a revolutionary Class II medical device that utilises functional electrical stimulation (FES) to activate the muscles that lift the foot that have become paralysed.  WalkAide is suitable for people experiencing foot drop caused by upper motor neuron injuries or conditions such as:

  • Multiple Sc​​lerosis (MS)​
  • Stroke (CVA)
  • Cerebral Palsy (CP)
  • Incomplete Spinal Cord Injury
  • Traumatic Brain Injury (TBI)​​

WalkAide is also utilised as a Neuro Rehabilitation tool by Clinicians.



WalkAide vs. AFO​

Traditionally, foot drop is treated with bracing using an ankle foot orthosis (AFO). The passive treatement offered by AFOs does not promote active use of neuromuscular systems and also limits ankle range of motion. In addition, AFOs can be uncomfortable, bulky, and, if poorly fitted, produce areas of pressure and tissue breakdown. For the appropriate candidate WalkAide may replace the traditional AFO to re-engage a person's existing nerve pathways and muscles. 

The recruitment of existing muscles results in reduction of atrophy and walking fatigue – a common side effect of foot bracing. WalkAide users have the freedom to walk with or without footwear, up and down the stairs, and even sidestep.

Comparison of Benefits of Functional Electrical

Stimulation (FES) and Ankle Foot Orthosis (AFO) for Foot Drop​

   AFO = ankle foot orthosis • FES = functional electrical stimulation • ROM = range of motion



The Quantum Leap in AFO Technology

Introduced in 1997, ToeOFF is now recognized as a quantum leap in AFO technology. Today hundreds of thousands of individuals with gait impairment now enjoy a higher quality of life, thanks to the stability and dynamic response provided when wearing one of our  patented carbon composite orthoses that are members of the ToeOFF Family of Products. With more experience than any company in the industry and as the world leader in carbon composite AFO technology, our product development team continues to extend the opportunity for improved gait and increased walking capacity to more individuals as they expand the product offering in the ToeOFF Family of Products.


The ToeOFF® Advantage


Anterior Design
The ToeOFF family of products comes up from the footplate onto the anterior surface of the leg to avoid pressure on the calf muscles and Achilles tendon. It allows for a floor reaction response to assist with knee extension.
Lateral strut
The strut is placed on the lateral side of the foot to create stability and function. It also allows for more functional use by bilateral users.
Light weight
The composition of Carbon fiber, fiberglass and Kevlar produces an extremely lightweight yet structurally superior design, which is of great benefit to the user. 
Graded Stability
To be able to accommodate different users’ needs, the sizes and products are graded in both stability and dynamic response. 
The extreme thinness of the product makes it light and almost invisible under slacks or trousers.
As the shin plate comes on the anterior surface of the leg it provides for a more comfortable design for the user.
Dynamic footplate
The unique layup and the shape of the footplate contributes to a more dynamic and functional gait pattern.
Fits in shoe
The thinness of the foot plate and ability to trim it often avoids the need to increase the shoe size.
Open heel
The open heel design allows the Calcaneus to invert and evert which happens naturally during the gait cycle and allows the biomechanical chain reaction to occur.

Triple Action™ Ankle Joint

In 1964 Becker Orthopedic introduced the Double Action ankle joint. The Double Action ankle joint has been adopted internationally and has become a standard means of managing lower extremity foot and ankle biomechanics.

Becker Orthopedic now introduces the Triple Action™ ankle joint.

Like the Double Action this new and innovative component has high stiffness in the coronal and transverse planes, intended for individuals with neuromuscular pathologies the increased range of adjustability coupled with an indpendent alignment feature allows the clinician to optimize biomechanical control of lower extremity joint segments through all phases of the gait cycle.




The Triple Action™ Stance/Swing Control ankle joint provides:

  • Independent adjustment features that correspond to the phases of the gait cycle
  • Simplification and optimization of alignment and range-of-motion
  • Independent alignment adjustment of the sagittal plane ankle angle of ±10°

Stance Control Orthoses

Stance Control KAFO componentry has been the biggest development in orthotics in the past 20 years. Giving patients knee stability during stance while allowing  them to bend their knee during swing phase allows gretaer mobility and a more natural looking gait.  +oapl's clinical team introduced this ground breaking technology to the Austrlian market and through their clinical program were instrumental in the devolpment of trial KAFO's for these systems.  A concept that has now been taken up by companies world wide. 


+oapl's clinical team introduced this ground breaking technology to the Australian market.....





Through our clinics +oapl now offers a range of stance control componentry from companies like Becker Orthopaedic, Fillauer LLC and Ultraflex Patient solutions.  Below are some of  Stance phase options currently available.




The PreStride is an evaluation tool that may be used in combination with a physical examination to assess candidacy for Stride stance control orthotic management. The PreStride is a modular and fully adjustable stance control KAFO that may be fitted to most adults who are between 1.57metres and 1.88 metres in height.




The FullStride, model 9006, is a mechanical stance control orthotic knee joint that utilises a low-profile cabling system to automatically unlock at the end of stance phase. At the end of swing phase, when the orthotic knee joint reaches full extension, the locking mechanism re-engages to provide knee stability for stance phase.




The SafetyStride, model 9005, functions the same as the FullStride, except it has the ability to resist knee flexion at any angle. Unlike the FullStride, the SafetyStride does not require full 180° knee extension to resist knee flexion in stance phase.





The Stride4 is the latest addition to the Stride Family of interchangeable stance control knee joints. The Stride4 is comprised of a four bar linkage system that offers (3) modes of operation: Stance control, free motion and locked with stance phase flexion.




The UTX is a lightweight, less than two pounds, KAFO that stabilises the knee during the stance phase of gait, but enables knee flexion during swing phase. At the end of swing phase, as the knee reaches full extension, a ratchet engages to stabilise and lock the knee.




The SPL2 (Swin Phase Lock) utilises a simple pendulem mechanism to lock and unlock the knee.  It has 3 modes of operation which are controlled by the satelite unit and as there are no requiremnent for an ankle joint, to activate the stance phase control, can be built into a knee brace for patient's with no distal impairment.