Name: Mona Sen
Condition: Multiple sclerosis
How long I’ve been living with MS: 34 years
I am in the secondary-progressive stage of multiple sclerosis (MS), and life is very different from when I was in the relapsing-remitting stage. My main issue now is mobility, which is compromised by foot drop in my left foot and spasticity in many parts of my body, including the left leg.
I tried a hip flexion assist device (HFAD) in the hope that it would address these problems and help me walk better.
RELATED: 8 Steps to Better Walking With MS
What Is the Hip Flexion Assist Device?
A hip flexion assist device has a waistband; two long bands made of a thick, bungee-cord-like material that are attached to the waistband and fall on either side (inside and outside) of the affected leg; and a strap at the bottom of the bands that attaches to the shoe. There is an optional popliteal strap that wraps around both bands and sits behind the knee to help with knee flexion, or bending.
The tension in the long bands lifts the leg, causing it to bend at the hip and knee, while also lifting the front of the foot as much as needed. This allows people with weakness in the muscles that normally lift the leg to walk with a relatively natural movement.
If needed, two sets of leg bands can be attached to the waistband so that both legs are receiving assistance in walking.
Here’s What Happened When I Tried It
The first thing I learned was to put the waist belt on while sitting down, not standing up. When I'm sitting down, the belt fastens around my waist more snugly. The two dynamic bands originate in the waist belt and fall to either side of my left leg, medially and laterally. I have to make sure I’m wearing laced shoes for the second step. The bands come together and attach to a piece with Velcro, which then attaches to the other part threaded through the shoelaces.
When I stand up with everything attached, my left foot is in a lifted position; the height of the lift can be adjusted by pulling or loosening the piece within the shoelaces. The last step is to attach the popliteal strap behind the knee. While there is tension in the bands, I am able to bring my foot down to the ground as needed. The bands always provide a leg lift.
Three Things I Like About the HFAD
1. I love the low-tech aspect of this device. It is not electronic or high-tech. It is practical and intuitive. My leg started dragging along the ground, so I raised the bands a little higher by tightening the piece in my shoelaces. It was that simple.
2. I like that the cost is under $300. My Walkaide (a functional electrical stimulation device that helps with foot drop) cost much more and doesn’t flex my hip or knee and doesn’t give me leg lift.
3. I love the thinking behind the creation of the HFAD. Who better to think of the physical needs of MS patients than physical therapists? One of the masterminds behind the HFAD is Matt Sutliff, a physical therapist at the Cleveland Clinic who watched the gait of his MS patients as they dragged their leg in his clinic.
Three Things I Dislike About the HFAD
It is difficult for me to give the HFAD any “dislikes,” because nothing I have ever tried comes close to giving me a leg up like the HFAD. Not my ankle-foot orthosis (AFO) and certainly not my Walkaide. But here are a few caveats:
1. The main thing I dislike about the HFAD is that it is very cumbersome to put on. For a person with MS, the whole process is exhausting, even sitting down. The bands are bulky and heavy.
2. I also find it difficult to thread the buckle underneath my shoelaces. It is a thick piece, and putting it on and taking it off is not a job for fumbly, uncoordinated fine motor activity.
3. The whole contraption, although well thought out and well meaning, is not something I would comfortably wear in public. The advertisement states that it can be worn under clothing, but I’m afraid that is false. I tried and could not do it.
Because in order to put the HFAD on and take it off I use the energy I need to walk while doing outside activities, I use it as a workout tool. I put it on and am able to get proper leg lift and knee and hip flexion to get a good “walk about” for a few minutes. I also leave my Walkaide on, because the combination of the two gives me the best possible workout.
The Bottom Line
The HFAD accomplishes what it is made for. It is just not pretty to look at. On a scale of 1 to 5 (5 being “excellent”), I would give it a 4 for performance and a 3 for looks. Overall, I am happy to have it.