Hereditary spastic paraparesis and the orthotic approach
An overview of stiffness and walking difficulty that increase over time in the lower limb, and of supportive orthotic options.
What is hereditary spastic paraparesis?
Hereditary spastic paraparesis (also known as hereditary spastic paraplegia) describes a group of inherited neurological conditions. Their common feature is stiffness (spasticity) and weakness in the leg muscles that increase over time.
Symptoms are mostly concentrated in the lower limbs and may follow a slowly progressive course. The age of onset and the severity of symptoms may differ from person to person, and even between members of the same family.
The approach to this condition is usually multifaceted; exercise, physiotherapy, lifestyle adjustments and, where considered appropriate, supportive orthoses may be considered as part of the treatment plan. Diagnosis and treatment decisions are made only through the physician's assessment.
How do symptoms appear and progress?
Increased tone in the leg muscles can make steps stiffer and movement more difficult. Over time, changes in walking, balance difficulties and quick fatigue may be observed. While symptoms may be mild in the early period, they may affect daily activities more in later stages.
- Gradually increasing stiffness and tightness in the legs
- Changes in walking pattern and the toes catching on the ground
- Balance difficulties and quick fatigue during activity
Common symptoms and signs
Symptoms do not occur to the same degree in every person; assessment and monitoring are carried out by the physician.
Increased muscle tone
Spasticity in the leg muscles may reduce the fluidity of movement and make steps stiffer.
Muscle weakness
Weakness in certain muscle groups may increase the need for support in walking and standing.
Balance and coordination
Difficulty with balance and coordination may affect the sense of confidence in daily activities.
Fatigue
Because movement requires more effort, it may lead to tiring more quickly during the day.
The supportive role of orthoses
Ankle-foot orthoses may be considered as part of the treatment plan to support the foot and ankle in an appropriate position. The aim is to contribute to more controlled movement of the foot during the step and to support walking.
- Support for lifting the toes during the step
- Holding the foot and ankle in a more balanced position
- The choice of orthosis is made according to the person's muscle tone, level of mobility and the physician's assessment
Long-term follow-up and adaptation
Because hereditary spastic paraparesis may follow a slowly progressive course, needs may change over time. Regular assessment helps keep the exercise program and supportive solutions in line with the current situation. Orthosis settings can also be reviewed during this follow-up.
The orthosis fitting process
Physician's Assessment
The fitting begins with a specialist physician's assessment and a prescription/medical report.
Measurement and Planning
The person's muscle tone, level of mobility and walking are assessed; the appropriate orthosis type and service plan are determined.
Fitting and Adjustment
The orthosis is fitted; fit and settings are adjusted to the person.
Follow-up
Training on use is provided; follow-up is provided for check-ups and adaptations when necessary.
Frequently asked questions
Does an orthosis eliminate spasticity?
Orthoses are a supportive part of the treatment plan; the aim is to support the foot and ankle and contribute to walking. Results vary from person to person and are determined by the physician's assessment.
Should I exercise?
Exercise and physiotherapy play an important role in managing muscle tone and movement. The appropriate program should be planned under the guidance of the physician and physiotherapist.
Does the need for an orthosis change over time?
Because the condition may follow a slowly progressive course, needs may change; for this reason, regular check-ups and orthosis adjustments when necessary are recommended.
This content is for information purposes only; consult your physician for diagnosis and treatment. Fittings are carried out at our licensed center addresses in line with a specialist physician's prescription/medical report.
