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If your child has hemiplegia, it is important that they have
footwear that is not only practical and comfortable but will help
keep the affected foot in the best position when walking.
Unfortunately, finding suitable footwear is one of the most
common problems faced by both parents and carers of children with
hemiplegia, and by adults with the condition. You can talk to your
child's physio about any issues they're having finding appropriate
The most common problem is that the child needs two differently
sized shoes. Sometimes the affected foot is smaller, or the child
may wear a splint, which requires a longer and wider shoe. Either
way you need differently sized shoes, so you have either to find
someone who will sell a pair of odd shoes or buy two pairs and hope
for a discount. Insoles are another option.
Children with hemiplegia should have orthopaedic shoes/boots,
for example Piedros. Piedros are prescribed and fitted for free on
the NHS. Often parents are refused this service, but it is worth
persisting if you can get support from your physio. Once their
child has stopped growing, some parents have had an expensive cast
(mould) made of their feet and then had shoes made to measure.
These should be rather more comfortable and the cost can be little
more than buying two ordinary pairs.
If one leg is shorter than the other, the shoe on that side can
be given a raise. These can either be stuck on the sole/heel by the
orthotist or fitted inside the shoe. These inner ones are removable
and so can be put into different shoes, but they can mean the shoe
is not deep enough for the foot and the heel comes out. You can
often get around this by dressing your child in boots, but this is
not ideal in hot weather, so it's often a case of finding the right
Another problem is fastening shoes with one hand. Fortunately,
many shoes for both children and adults now come with Velcro
fastenings, and many orthotists will also replace existing
fastenings with Velcro. A few parents, however, have mentioned that
this can look rather strange unless it is well done.
Piedro boots and other special shoes, which many children obtain
through their physiotherapists, can be ordered with Velcro
fastenings, and straps on shoes, slip-ons and sandals can be
extended with elastic and Velcro to fit over splints.
Bear in mind, however, that as your child grows they might want
to choose from a wider range of footwear. Sooner or later you need
to tackle the shoelace problem head-on!
These stretchy, 'curly' laces, which come in a range of colours,
are the best solution for many children. You put on the shoe, pull
them tight and they stay tight without actually being tied. The
shoelaces have no pressure points and allow natural movement.
Greepers (www.greeper.com) are another clever
kind of shoelace that doesn't need tying and untying, but is
tightened/loosened by pulling on tabs. If you go to the website you
will be directed to a video on YouTube showing how they work.
Nottingham Rehab www.nrs-uk.co.uk sell elastic shoe
laces, in brown or black, that convert lace-up shoes to
If your child finds it difficult to learn to tie laces, it is
worth experimenting with different types. Some children find flat
laces easier than round ones, some find round ones easier. In
general, the thicker the lace, the easier it is to tie.
Four methods for tying laces with one hand
If your child can only use one hand or finds it difficult to
reach their feet, there are several ways of tying laces
single-handed. We list four such methods below, with diagrams.
You may find your child needs a longer lace than the type
supplied. But it is not necessary to use a conventional lace:
strong string or stool cord is just as efficient if a lace of the
right length is not available.
The numbers indicate the direction in which the lace should be
threaded. For all these methods, only one end of the lace is
threaded down or up the shoe and then tied. The other end is
secured in position with a knot.
Secure the knotted end at 1. Thread the other end down 2, up 3
and so on to 8. Thread 8 up through 2 to tighten lace. Work up from
the toe and pull at 2. Make a loop in the end, pass under 1, 2 and
pull tight. NB: Run lace underneath and come up to 2.
This is A in reverse. You lace from the top towards the toe.
Pull the lace back up through 2 and secure as shown in diagram.
This is the simplest method. Lace up from the toe and secure as
shown in diagram.
Hook method. Start by attaching a ring to the unknotted end of
the lace. Lace in the direction of the numbers and fix by hooking
the ring attached to the end of the lace on to one of the ski-boot
hooks. To loosen, unhook the lace. If the boot has an ordinary
eyelet at the bottom the fixing knot can be threaded through
Some open-to-toe boots have holes in the base of the tongue and
the lace can be fastened through these. This holds up the tongue
and keeps the knot on the surface where it cannot rub the toes.
In general, you'll usually find the bigger brands (Clarks, Ecco,
Geox, Hush Puppies and Startrite) cater well enough. Wynsors,
Clifford James and Brantano are other options. Some firms have
factory outlets with good discounts. Clarks runs an odd shoe scheme
for children with different sized feet.
People with hemiplegia often cite trainers as the easiest
footwear for both children and adults, since they are designed to
support the foot and often have insoles that can be removed (if
necessary by force) to accommodate an AFO. Many of them have Velcro
You can ask your child's school to allow them to wear trainers
for PE rather than plimsolls, which allow the foot to roll over.
Some black trainers you can pass off as shoes if your child needs
to look more formal.
And if you do buy two pairs of trainers of different sizes, make
sure both trainers have the same height soles, as the bigger the
trainer the higher the sole height.
If you are concerned about shoes being properly fitted, the
Children's Foot Health Register http://www.fitkidsshoes.org/
is a list of Centres of Excellence for Children's Shoe Fitting in
the UK, which you can download from their site.
The Disabled Living Foundation has information on finding
suitable footwear at https://www.dlf.org.uk/factsheets/footwear