Abstract
<jats:p>Abstract. Complete transection of the peroneal nerve followed by the development of foot drop syndrome transforms a patient’s daily life in a manner that cannot be adequately explained solely through isolated motor impairment. Altered gait patterns, reduced postural stability, increased incidence of microtrauma and falls, as well as the constant need for conscious movement control create fundamentally new conditions for performing everyday tasks. Within this context, the patient is required not only to physically reorganize motor behavior but also to reconsider their role in professional, social, and family environments. Therefore, foot drop should be viewed not as a local motor deficit but as a condition that initiates a systemic reorganization of functioning at the levels of activity and participation. The aim of this study was to substantiate and systematize occupational therapy approaches to the adaptation of daily activities and restoration of participation in patients with foot drop syndrome following complete peroneal nerve transection, in accordance with the principles of the ICF. The methodological framework is based on the biopsychosocial model of functioning operationalized through ICF domains, allowing for the integration of physical, behavioral, and contextual aspects of impairment within a unified rehabilitation framework. A participation-oriented model of occupational therapy intervention is proposed, prioritizing the development of stable performance strategies for daily activities over the restoration of a biomechanically “normal” gait pattern. Adaptation of activities of daily living (ADL) and instrumental activities of daily living (IADL), integration of assistive devices, including ankle–foot orthoses, environmental modification, and training in compensatory mobility strategies are conceptualized as interrelated components of a functional compensation system. Isolated orthotic use has been shown to improve specific spatiotemporal gait parameters; however, clinically meaningful changes at the participation level are achievable only when orthotic support is integrated into activity-based interventions targeting real-life task performance. Particular attention is given to psychosocial factors, including fear of falling and reduced movement self-efficacy, which may act as independent barriers to engagement in daily activities despite partial motor compensation. Addressing these factors within occupational therapy interventions may facilitate improvements in functional autonomy, reduce dependence on external assistance, and support gradual reintegration into socially meaningful roles. The proposed approach enables the conceptualization of daily activity adaptation as a key mechanism for restoring participation in patients with complete peroneal nerve injury and may serve as a framework for planning interdisciplinary rehabilitation programs.</jats:p>