To Lock or Unlock? That Is the QuestionBy Brandt, Jeffrey M.; Rehab Management,
Publication Date: March 2010
Article discusses the option of stance control (SC) for knee-ankle-foot orthoses (KAFOs) with locked knee joints. KAFOs are prescribed for people with walking disabilities due to conditions such as post-polio syndrome, spinal injuries, multiple sclerosis, and muscular dystrophy. SCKAFOs offer a solution to the problem of altered gait patterns associated with conventional KAFOs resulting from not being able to bend the knee. The SCKAFO wearer generates a toe or knee extension moment to cause a manually adjusted joint to release just prior to the swing phase of the gait cycle, allowing the knee to flex or bend; then, during the stance phase of gait, the brace locks to block knee flexion for stability and weight transfer to the brace. Microprocessor-controlled SCKAFOs, in addition, can be calibrated to the user and help the brace adapt to variations in velocity, stride length, and cadence. As there are several options of SCKAFOs, factors for consideration of patient selection discussed include: (1) hip strength; (2) knee angle as well as any presence of knee contracture and hamstring spasticity; (3) patient weight; (4) patient strength and flexibility; (5) cognitive ability; and (6) expectations of function and physical therapy training. The author recommends having a physical therapist present for the trial fitting and notes that most patients are comfortable with their new brace, and rewarded with increased stability and mobility, after 4 to 6 weeks.
Published by: Ascend Media LLC (Website:http://www.ascendmedia.com)
Link to text: http://www.rehabpub.com/issues/articles/2010-03_02.asp