KAFOs for post-polio syndrome patient with stroke
Stacey Richardson
Description
Collection
Title:
KAFOs for post-polio syndrome patient with stroke
Creator:
Stacey Richardson
Date:
12/11/2018
Text:
Male, 65, 215 lbs, 5'7 post-polio syndrome (since infancy), last pair of
braces when 12 years old. Was ambulating with a cane until he had a stroke.
Using chair and lofstrand crutches in SNF. Says he usually gets around the
house by crawling from room to room. Highly active and motivated. Patient
has developed excellent adaptive mechanisms in his daily life. One of his
goals for bracing is that they not contribute to muscle atrophy while he
gets back on his feet.
Left leg muscle grade 2- in all planes for hip, knee and ankle. Passive ROM
within normal limits in all joints/planes. Circumducts and hikes hip to
advance limb. Stance is reliable because his knee will maintain extension
when he bears weight on it. He says he can always lock it out when I'm
standing on it. No knee hyperextension/recurvatum. Insufficient knee
flexion and DF during swing phase.
Right leg was the strong leg until the stroke. Now muscle grade 2 in all
planes for knee and ankle. Passive ROM WNL for hip and knee. Ankle fused as
a child. ~10 degrees passive DF and ~20 degrees passive PF available.
Patient states he feels like the right knee will buckle on him, but he can
prop it against something and it will stay in place. Unable to
mechanically increase toe clearance due to fusion. No circumduction or
hiking of hip in swing phase, but limb advancement is slow.
I was considering stance control for the right side and posterior offset
free knee joint with dorsiflexion assist ankle joints for the left side.
However, I've never had a patient use such different componentry at the
same time, and I'm not sure how the two devices would work together. Does
anyone have any thoughts, recommendations, or componentry selections that I
haven't considered? I'd appreciate the feedback. Thank you:)
Stacey Richardson, CO
Taylor, MI
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braces when 12 years old. Was ambulating with a cane until he had a stroke.
Using chair and lofstrand crutches in SNF. Says he usually gets around the
house by crawling from room to room. Highly active and motivated. Patient
has developed excellent adaptive mechanisms in his daily life. One of his
goals for bracing is that they not contribute to muscle atrophy while he
gets back on his feet.
Left leg muscle grade 2- in all planes for hip, knee and ankle. Passive ROM
within normal limits in all joints/planes. Circumducts and hikes hip to
advance limb. Stance is reliable because his knee will maintain extension
when he bears weight on it. He says he can always lock it out when I'm
standing on it. No knee hyperextension/recurvatum. Insufficient knee
flexion and DF during swing phase.
Right leg was the strong leg until the stroke. Now muscle grade 2 in all
planes for knee and ankle. Passive ROM WNL for hip and knee. Ankle fused as
a child. ~10 degrees passive DF and ~20 degrees passive PF available.
Patient states he feels like the right knee will buckle on him, but he can
prop it against something and it will stay in place. Unable to
mechanically increase toe clearance due to fusion. No circumduction or
hiking of hip in swing phase, but limb advancement is slow.
I was considering stance control for the right side and posterior offset
free knee joint with dorsiflexion assist ankle joints for the left side.
However, I've never had a patient use such different componentry at the
same time, and I'm not sure how the two devices would work together. Does
anyone have any thoughts, recommendations, or componentry selections that I
haven't considered? I'd appreciate the feedback. Thank you:)
Stacey Richardson, CO
Taylor, MI
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Stacey Richardson, “KAFOs for post-polio syndrome patient with stroke,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/209270.
