Geriatric orthotic issues

Geriatric orthotic issues

Molly Pitcher C.P.O.

Original post with replies. Thanks to all who responded.

Dear list, Is there a simple way to address transfers for elderly individuals
who need some knee stability during the transfer? I am talking about mostly
non-ambulatory individuals. Is there something between a Step-lock type of
KAFO that can be locked and unlocked in varying degrees of knee flexion vs a
drop lock KAFO where the individual would have to come to a full stand, lock
the kj, pivot, and then sit. Is there anything non-custom that is not fixed
in a permanent position as a fx orthosis would be. I am talking about AP
knee instability not ML.
Thank you for your replies. Molly Pitcher CPO

You might try an Elcross velcro wrap around with knee hinges. Turn it around
backwards so the joints are facing the wrong way. Due to the softness of the
material there is still moderate flexibility despite restricting bending of
the joints...and it goes on and off very easily. Good luck.Jim Price, MEd,
CPO

Without too many details, I don't know if this is viable, but have you
considered simply using an off the shelf knee orthosis? Maybe a sweedish
knee cage? Simple to use, simple to wear, not cumbersome.
This won't help with quad weakness, though. This may suffice for transfers
only and can be tested quickly and easily. Many companies offer a return
policy for 30 days if it doesn't work. However, watch out with payment if
the patient is in an electric wheelchair. Note my previous post. You won't
get paid! Good luck. Joan Cestaro, CP

If you are looking for a locking mechanism, you could also try a simple wrap
style knee orthosis (the
cheap $60 variety) with drop lock hinges. Truform I know that they sell drop
lock hinges for
their braces. Others may off this as well. Again, simple to wear, simple to
operate, non cumbersome. Just another thought. This idea WOULD work for
quad and ham weakness. Again, good luck,Joan Cestaro, CP

Don Joy makes a couple of products you might look at. GLS and another IROM
with a 20 degree stop.Don Shurr CPO,PT

Check your donjoy catalog. They have an inexpensive locking knee
support...actually a few varieties.

For some with Duchenne's just an elastic knee support (without any hinge
creates just enough resistance to knee flexion that the number of falls is
decreased, maybe that would help here as well. Grab bars or poles
strategically installed can be of help also- an OT or soemone who can do a
home eval may provide a worthwhile consultation.

Try Becker. I do not remember the part number but they have a kneejoint
which will accomodate a flexion contracture at varring degrees and has drop
locks, I believe they called it a CP joint years ago.Gordon Bass CPO

Yes, Elcross...they have a complete line of lower, upper, and spinal
applications made from the same material. You can order through SPS and I am
sure other major suppliers such as PEL. The device I am describing is simply
a soft wrap-around velcro closure KO w/ joints.

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