polio - stance control
Jeff and Diane Conuel
Description
Collection
Title:
polio - stance control
Creator:
Jeff and Diane Conuel
Date:
1/26/2006
Text:
Presenting a 77 yo man who had polio affecting R LE at age 3. He is
6'2, 190#. He reports he briefly wore a brace, but has not for at
least 70 years. He has zero quad strength. All other muscle groups are
virtually unaffected (dorsiflexion, hip flexion are 4/5. hip extension,
plantar flexion are 5/5 (and therefore he has good calf definition)).
Over the years, the patient has been very active (even downhill skiing!),
and learned to always keep his weightline anterior to knee center when
weightbearing on R. He uses R knee flexion in swing to clear floor
nicely; knee snaps back as he comes into single limb support. Patient
does report a few incidences over the 70 years where he has inadvertently
stepped on a rise with his R heel and buckled, with nasty falls.
Today, his complaint is PAIN due to recurvatum at R knee. He is also
concerned of the occasional fall, as he knows that at his age it could
easily result in a hip fx or the like. Pt is still very active with
walking 4-5 miles and easy hiking. ROM at all joints is normal, except
for the 20 degrees of recurvatum at R knee in weightbearing.
I have many ideas for this patient, but am very interested in the list's
input. He is an engineer and is very interested in the BEST design for
him -- he is in no hurry, and wants to carefully consider the options --
he is not sure he will be able to tolerate a brace.
Your thoughts on 1) KO vs KAFO (patient very concerned about ankle
flexibility for driving)?
2) Stance control brace that also controls recurvatum?
3) Is stance control really better for him, or is posterior offset knee
joints and recurvatum control simpler/more effective?
3) Lightweight, least cumbersome design for this very active, never worn
a brace guy?
TIA,
Diane Tormey CO
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6'2, 190#. He reports he briefly wore a brace, but has not for at
least 70 years. He has zero quad strength. All other muscle groups are
virtually unaffected (dorsiflexion, hip flexion are 4/5. hip extension,
plantar flexion are 5/5 (and therefore he has good calf definition)).
Over the years, the patient has been very active (even downhill skiing!),
and learned to always keep his weightline anterior to knee center when
weightbearing on R. He uses R knee flexion in swing to clear floor
nicely; knee snaps back as he comes into single limb support. Patient
does report a few incidences over the 70 years where he has inadvertently
stepped on a rise with his R heel and buckled, with nasty falls.
Today, his complaint is PAIN due to recurvatum at R knee. He is also
concerned of the occasional fall, as he knows that at his age it could
easily result in a hip fx or the like. Pt is still very active with
walking 4-5 miles and easy hiking. ROM at all joints is normal, except
for the 20 degrees of recurvatum at R knee in weightbearing.
I have many ideas for this patient, but am very interested in the list's
input. He is an engineer and is very interested in the BEST design for
him -- he is in no hurry, and wants to carefully consider the options --
he is not sure he will be able to tolerate a brace.
Your thoughts on 1) KO vs KAFO (patient very concerned about ankle
flexibility for driving)?
2) Stance control brace that also controls recurvatum?
3) Is stance control really better for him, or is posterior offset knee
joints and recurvatum control simpler/more effective?
3) Lightweight, least cumbersome design for this very active, never worn
a brace guy?
TIA,
Diane Tormey CO
********************
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
Jeff and Diane Conuel, “polio - stance control,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/226042.
