Please post
Jim Rogers
Description
Collection
Title:
Please post
Creator:
Jim Rogers
Date:
10/27/2011
Text:
I have a patient who presents an unusual neurologic challenge. He is a 58
year old man status post two cervical spine surgeries that have resulted in
residual damage to the nerve roots. He presents as if he has a central cord
defect or upper motor neuron disorder, but in fact he is an incomplete lower
motor neuron defect. His upper extremities move in ataxic patterns but he
can control them and grasp a walker with a small amount of effort. His lower
extremities display a strong extensor pattern if his knees are extended:
Plantarflexion, knee extension with hip and lower trunk hyperextension. He
is rigid and immediately loses his balance posterior. BUT. if his knees are
maintained in a flexed position at about 30 degrees, his tone relaxes and he
can advance his lower extremities and control himself to the point where he
can ambulate with minimal assistance.
Conventional KAFOs with their weight and bulk would not be tolerable but my
question to the list is: Has anyone used the Otto Bock or another stance
control system KAFO to maintain a fixed knee flexion position successfully.
Please provide details as the design criteria is all that stands between a
wheelchair and purposeful ambulation for this motivated gentleman. I'll post
the responses.
Jim Rogers, CPO, FAAOP
***************
Jim Rogers, CPO, FAAOP
Pinnacle O&P Services
5959 Shallowford Rd.
Suite 215
Chattanooga, TN. 37421
Off: 423-648-4898
Fax: 423-499-4979
Cell: 423-987-9559
**************
year old man status post two cervical spine surgeries that have resulted in
residual damage to the nerve roots. He presents as if he has a central cord
defect or upper motor neuron disorder, but in fact he is an incomplete lower
motor neuron defect. His upper extremities move in ataxic patterns but he
can control them and grasp a walker with a small amount of effort. His lower
extremities display a strong extensor pattern if his knees are extended:
Plantarflexion, knee extension with hip and lower trunk hyperextension. He
is rigid and immediately loses his balance posterior. BUT. if his knees are
maintained in a flexed position at about 30 degrees, his tone relaxes and he
can advance his lower extremities and control himself to the point where he
can ambulate with minimal assistance.
Conventional KAFOs with their weight and bulk would not be tolerable but my
question to the list is: Has anyone used the Otto Bock or another stance
control system KAFO to maintain a fixed knee flexion position successfully.
Please provide details as the design criteria is all that stands between a
wheelchair and purposeful ambulation for this motivated gentleman. I'll post
the responses.
Jim Rogers, CPO, FAAOP
***************
Jim Rogers, CPO, FAAOP
Pinnacle O&P Services
5959 Shallowford Rd.
Suite 215
Chattanooga, TN. 37421
Off: 423-648-4898
Fax: 423-499-4979
Cell: 423-987-9559
**************
Citation
Jim Rogers, “Please post,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/233057.
