Allard COMBO/ToeOFF

Allard COMBO/ToeOFF

Douglas Hodge

9/10/2013

Thanks to all who responded. I have included responses.

 What we have done in the past to make a lightweight brace is to get an
OTS ACL knee brace that fits her well. We then cast her for an AFO
incorporating the calf portion of the knee brace. Then when you vacuum
form the AFO you have your mold for attaching the ACL brace. It works well
for this diagnosis and it’s lightweight. I was always under the impression
that the ToeOff AFO had a floor reaction action and so I don’t use it if
the patient has recurvatum. I normally would use an AFO with joints and a
stop or a KAFO. I have never tried the Allard combo.


*Allard has a Combo demo that you can try on her. The trial is for 15
days. They provide the AFO section and the thigh section. I have one
patient using it and he loves it. I have just ordered a trial for another.
 Give their customer service rep a call.*

Good Luck

I came across your inquiry regarding your patient in need of a light weight
custom carbon KAFO. Trulife is proud to present two new KAFO designs which
would be ideal for your patient. The KAFO weights approximately 2 lbs, less
for a smaller individual. We have either a fixed KAFO as well as the COMBO
custom KAFO. The custom COMBO KAFO is detachable and is a fully functional
KO/AFO.****

 I am attaching images of both designs as well as color choices.****

** **

Feel free to contact me If you would like more information on how cast for
this orthosis as well as cost and suggested codes.****

** **

Best Regards****

** **

*Jackie Valdez **BSc., CO(c)*****

Clinical Education Manager****

Trulife
26296 Twelve Trees Lane NW****

Poulsbo, WA 98370
United States

 I started with poor results but have found some tips for success (it's
great for the right person).

I do not use the prefab thigh shells as I feel they are not shaped
correctly and that's always been a fitting nightmare. Rather I cast them
for a custom polypro thigh shell and use copper rivets to attach the
uprights. It's nice to not have to come within 1 of the perineum. I use
the remaining suggested allard components and their instructions. Pretty
straight forward.

Slender/firm limbs are the best candidates, as the pressure behind the knee
will become excessive for fleshier patients. Make sure the recurvatum is
not due to a contracted soleus/gastroc or you will have to accommodate it
with a heel lift.

Since figuring it out I've successfully fitted 4 recently and have been
very pleased with the results. Don't mess up with the components -- allard
is firm on not doing any exchange/refund if any item is used in an way.

Good luck!

Eric Chen, LPO
Atlanta P&O

Very definitely worth a try. Nothing is 100%, but you should have a good
chance of success. The COMBO is by far the lightest KAFO I know of at less
than two pounds.

Consider going up one size on the ToeOFF and trimming it down for a
customized fit to provide a little extra support.

A key to getting patient acceptance is to make the correction gradually.
Going from 20 degrees recurvatum to neutral may be too big of a change in
her gait pattern and that may not be accepted real well. If it is an issue,
it is suggested to make two or three incremental changes in her recurvatum
before finally taking her to neutral. The sub-cortical gait system will
adapt better to gradual changes than to big changes.

Finally see if she can get into some gait training. A lot of the recurvatum
issue can be address by having the patient lean their tibia into the
anterior shell at initial contact. This avoids some of the recurvatum
moment, and does a better job in loading up potential energy in the ToeOFF
to get better energy return in the propulsive phase of gait. Sometimes a
temporary 3/8 heel lift can help the patient learn that new gait pattern.

Good luck!

Bob


Robert Meier, CO, BOCO
Kassel Group Inc


Jason Auyer < <Email Address Redacted> >
10:03 AM (3 hours ago)
to me
I have used it on a few patients. I have had issues when it is used on
overweight patient or large thighs. Works well for thinner patients. To
be honest, if you do Allards CHECK KO it is a lot lighter than the combo.
 However, it is nice to have them all together. Combo has a smaller
posterior check pad but it can still work well to prevent hyperextension.
 This would also give patient the option of using the AFO separately if
just around the house and then add the thigh component for long distances

At this point, I will try the Allard and see how it goes.
--
Doug Hodge, CO
Ortho Design
9591 Valparaiso Ct.
Indianapolis, IN 46268
P: 317.218.4270
F: 317.218.4271
<Email Address Redacted>