FW: hyperkyphosis in the elderly replies

FW: hyperkyphosis in the elderly replies

Lucy Best

8/3/2014

Thank you to all those who responded to my question about effective
treatment of hyperkyphosis.

There was such a great response, so many that I need to put them in 4
emails. Here is part 1.

The gentleman in question is currently trying a loaded back pack which is
says helps him see straight ahead rather than looking at the ground.

Many thanks again!

 

Lucy Best

Orthotist and director of Hampshire Orthotics ltd, UK

 

On 2014-07-12 17:18, Hampshire Orthotics wrote:

I have a gentleman aged 92 years who came to me asking for a spinal brace to
prevent him doubling up when he walks and stands. He has tried corsets
with shoulder straps and a soft LSO Boston style brace in the past but they
did not help at all.
 
He has a flat rigid lumbar spine and hyperkyphosis which brings his head
very anterior of the central line, so there is a massive moment pulling him
down, mostly flexing at the hips.
 
I suspect his best option is to use a high walking stick/frame, but want to
look into orthotic options for him.
 
I think the only way to stop this is to use a body jacket with thigh cuffs,
hip joints set up as in an RGO to enable him to walk (OK to lock for
standing only). He probably wouldn't want to have all that bulk and weight.
 
He walks his dog every day and is the main carer for his wife.
 
Does anyone have any suggestions or orthotic braces they have tried (fails
and successes) for this patient group?
 
I would be grateful for any info and will post all on here.
 
Thanks, Lucy

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I had a client several years ago with similar issues. She was in
mid-sixties and had very weak hip extensors. She was only able to stand and
walk for 5 minutes. Your RGO concept is good, since it solves the hip
flexion issue with the anterior trunk lean. He is fighting gravity in a big
way, he has 70% of his mass leaning forward. The RGO can help manage his
weight-line to minimize the ill effects of gravity.

 

I made a short pants RGO, anterior thigh cuffs, posterior pelvic section and
for the spinal component, I made an anterior Jewett proximal piece, with
step lock joints. The step lock joints allowed the whole top fall away, yet
when you put it on, she would just ratchet it up. I taught her how to
extend to keep her more upright. I used sheep skin padding on the swivel
pad and made it as broad as you can make it. It was able to be donned while
sitting or put on the floor, step into it and pull it up. I took a well
molded cast mold and made it out of carbon composite, strong and light. It
worked so well, she would not sit down, after 30 minutes I had to force her
to sit and rest. About the 20 minute mark, while I was video taping, she
turned around and asked me to marry her. I politely said no, but we had a
nice laugh.

 

We machined and made 95% of all the components. The Jewett, type top
section kept the whole trunk open without being wrapped in plastic.

 

After utilizing the hybrid RGO, she was able to obtain positive follow
through. It stretched her hip flexion contractures and she was able to
stand up straighter and walk further without the RGO. She did not have to
wear it all the time.

 

Good luck, please contact me if you would like to discuss this further,

 

Marmaduke Loke

Dynamic Bracing Solutions

 

6092 Innovation Way

Carlsbad, CA 92009

Office: 760-814-8475

Fax: 760-814-8497

 

 <mailto:<Email Address Redacted>> <Email Address Redacted>

 < <URL Redacted>> www.DynamicBracingSolutions.net

 

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