why is it important to mobilise someone quickly?
- stop contractures
- stop pressure sores
- help mental wellbeing
- increase bone density
- stop muscle atrophy
- DVT, deep vein thrombosis
what does LETOR stand for
lower extremity telescopic orthosis
what is a convertible KAFO
- N=28
- 11 replaced with AFO (average 4 months)
- 17 unchanged
- Modified Barthel index
- Actuarial analysis
what is a quick disconnect ?
can be used to disconnect the top piece from the AFO for physio so the patient can mobilise.
The KAFO can be turned into an AFO once the patient has their quadricep function back.
what is a stance control orthoses?
a KAFO that provides:
- stance phase knee stability
AND
- swing phase knee freedom by unlocking at or around terminal stance
- biomechanical principles and functional deficits form the basis of decision making
what are some common gait compensations seen in patients with KAFOs?
- circumduction
- hip hiking
- vaulting
what are the gait benefits of SCO?
- improved knee flexion in swing, increased walking velocity, stride length and cadence
- significant reductions in vaulting and pelvic obliquity have also been found comparing SCO with locked KAFO
- this suggests SCOs may offer users a more natural gait
what is the function of the quadriceps?
- the quadriceps restrain knee flexion during stance and assist extension in swing
- all the quads respond simultaneously
what needs to happen for the knee to unlock in a SCO KAFO?
there needs to be an extension moment in front of the knee joint.
this is why gait training is so important
how long can it take for a patient to benefit from a SCO KAFO, after a locked knee?
6 months
how does a ankle activated SCO work?
dependent on movement of the tibia over the foot to unlock for swing phase
how does a position activated SCO work?
it must be placed in a predetermined position to unlock
how does a weight activated SCO work?
sense load change during stance phase
describe the UTX and free walk
- not good for ML instability.
- Sagittal plane control issues
- low profile
- lateral side bar
- single lateral knee joint
what is stumble control
If the patient doesn’t achieve full extension in TS then when the patient puts their foot down the knee might buckle
what are the components of an electric, weight activated knee joint?
- foot plate sensor
- electric knee joint
- intelligent controller
- battery and charger
what are some common contraindications for SCO use?
- moderate to severe spasticity of the hamstrings
- fixed knee flexion >15°
- significant genu varum/ valgum
- weight limitations
- inability to advance limb because of weak hip flexors or lack of substitute patterns
- significant impaired cognition, balance, motivation or inappropriate expectations
- substantial leg length discrepancy
- other factors according to manufacturers specifications
what is the gain for the patient in SCO?
all users will gait stance-phase stability and swing-phase mobility
does a locked knee or SCO knee have less energy consumption?
SCO has less energy consumption than a locked knee brace
