Lower Extremity Prosthetics

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Lower Extremity Prosthetics

Knee Orthotics

FNMES

history of phlebitis

defibrillators

healing fracture

metal implants

pacemakers

PD

MS

Stroke

Intact common peroneal nerve

Dorsiflexion

Conventional KO

Malalignment

Genu varum

Genu valgum

Genu recurvatum

Insufficiency of lesser devices

Protection from loading/stress

Control hypermobility

Preventative/corrective tx

Foot Orthotics

Ankle and Foot Orthotics

Solid

Floor Reaction Orthosis (FRO)

Cruciate ligament insufficiency

Recurvatum during stance

Post polio syndrome

Children with CP

Restriction of tibia rolling forward over foot

Hold ankle in slight plantarflexion

Solid AFO

Limitations

Sit to stand

Uneven Surfaces

Stairs

Preposition foot for initial contact

Assist swing foot clearance

Holds ankle in fixed position

Dynamic

Metal (single or double) Upright

Indication

Transition from IC to LR

Edema/swelling

Assist foot clearance

BICAAL (locking mechanism)

Posterior Leaf Spring AFO

Contraindications

moderate to severe hypertonicity

LMN flaccid paralysis of DFs

impaired motor control

Dorsiflexion weakness

Allow ankle rocker function

Preposition foot for IC

Assist limb clearance

Hinged thermoplastic AFO

Neuro

Children w/ CP

Post-stroke

MSK

Ankle protection

Weak ankle mms

Knee hyperextension

Actions

Reduce energy expenditure of walking

PF/DF stop

Hip, Knee, Ankle, and Foot Orthotics

Reciprocal Gait Orthosis

traumatic SCI

hip joint motion for swing phase

rigid stability for stance

Conventional HKAFO

Progressive NM disorders

Myelomeningocele

Action

Extension for upright standing

Restore functional mobility

Knee, Ankle, and Foot Orthotics

Populations

Neurologic

Post-polio

SCI

TBI

CVA

Excessive hypertonicity that overpowers external moments

Abnormal knee varus or valgus

Late stance phase excessive genu recurvatum

Inability to control early stance phase knee flexion

When AFO cannot provide gait or standing stability

Stance Control KAFO

Assists knee flexion

Allows flexion during swing phase

Prevents knee flexion during stance phase

Harder to adjust

Can be hot

Lightweight

Better cosmoses

Interchangability

Locking

Features

Control knee hyperextension

Drop lock knee joints

Bail locking

Single axis joints

Control of knee buckling

Conventional Non-Locking

Indications

Posterior offset joints

Control of mild/moderate varus/valgus angulations

Reduction of knee hyperextension

Strong

Durable

Easy to adjust

Heavier

Less cosmetic

Must be attached to shoe

Components

Superstructure

Knee Control

Ankle Control

Footplate

Shoe