KAFO Flashcards
L Trendelenburg =
- L side drops
- R weak hip ABD
Why does a R trunk lean happen with L Trendelenburg?
- shortens hip ABD to a passive shortened position
- attempts to get pelvis close to level
- need clearance on L side
When should a KAFO be considered?
there’s excessive movement of the knee that CANNOT be controlled with an AFO
Knee in midstance: What are the muscles doing? (quads, hamstrings, gastroc)
- quads: firing to extend the knee
- hamstrings: trying to stabilize hip
- gastroc: eccentrically slowing down tibial translation
What should be considered with the knee joint if we think the pt is going to go into a lot of hyperextension?
- should be able to bend/hinge to sit comfortably
- consider if we ned to offset
offset
does the hinge need to be:
- inline
- anterior
- posterior
to the knee joint?
What would you do with offset to correct hyperextension?
- should be neutral/inline
- the hinge will prevent hyperextension from happening
Which patient population will likely need a KAFO?
- spasticity into hyperextension
- knee instability from weak quads (risk for buckling)
- hyperextending the knee on their own
What are the types of knee joints for KAFOs?
- completely open/non-locking
- simple drop lock
- drop lock with ball bearing
- bail lock
completely open joint
- single axis
- allows free movement
Who would use a completely open joint?
spastic hyperextension caused by muscles (not by compensation)
simple drop lock
- locks fall into place with sit «» stand
- requires manual locking
Who would need a simple drop lock?
- someone at risk for buckling
- keep from compensating with hyperextension
- keeps them neutral throughout the gait cycle
drop lock with ball bearing
- must be engaged by the patient (patient-assisted lock)
- able to do things with a free knee but can make it stable if needed
Scenario where a drop lock with ball bearing would be a good choice
- post-polio: have good and bad days
- if we don’t strengthen it, they won’t get stronger
- need the stability when doing community ambulation