What is the common indicator for recurvatum or hyperextended knee?
As it can provide stability of the knee while having a lighter weight than KAFO and is less bulky. Also, one of the common indications for it is recurvatum or hyperextended knee that occurs as a result of weak quadriceps. The design will be incorporated with a dorsiflexion restraint. It is essential that the dorsiflexion resistant is made stiff because the torque created by the body is very high. The AFO will be custom made with moulded plastic and will have anterior trim lines to ensure that it is rigid and does not deform under the weight of the body. It will have a full toe plate, rigid ankle section that is reinforced with carbon fibre sections, and an anterior tibial shell section. As these three components result in a plantarflexion – knee extension couple, causing a knee extension moment. This knee- extension couple aids in the support of the weak quadriceps.
Furthermore, a proximal strap and an ankle strap that is at 45 degrees to the malleoli are utilized for added stability. Finally, accounting for the leg length discrepancy, a 10mm heel rise is added for LLD and the required forward tibial inclination, of 5 degrees. The rest of the tibial inclination angle is provided from the heel height of the shoe so achieve approximately 10 degrees. A shoe raise is also incorporated to address the remaining 5mm of the leg length discrepancy.
To conclude, reviewing the patient after the fitting is important so acknowledge the success rate of prescription or if additional adjustments are required. Furthermore, dealing with muscle weakness of the post-polio syndrome can be physically difficult. Hence a physiotherapy interference may be required to strengthen the muscles. However, KAFO suggestion and advice to the patient may be important if instability was constantly increasing to prevent the risk of falls, and the same ground reaction design can be incorporated into knee- ankle- foot orthosis