ORTHOTIC SYSTEMS KneeAnkleFoot Orthoses KAFOs KAFOs o o

ORTHOTIC SYSTEMS Knee-Ankle-Foot Orthoses (KAFOs)

KAFOs o o o Designs Materials Uprights Joints Control Components

KAFOs o Designs n Metal n Plastic n Hybrid

KAFO Materials o Metal KAFOs n n n Uprights Bands Joints Stirrups Leatherwork

KAFO Materials o Plastic KAFOs n n Thermoplastics Uprights Joints Straps

KAFO Uprights o Aluminum n Lightweight o Stainless Steel n Heavier but stronger

KAFO Knee Joints o Free/limited motion o Locking

KAFO Knee Joints o Single Axis Free Motion n Controls hyperextension n When M-L control is needed

KAFO Knee Joints o Offset Free Motion n Axis is posterior n Increased knee extension stability

KAFO Knee Joints o Polycentric Free Motion n Multiple axes of motion n More closely approximates instantaneous axis of rotation in anatomical knee joint

KAFO Knee Joints o Drop Lock n Metal ring drops over top of joint, preventing flexion n Simplest of locks

KAFO Knee Joints o Bale Lock n Both locks are connected by metal hoop, or bale n Locks are disengaged by pulling bale up n Locks engage automatically when orthosis is extended

Metal KAFO Ankle Joints o Free motion o Dorsiflexion assist o Double-action

Metal KAFO Ankle Joints o Free/Limited Motion n ROM determined by stirrup head shape

Metal KAFO Ankle Joints o Dorsiflexion Assist n Posterior spring creates dorsiflexion moment

Metal KAFO Ankle Joints o Double-action n Anterior & posterior channels allow for insertion of pins and/or springs to provide various combinations of ROM and assist

Plastic KAFO Ankle Joints o Free or limited motion o Variable motion

Plastic KAFO Ankle Joints o Tamarack n Flexible with no ROM control n One variant can produce dorsiflexion assist DF Assist Neutral

Plastic KAFO Ankle Joints o Oklahoma n More rigid than Tamarack with single axis of motion n No inherent ROM control

Plastic KAFO Ankle Joints o ROM Controls n Molded into plastic at time of fabrication n Used in conjunction with previous joints to limit or influence ROM Dorsiflexion Assist Adjustable Stop

Plastic KAFO Ankle Joints o Friddle Variable Motion n Allows fixed or variable ROM n Cannot be adjusted on patient

Plastic KAFO Ankle Joints o Camber ankle joint n Cams are installed to create limited ROM n One of several designs using interchangeable components to produce specific ROM

Plastic KAFO Ankle Joints o Laminated foot plate w/ stirrup n Used when high stress or activity is anticipated n Allows for use of metal ankle joints

KAFO Control components o Supra/Infra Patellar Pads n Generates extension moments above and below knee axis

KAFO Control components o Full knee control pad/strap n Generates extension moment over patella which is actually above knee axis n May have flange (shown) to provide M/L control

KAFO Control components o Adjustable extension component n Position of serrated ring over serrated disc determines point of full extension n Useful for knee flexion tightness/contractures

KAFO Control components o Quad/Narrow M-L Brim n Provides method to unweight knee and distal extremity during stance phase

KAFO Control components o Hip joints/Pelvic band n Created increased hip and trunk stability n Some designs generate a reciprocating action to produce a swingthrough gait