Introduction

Mr A presented with Progressive Peripheral Neuropathy of unknown aetiology, worsening over the last 20 years. He walks with a mixture of crouch gait and knee hyperextension
bilaterally; left worse than Right and used a 4-wheeled walker for long distances or SPWS for shorter ones.

Mr A has trialled off-the-shelf carbon AFOs with various tuning combinations, however the rigidity decreased patient’s balance. He also trialled Knee Orthosis to block hyperextension –rigidity but again made him unbalanced.

Mr A has been successfully fitted with the Ottobock Freewalk on his Left side, which controlled his knee hyperextension in stance, but allowed a physiological swing phase.  This added control on the Left, and also helped to control the Right side. It also helped to reduce his flexion and extension moments.  A Freewalk may be considered for Mr A’s Right side in future.

FirstSpiritExport,OBISCM-1557,web_site,orthotics_2,freewalk

Presentation

Gait

Swing Phase: Sound clearance, intermittently mild foot slapping on the LT adequate knee flexion and hip flexion in swing.

Stance Phase: Intermittently RT knee flexion, LT knee hyperextension, occasionally both knees into flexion, drop foot (mild).

Full Range of Motion in Ankle & Knee

Results

No Bracing

With Freewalk

Timed Up and Go (secs)

18.36

22.41

10MWT (secs)

14.74

13.05

Before

After

Comments

Transitions in timed up and go slow me down with the brace

Quality of walking is much better

Knee very much controlled the hyperextension

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