Thank you to all the responses regarding my query about Zero G Brace, I
was grateful to all who took the time to get in touch, what a great
forum for sharing information!!
I have listed the main responses below, for your information:
Just to clarify, I am based in Australia so have removed any info about
US funding etc. The main points I’ve taken from the responses is that
the device has been used widely, with varying results, and is not a
definitive treatment option. Most people have used a custom style PTB
style AFO for longer term treatments.
Responses:
1. Have used them several times with varying results.
2. You may want to look at the TOAD brace as well. It is quite
interesting.
3. I did not have luck with that system, I have found that a custom
PTB type of offloading appliance has worked been more effective. I make
a total contact PTB/CROW hybrid walker.
4. Have you considered an intimately contoured foot orthosis with
shear ban is the at risk areas?
5. While the Zero G is ok, you would probably be better served by
fabbing a PTB type AFO, whether conventional in design, or molded
plastic.
If you go the molded type, incorporate a full length foot plate/lift in
the casting so that you have the necessary clearance built in to the
cast model itself. And given that the patient is already a TT amp, there
should be minimal issues with getting fairly aggressive in the
modification process to achieve maximum off load through the PTB design.
6. The 0G boot is an awesome product. I would not say at offload
100% but very close. It has about an inch thick pad that you placed
under the foot before you tighten it up. I have used about 10 of them so
far with great success.
7. This is similar but custom.
http://www.toadcorporation.com/product-information-2/
I have not tried this out yet but I already have a
couple of podiatrists that are interested and are waiting for the right
candidate
8. We have used the Zero-G in the past. It will provide 100%
offloading, but it is also not a definitive orthosis. I think it would
make a nice transitional device or temporary system, but if you are
thinking more long term, I don’t think that it will hold up. Also, my
experience is that even though you get 100% offloading, it comes with
some significant discomfort.
I would suggest that if you are looking for a longer
term system, that you consider a calf lacer style unloading AFO. We use
these quite often in our practices have had great success.
9. I just fit one of my patients with that type of AFO. I had tried
to use a CROW boot for a couple of months to see if he would be less
sensitive over the lateral and plantar aspect of his foot/ankle due to
multiple ankle surgeries with some equinus/plantarflexion deformity. The
CROW boot did not work out for him so I ordered the Zero G AFO. The
patient instantly liked the off-loading (I would say about 70%) and the
cushioning under his foot (underneath the P-Cell is about a 1″ thick
soft T-foam) First time order was 375.00 plus shipping.
10. I’ve never seen this device and it definitely looks
interesting, however, having fitted several PTB CROW style orthoses, I
know how hard it is to truly unload the plantar surface even with a
custom device and the ZeroG would have to be seriously tight to achieve
it’s aim. I could see it being effective for a young, lightweight calc #
with good skin, but would envisage shear/pressure issues around the calf
for a heavier vascular type patient. (maybe it would work for limited
walking??) If you do try it, I’d be interested to hear the results, as
well as other feedback from the list on their experiences!
11. I don’t know about the zero G but I make a custom design
12. If patient is not obese, do clamshell PTBO. Treat tibial section
of it like as if a TTA. I had them suspended completely with 1/4 inch
clearance. Once again, if not fat, soft, mushy leg. NOTHING holds that.
13. Or, you can do CROW with TTA/PTBO mods proximal, but then you
have to have very strong and compliant patient to close it right and
straps let go eventually. With clamshell, design, as it pivots proximal,
it is much easier to lock leg in place.
14. It’s not a definitive treatment device. It’s designed to last
about 30-90+ days depending on walking habits. If that’s enough to treat
the heel ulcer you’re in business!
15. It works well, surprisingly so!
16. No longer make the Zero G. Use a PTB style offloading crow or
similar.
Original query:
Has anybody had experience with a Zero G Brace (or equivalent)?
It claims to be able to offload 100% of plantar weight bearing loads,
however I would like to know if anyone has had experience in using one
and what the outcome was. I have a complex right TT amputee, with
chronic plantar surface breakdowns on the left foot (mainly heel) with
over active dorsiflexors.
I would be very grateful for any experience anyone’s had with this sort
of device.
I am trying to assess if this device would be better than a CROW/Arizona
style brace for a definitive treatment option.
Many thanks,
Monique
Prosthetist/Orthotist
Austin Health – 2012 Metropolitan Health Service of the Year
Austin Health – 2012 Metropolitan Health Service of the Year
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