Hi Listmembers,
I evaluated a 50+ lady with CP who has internal hip rotation, knee valgus
(visually exaggerated by the internal rotation), knee flexion contractures
and flaccid ankles which are in varus (to get the foot flat on the floor
with the medial leaning tibia). She can ambulate with great effort using a
cane or walker. Forefoot drag is the first thing I notice that seems to be
holding her back with her highly-compensated method of ambulating. I suspect
I’ll need to hold her in her maximum dorsiflexion to get clearance
To avoid interfering with the compensations/adaptations that allow
ambulation in persons with CP, I understand we try to avoid the temptation
to straighten out deformed joints. I know this would not work with this
patient. But to make an AFO with dorsi assist that would fit her alignment
when standing would result in a very deformed-looking device.
Please let me know what you’ve had success with for this type of case.
Thanks,
Randy McFarland, CPO
