I am currently working with a 7 year-old girl diagnosed with Prader-Willi syndrome. With the extremely low muscle tone and laxity of ligaments, I would have expected more involvement in the foot and ankle complex, but this child actually has a fairly neutral gait. My concern is at the knees, though. Her quad and hamstring strength are both about a 3+ maybe 4- and her medio-lateral stability is more than adequate. She is able to ambulate with no sign of genu recurvatum. In standing, however, she will tend to hyperextend approximately 20-25 degrees and “hang” on the ligaments. This too can be actively controlled with verbal cueing.
My question…
I will fabricate a pediatric neoprene knee sleeve with spiral stays. My hope is that this will provide a constant cueing. I fear though that she will just get used tho this and quickly go back to old habits. Does anyone know if any of the knee brace manufacturers make pediatric ACL type KOs. I would like to take a look side-by-side and see which type of orthosis she responds to better. (and yes I know that I cannot get reimbursement for them
both)
I thought of an AFO, however, I do not want to create any new fuctional limitations that would become evident with a plantarflexion stop.
I would appreciate any input.
Thanks in advance.
Bernie T. Veldman
BOC Orthotist
[email protected]
www.surestep.net
