In message
writes
>List members, I was hoping you could offer some advice.
>I work with stroke pt’s in a acute rehab setting ( often I week post)
>Many of our folk need bracing for ankle and knee stability and we have been
>using a lot of full control anterior trim afo’s set in neutral. My question
>is this: when we receive the afo it is set to true neutral (0 degrees),
>however, when the shoe heel height is added, the tibia is advanced and we end
>up with a brace set in apparent dorsiflexion ( in weight bearing) My problem
>is that many of my pt’s are not benifiting from the knee stability because
>they are getting a flexion moment at the knee at initial contact instead of
>the desired extension one? Also in static stance, the AFO causes the knee to
>flex in order for the foot to be in full contact with the floor.
>I was wondering if anyone else is having similar problems and how best to
>address them.
Hi
Suggest you cast with the foot in a few degrees of p/flexion or cast
with a shaped 1″ heel lift (Standard ht of heel on most shoes). this is
the only way to overcome this. It’s obvious if you cast the foot at 90
degrees that you will get Ant Tibial pitch. you could of course fit
rocker soles to the front to get rid of the natural pitch of the shoe,
but I find that dosen’t really work and patients object to you cahnging
their shoes. I always check out the shoe. If you are fitting to trainers
then, usually no prob.
This is a case of “No way out” unless you accomadate it. Or make all you
patients wear Trainers all of the time!!!!!
Like hell you will..;-))
—
Chris Drake “Life’s a Bitch and then one
pulls out in front of you”
