Poster 362: Application of Microprocessor Stance Control Knee Ankle Foot Orthoses: A Case Series Report

Abstract

Disclosures: W. Yang, None. Objective: To report 4 clinical cases in which patients had improved gait and function with microprocessor controlled stance knee ankle foot orthosis (KAFO). Design: Case series report. Patients or Programs: Patient A was a 52-year-old man with Charcot-Marie-Tooth (CMT) disease. Patient B was a 64-year-old man with paraplegia and bilateral knee osteoarthritis. Patient C was a 42-year-old woman with right femoral nerve injury. Patient D was an 84-year-old man with right leg weakness after a cervical surgery with severe right knee hyperextension.Program Description: Patient A had muscular atrophy and only walked 100 feet each time because of leg weakness and fatigue. Bilateral microprocessor controlled KAFOs with electronic stance control and pressure-sensor (PS-KAFO) were prescribed. Patient B had bilateral lower extremity weakness and cardiac problem. He did not use his traditional KAFO due to high energy consumption and difficulty with donning and doffing. He was prescribed with bilateral PS-KAFO. Patient C had muscle strength of 3-/5 on her right leg. With a traditional plastic and metal KAFO, she experienced increased fatigue that led to decreased usage of the brace. A right microprocessor controlled KAFO with electromagnetic stance control and gyroscope-sensor (GS-KAFO) was prescribed. Patient D had been using a traditional plastic and metal KAFO for many years, with progressively worsening right knee hyperextension and pain on weight bearing. A right GS-KAFO was fitted for this patient. Setting: Hospital-based outpatient clinic. Results: Patient A walked more than 1000 feet each time with the PS-KAFO and regained some lost muscle strength. Patient B walked about 100 feet with a better gait with the PS-KAFO. Patient C walked up to 4 hours a day with much better gait with her GS-KAFO. Patient D walked 125 feet each time with his GS-KAFO. Discussion: A new generation of KAFOs, such as PS-KAFO and GS-KAFO, provides better gait and less energy expenditure. It leads to better mobility and compliance. The pros and cons of different KAFOs, ranging from mechanically controlled to microprocessor controlled KAFOs are discussed. Conclusions: Microprocessor stance control KAFOs improve mobility and compliance.