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Dear Murray,
The lady (in her 60s) has grade 1 quads activity, but good hamstrings (grade
4). Her
knee hyperextends so much when standing and walking that she has to pull it
forward
with her hand when she is walking, inorder to get it to flex. Please could you
describe
the nature of the ankle foot orthoses that you mention, and what it actually
does
biomechanically. (It is ages since I did neuro). She asked me about calipers
too.
Her knee hyperextension has been getting progressively worse over time and she
is
becomming quite anxious that she will no longer be able to walk. There are NO
orthoses
available here in Zimbabwe to buy, and her only hope would be to
1. get it hand made (if this is possible)
2. buy it on this trip that she is making to the US. But with no possibility of
follow up on
one she gets there, I want to be sure that she gets the right thing (knee or
AFO). She is
desparate (and so am I).
The Townsend brace for the knee has been suggested to me.
Thanks
Tambu
m> From: [log in to unmask]
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m> From: "Murray Maitland" <[log in to unmask]>
m> Tambu:
m> The lack of knee control may be due to quadriceps and or
m> hamstring insufficiency among the issues here. Is the person
m> hyperextending because of inability to walk with a flexed knee
m> requiring quadriceps muscle activation or is the person unable
m> to control the extension forces due to the quadriceps? I have
m> seen both situations in the clinic here.
m> A long-standing solution to quadriceps muscle weakness in
m> neurological disorders has been to use an ankle foot orthosis
m> because it assists the quadriceps. This solution would not
m> work if the problem was related to knee flexors.
m> Bracing the knee to prevent hyper extension would be a
m> reasonable solution for a hamsting muscle problem but probably
m> would not work if the problem were related to quadriceps.
m> Murray
>>
>>
>>
>> I wonder if anyone could help me out.
>> I have a lady in her 60s suffered form polio. Now walks with
>> one crutch and badly hyperextends on both knees (more than
>> 20deg.) when standing and walking. She has been advised to go
>> into a brace for the particularly bad knee.. One Donjoy that
>> she got in South Africa was had bar across the thigh and across
>> the upper leg which gave her foot drop from pressure on the
>> nerve. Here in Zimbabwe there is virtually zero choice for
>> braces, but she is travelling to US and wanted a recommendation
>> for what brace to get.
>> She needs super light brace and one that stops her from
>> hyperextending. Anyone
>> with experience with this kind of problem or has any
>> suggestion, brand names of braces or if custom made braces are
>> a choice, very light, minimum presure...etc, or email address
>> of companies that make these braces (or calipers) in the
>> US........would be very grateful for any kind of
>> advice.......... Thanks in advance
>> Tambu Masaya
>>
m> --
m> ______________________________________________________________
m> __
m> Murray Maitland PhD PT
m> Associate Professor and Physical Therapist
m> Faculty of Kinesiology
m> Sport Medicine Centre
m> University of Calgary
m> 2500 University Drive NW
m> Calgary, Alberta
m> T2N 1N4
m> (403) 220-8943 office
m> (403) 220-8232 clinic
m> (403) 282-6170 fax
m> [log in to unmask]
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