Spastic diplegic, and quadriplegic cerebral palsy; Spinal cord pathology, Challenging neurological and developmental conditions
Clinical Problem: Childhood crouch (flexion gait moment) hamstring and gastroc-soleus spasticity with rear, mid and/or forefoot deformities, shortened hamstring and gastroc-soleus
Common Clinical Measurements:
R1: some dynamic limitation
R2: popliteal -deficit no greater than 10° from normal limits
Weak hip extensors, quadriceps, and gastroc-soleus.
Gait - First (Heel), Second (Ankle), Third (Toe) Rockers
First: Full mid or forefoot contact
Second: Too much hip flexion, knee flexion, and ankle plantarflexion, (or dorsiflexion) in mid-stance.
Third: early heel rise or no heel rise (crouch with no heel contact)
Ultraflex Solution: Custom molded unilateral strut KAFO ADR™ with UltraSafeGait™knee and ankle joints, (Ultraflex recommends placing joint on lateral side except in those cases where the knee would benefit from a medial placement to control the knee medially in the frontal plane)
Clinical goals: Facilitate gait training and a more upright posture, improve first rocker, create knee extension moment in mid to late stance, lengthen hamstring and gastroc-soleus.
Evaluation/Casting: Standard for articulated KAFO. Read more on casting considerations
Evaluation/Ordering Information: Clinical Technical Support
AFO ADR™ Components Only
lateral Joint Ultraflex Universal Joint
medial Joint UltraSafeGait™
>55lb/25kg but < 110lb/50kg :
lateral & medial Joint UltraSafeGait™
UltraSafeStep™ medial Ultraflex Universal Joint lateral
KO ADR™ Components Only
•Safe stance control, without locking the knee, with an Adjustable
Dynamic Response™ and stance control from 0 -30°
•The joint prevents knee buckling from sit-to-standing with ratchet support from 120° flexion to full extension
•The sit-to-stand slide lock/safety release at the joint is low profile and easy to engage and disengage for patients with normal cognition and manual dexterity (no cable release needed)
Ultraflex Custom Fabrication:
Above listed components and ADR™ Measurement Form
Choice of interface: Custom interface available in a wide range of designs (transfer papers) and colors
AFO ADR™ Component Channel Adjustments-Childhood Crouch:
Posterior Elastomer: Little to no compression needed.
Posterior Stop: Only if required for swing clearance and initial contact with heel.
Anterior Elastomer: Near to fully compressed.
Anterior Stop: Only if anterior elastomer compression alone does not create sufficient knee extension moment in mid to late stance.
With special thanks to Amanda Hall Perine, PT, MPT, PCS for her invaluable help in beta testing our prototype ADR™ knee components within unilateral KAFOs for pediatric patients with crouch gait and for refining the clinical program for its proper use in gait and gait training.