Component Selection - Areas of Specialty

Spasticity Management

Spasticity from a Cerebral Origin, CP, CVA, TBI - Pediatric

Clinical Problem

Ultraflex Solution

Multi-level lower extremity spasticity, adductors, hamstrings, gastroc-soleus (quadriplegia, diplegia)

HKAFO recommended components:
EO SS2L; EO P3L; Hope1 Kit  
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Hamstring spasticity
(quadriplegia, diplegia)

KAFO recommended components:
KO SS1 (x2); KO P1, P3 or P5 depending on weight (P1>50 kg, P3>25 kg, P5 <25 kg), add

Pediatric:< 25 kg (no donning lock desired)
AFO PROM T for ankle ROM stop
AND/OR
KO PC1 and KO PROM
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Gastroc-soleus spasticity
(quadriplegia, diplegia)

KAFO recommended components:
AFO SS1T (x2), AFO P1T, P3T, P5T depending on weight (P1>50 kg, P3>25 kg, P5 <25 kg)

Pediatric:< 25 kg (no donning lock desired)
AFO PC1 T and AFO PROM T for
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Soleus spasticity
(hemiplegia)

AFO with SMO recommended components:
AFO SS1T (x2), AFO P1T, P3T, P5T depending on weight (P1>50 kg, P3>25 kg, P5 <25 kg)

Pediatric:< 25 kg (no donning lock desired)
AFO PC1T and AFO PROM T
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Upper extremity flexor-pronator spasticity (quadriplegia)

EWHO recommended components:
EO SS1; EO P1, P3 or P5 depending on weight; (P1>50 kg, P3>25 kg, P5 <25 kg)

Pediatric: < 25 kg (no donning lock required)
EO PC1 and EO PROM
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Spasticity, good passive range but lacking reach, grasp and pinch and active supination
(hemiplegia)

EWHO FirstFlex recommended components:
EO SS1; EO P1, P3 or P5 depending on weight; (P1>50 kg, P3>25 kg, P5 <25 kg). WHO PROM (x2), DFP Dynamic Finger Pan

Pediatric:< 25 kg(no donning lock required)
EO PC1 and EO PROM
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Traumatic Brain Injury – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Gastroc-soleus and intrinsic foot spasticity; Equino-varus deformity that cannot be corrected with ankle in maximal plantar flexion.  

AFO - Lively recommended components:
AFO SS1 (x2); AFO P1. LSK with subtalar lockout
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Cerebral Vascular Accident – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Tight intrinsic finger flexors and wrist flexors

WHO recommended components:
WHO PC1, WHO PROM
OR
WHO AA1, WHO P5, WHO PROM (if donning lock is needed) 
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Spasticity, good passive range but lacking reach, grasp and pinch and active supination (hemiplegia)

EWHO FirstFlex recommended components:
EO SS1; EO P1, P3 or P5 depending on weight; (P1>70 kg, P3>50 kg, P5 <50 kg). WHO PROM (x2), DFP Dynamic Finger Pan
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Erbs Palsy/Brachial Plexus Injury - Pediatric

Clinical Problem

Ultraflex Solution

Injury causes muscle imbalance leading to flexor-pronator posture and loss of active supination

EWHO recommended components:
EO SS1; EO P1, P3 or P5 depending on weight; (P1>70 kg, P3>50 kg, P5 <50 kg) OR EO PC1 and EO PROM < 25 kg (no donning lock required)
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Pediatric Gait Deviations - UltraSafeGait™ Adult/Adolescent Gait Deviations - UltraSafeStep™ - patients 110 lb/50kg - 250 lb/115kg

Post stroke, Post Polio syndrome, ankle instability – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Drop foot, foot slap or crouch gait

AFO USS recommended components:
AFO USS components medial and lateral > 70 kg; AFO USS medial with Ultraflex Universal Joint lateral <70 kg
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Post stroke, Cerebral Palsy, Post Polio Syndrome, incomplete spinal cord injury – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Gross low extremity weakness causing combined knee and ankle instability

KAFO USS recommended components:
KO USS at knees; AFO USS components medial and lateral

Patients > 70 kg; AFO USS medial with Ultraflex Universal Joint lateral <70 kg
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Pediatric Gait Deviations - UltraSafeGait™ - patients up to 110 lb/50kg

Spastic hemiplegic, diplegic and quadriplegic cerebral palsy; Peripheral weakness; Spinal cord pathology; Idiopathic toe walking syndrome; Post-stroke, Challenging neurological and developmental conditions

Clinical Problem

Ultraflex Solution

Early Childhood Equinus (Extension Gait Moment) Soleus Spasticity with flexible rear, mid and/or forefoot deformities

< 55lb/25kg:
lateral joint Ultraflex Universal Joint
medial joint UltraSafeGait™

>55lb/25kg but < 110lb/50kg:
lateral & medial joints UltraSafeGait™

Clinical Problem

Ultraflex Solution

Late Childhood Equinus (Extension Gait Moment) Soleus Spasticity with rigid foot deformities

> 55lb/25 kg but < 110lb/50kg: 
UltraSafeGait™ components medial and lateral 

> 110lb/50 kg:
UltraSafeStep™ medial with Ultraflex Universal Joint lateral

Clinical Problem

Ultraflex Solution

Early Childhood Crouch (Flexion Gait Moment) Hamstring and Gastroc-Soleus Spasticity with flexible rear, mid and/or forefoot deformities

<55lb/25kg:
lateral joint Ultraflex Universal Joint
medial joint UltraSafeGait™

>55lb/25kg but < 110lb/50kg :
lateral & medial Joints UltraSafeGait™

Clinical Problem

Ultraflex Solution

Late Childhood Crouch (Flexion Gait Moment) Hamstring and Gastroc-Soleus Spasticity with rigid rear, mid and/or forefoot deformities

> 55lb/25kg but < 110lb/50 kg:
UltraSafeGait™ components medial and lateral   

> 110lb/50 kg:
UltraSafeStep™ medial with Ultraflex Universal Joint lateral

Clinical Problem

Ultraflex Solution

Childhood Crouch (Flexion Gait Moment) Hamstring and Gastroc-Soleus Spasticity with rear, mid and/or forefoot deformities

<55lb/25kg:
lateral joint Ultraflex Universal Joint
medial joint UltraSafeGait™

>55lb/25kg but < 110lb/50kg :
lateral & medial joint UltraSafeGait™

> 110lb/50kg:
UltraSafeStep™ medial Ultraflex Universal Joint lateral

See KO CM Neuro page for theraputic knee joint option addition

See UltraQuickRelease™ Page for Day/Night Bracing option KAFO / AFO

Ortho Rehab

Biceps Tendon Repair – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Power lifting injury - biceps tendon avulsion

EO Bi-Directional recommended components:
For custom molded or made to measure EO SS3, EO P7, EO ROM ;
for prefabricated EO CF with EO SS3, EO P7 and EO SS2
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Severe elbow, forearm and/or wrist trauma and post-op – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Loss of elbow flexion and/or extension motion in early rehab

EO recommended components:
For custom molded or made to measure EO SS1H with EO P1H, P3H or P5H for extension assist
OR
EO SS3 and EO P7, EO ROM ; for prefabricated EO CF with EO SS3, EO P7 and EO SS1
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Loss of supination and/or pronation motion in early rehab  

EWHO recommended components:
WHO P11
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Below Knee Amputee – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Limb loss below knee, post op loss of motion

KO recommended components:
KO SS1H (x2) KO P1
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Total Knee Replacement – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Post op loss of extension and/or flexion in early rehab

KO recommended components:
For custom molded -
Extension assist: KO SS1H (x2) KO P1H
Flexion assist: KO SS2 (x2) KO P2,
Bidirectional: KO SS3 (x2) KO P9

Custom Fit Units
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Iliserov or external fixation for trauma - Pediatric

Clinical Problem

Ultraflex Solution

Maintain soft tissue extensibility throughout extended rehab

Ilzarov recommended components:
KO IL1;AFO IL1
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Loss of motion - great toe post surgery – Adult/Adolescent

Clinical Problem

Ultraflex Solution

Post operative loss of great toe motion impacting gait

GTO recommended components:
AFO PC1T; AFO PROM T
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