I. Hip, knee, ankle and foot orthoses (HKAFO), including.
1.RGO:
Principle: Use the mechanical hip joint on both sides of the hip joint to drive the patient to stand and walk therapeutically, assembly plane: TH6-TH12 complete or incomplete spinal cord injury.
Disadvantages: inconvenient for patients to put on and take off, bulky, walking energy consumption, patients generally do not accept.
2.Walkabout.
Principle: Use the mechanical device under the perineum to connect the two KAFOs to improve the patient’s standing stability, the mechanical device under the perineum compensates for the function of the iliopsoas muscle, which facilitates the patient’s center of gravity swing, assembly plane: TH8-L1 complete or incomplete spinal cord injury.
Disadvantages: because the KAFO of both legs are connected together, they cannot resist the rotation of the pelvis during walking, and the stride length is affected.
Second, knee ankle foot orthosis (KAFO): for complete and incomplete spinal cord injuries below L1. Including.
1, the traditional drop ring lock knee ankle foot orthosis.
Principle: mechanical knee joint is a drop ring structure, orthotic knee extension, the drop ring automatically falls and locks the knee joint.
Advantages: cheap
Disadvantages: not easy to unlock, the patient can only sit with straight legs or rely on family members to help if they can not free their hands.
2, the traditional pawl locking knee ankle foot orthosis.
Principle: mechanical knee joint is a pawl structure, the back side of the knee joint has a crossbar connecting the knee joint inside and outside the mechanical joint, orthotic knee straight, pawl automatically drop and lock the knee joint.
Advantages: cheaper than the former, easy to unlock (but must be hip muscles and psoas muscle strength to level 4)
Disadvantages: pawl lock knee joint because of the unlocking principle of the rear crossbar, the rear of the patient’s knee hanging to what the mechanical knee joint is particularly easy to unlock, there are better requirements for the use and safety of the patient.
3, the traditional wire lock knee ankle foot orthosis.
Principle: mechanical knee joint is a line lock structure, the back side of the knee joint has a plastic line connecting the knee joint inside and outside the mechanical joint, the orthotic knee is straightened, the knee joint lock automatically drops and locks the knee joint.
Advantages: easy to unlock by the patient’s hands and the help of family members, small size.
Disadvantages: more expensive, wire lock knee joint because of the unlocking principle of the rear unlocking wire, the patient must free one hand to unlock when using.
4, the modern electromagnetic locking knee ankle foot orthosis:
Principle: The electromagnetic locking knee has a position receptor that automatically unlocks the knee joint when the hip is flexed and when the hip is extended. The knee joint is automatically occluded. The power to unlock and unlock is all powered by the battery of the electromagnetic lock.
Advantages: automatic unlocking reduces the displacement of the patient’s center of gravity during walking, and is correspondingly helpful for the exercise of the quadriceps muscles. The patient’s gait is close to the normal walking gait, and energy consumption is relatively small.
Disadvantages: the patient’s control requirements for the orthosis are high, the knee joint is easy to unlock, which puts high demands on the safety of the patient.
Third, ankle-foot orthosis: used for patients with common peroneal nerve palsy, cerebral palsy, traumatic brain injury, and cauda equina injury below L4.
1.Static ankle-foot orthosis.
Principle: Restrict foot drop and correct ankle inversion.
Advantages: good stability, large correction force
Disadvantages: limited movement of the ankle joint, walking gait is relatively stiff.
2. Dynamic ankle-foot orthosis.
Principle: restrict foot drop, correct ankle inversion.
Advantages: good mobility, relatively good gait of the patient.
Disadvantages: correction force is relatively small, high cost.
Fourth, the foot orthosis: for flat feet, minor inversion and eversion, diabetic foot, heel spur, transverse arch collapse, etc..
Principle: the use of insole production, redistribution of the force system of various parts of the foot.
Advantages: lightweight and easy to use
Disadvantages: relatively weak correction force