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Reinforced Energy Storage and return AFOs RES AFO

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Reinforced Energy Storage and return AFOs RES AFO

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    1. Reinforced Energy Storage (and return) AFOs (RES AFO) For RUNNING

    2. spinal vascular tumor 8 ½ yrs Left foot drop after spinal surgery Likes to run Muscle strength Hip abd 3 knee flex/ext 5 dorsiflex 2+ plant flex 4+ tib post 4 peroneals 3 ““

    3. spinal vascular tumor Has not used orthosis in 5 years Introduced to reinforced energy storage AFO 3/16” colyene base material 1/4” PP post. reinfor.(inside) 1/4” PP plantar reinfor. (outside) Flexibility of AFO does not restrict activity – he wants to use it! Adaptable and stable on uneven terrain ““

    4. The Structure and Biomechanics of Reinforced Energy Storage AFOs Applied to Jumping and Running (2 Case Studies)

    5. Cerebral Palsy 14 yrs old spastic diplegia, GMFCS Level I, Previous achilles tendon lengthening Weakness of dorsi/plantarflexors Likes to run Barefoot With reinforced energy storage AFOs and jump

    6. Characteristics of Reinforced Energy Storage AFOs AFO characteristics in jumping Energy storage Structural stability of AFO Interactive forces (orthosis/body) Gait Assessment (running) 3 orthoses, shoes only, barefoot Temporal parameters, AFO flex characteristics Energy storage (impulse)

    7. Energy storage and return in jumping stored energy (PE) due to body height off of ground Stored energy due to bending of plastic Energy return due to uncoiling of plastic

    8. Interactive forces At orthosis compression TBF/GRF Forces on body Forces on orthosis

    9. AFO STRUCTURAL STABILITY Plantar reinforcement Posterior ankle reinforcement Posterior prox. reinforcement Proximal AFO contour

    10. Multiple Sclerosis: Marathon Runner!!!! Diagnosed with MS 25 yrs ago (at age 16) 1/2 marathon runner – running for last 5 years – quality of life Relapse 1 1/2 yrs ago – decreased MS resulting in foot drop Orthosis – helps drop foot Running Before orth: 2 1/2 hour runs Now no orth: 45 min – 1 hour With orth: 1 1/2 hours (after 9 weeks with orthosis) Adjustments didn’t wear brace tight enough – blisters on heels calf cramping feels heavy Goal 1/2 marathon this year full marathon at 50

    11. MS: Runner - orthosis Orthosis materials 3/16 in colyene base mat’l 1/4 in. post tibial reinf. 3/16 in. plantar reinf. 2 ankle straps (1 in.) Lock heel in orthosis Achilles tendon pad as counterforce and take pressure off of heel prominences Low profile No forefoot control Allow metatarsal break (left click top video) Flexibility long and flexible for jogging and walking (left click bottom video)

    12. Club Foot: RES SMO – sports application overview 16 yrs old corrective surgery for club foot plantarflexion contract. hypermobile first ray hallux rigidus weak plantarflexors Passionate basketball player (left click video)

    13. Reinforced AFOs Indications Weak plantarflexors/dorsiflexors Endurance (energy storage and return for increased efficiency) Power (energy storage for performance) Running activities Balance Subtalar joint M/L stability (need outrigger and medial leather strap for high spasticity) Rigid immobilization (low profile) Lack of sensation (low profile) No heat problems Cosmesis Contraindications Strong and functional plantarflexors When only M/L control is needed Nighttime stretching required Ideopathic toe walkers (pre flexed Tamaracks better for this) Stroke patients with slow walking, foot flat contact at initial contact

    14. Take Home Message Energy storage AFOs allow you to enhance rather than restrict the performance of your more active patient

    15. Acknowledgements Donna Twose, Bsc. H.K. C.K. Childrens Developmental Movement Laboratory Karen Litman, BSc. CO(c) Prosthetics and Orthotics Department

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