Bilateral SCOKJ Fitting

Steve Prendergast, CO recently fitted a policeman who was injured in the line of duty with a pair of KAFOs with Horton's Stance Control Orthotic Knee Joints. He was kind enough to furnish these digital photos and video clips, and granted permission to post them in this Corner.

The patient sustained an incomplete Spinal Cord Injury that resulted in mixed paralysis and paresis in both lower limbs. At this point in his rehabilitation, the gentleman requires bilateral KAFOs with locking knees, but continues to gradually recover some lower limb muscle function. This is an ideal application for these Stance Control joints since extension is not impeded, so the patient can fire his knee extensors with every step.

Modified plantarflexion stops are used to actuate the SCOKJ cam locks.
Modified plantarflexion stops are used to actuate the SCOKJ cam locks.

Steve used ankle articulations to trigger the SCOKJ KAFOs, and he reports that this worked well once the control rod lengths were optimized. Modified plantarflexion stops engage the locks and prevent knee flexion from Initial Contact through Midstance.

Steve Prendergast, CO created these KAFOs that incorporate Horton's SKOKJs bilaterally.
Steve Prendergast, CO created these KAFOs that incorporate Horton's SKOKJs bilaterally.

Once the Tamarack ankles are dorsiflexed a few degrees, the control rod retracts and the joints are ready to release. Because this patient has active plantarflexors on both sides, he can control when heel-off occurs. The knee extension moment that is created by firing his plantarflexors releases the cam locks, and he is able to flex both knees freely during swing phase.

This patient readily mastered bilateral SCOKJ fittings and can walk with nearly normal swing phase motion on both sides.
This patient readily mastered bilateral SCOKJ fittings and can walk with nearly normal swing phase motion on both sides.

A short video clip is available for downloading that shows this gentlemen quite early in his rehabilitation. Video Clip Since this footage was taken, he has learned to walk in the community using bilateral forearm crutches for balance. For more details, you can contact Steve via email at SJPrender@aol.com.



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