Short Report from AOPA Meeting in Chicago
Due to a prior commitment in England, I could only attend the first day of this year's AOPA meeting. But, from all reports this was one of the most successful AOPA meetings that anyone could recall. I spotted a couple of new developments on the first day.
New Carbon Fiber Feet
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One of the surprises of the meeting was the debut of three new high performance carbon fiber feet, from a new company called Freedom Innovations. They are being designed and produced by Roland Christensen, PhD who has been quietly creating Flex-Foot products in his rural Utah company for many years.
I was impressed with the thinking behind these feet, which should theoretically be easier to walk on at slow cadences and yet quickly stiffen at a higher pace to allow jogging or running. Reactions from transtibial amputees who participated in the preliminary clinical trials confirmed that the feet seem to perform this way in the real world, although the lower initial spring resistance felt too soft to some folks until they became accustomed to it.
One interesting wrinkle I noted was that the pylon of their high profile foot is inclined anteriorly about fifteen degrees or so. This seems to add a certain amount of vertical compliance and should make this foot feel very "springy".
They have a web site at www.freedom-innovations.com that is still under construction but has some good basic information about the company and their feet. Check out the "two-view" digital photos of their feet: when you move the cursor over the image, it rotates to provide a different perspective
Electronic "Smart Knee" & DA Ankle Adapter for SCOKJ
The folks from Horton's Technologies showed two examples of stance control KAFOs that were electronically operated, using a slightly modified version of their mechanically actuated joints. Basically, they retrofitted electric solenoids onto the joints where the mechanical push rod is normally attached. A heel switch combined with eight standard AA batteries automatically engaged and disengaged the flexion locks.
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They had a patient model walking on both the mechanical and electronic versions during their workshop. The electronic version seemed to work fine, and the patient could easily switch back and forth between both systems. They are beginning clinical trials with their "Smart Knee", and reportedly the final version will have micro-solenoids integrated inside the standard joint housings.
Horton's also developed a small adapter kit that connects their control rods to the posterior channel of a Becker Double Action Ankle Joint. The standard Becker spring provides a dorsiflexion assist; two degrees of motion are sufficient to trigger the stance control knee joints. This should be one of the simplest methods to control these joints.
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Stance Phase Lock KAFO
Fillauer showed Basko's SPL KAFO and had a patient model walking at their booth. As anticipated, this is a gravity-actuated stance control orthosis, so there is no need to fabricate any ankle controls. The angle when the pendulum lock engages and disengages is adjusted on the joint head itself.
The joints are used in pairs. The lateral joint locks in full extension. The medial is designed to snub heel rise, and this is also adjustable. They are sleek and attractive looking, and connect to standard Bock side bars. There is also a clever remote release, mounted either on the orthosis or on the patient's belt, to select free motion, manual lock, or automatic lock.
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This is the third mechanical approach to creating a stance control orthosis released in North America since January, and more variations are on the way. There is little doubt now that stance control will become more and more common in the future, and will gradually change the way we practice as orthotists.
The fabrication manual is available as a PDF file online at www.fillauer.com/customfab/pdfs/splmanual.pdf. Kudos to Fillauer for posting this information so soon after introducing this technology to the US.
