[Orthotics]

I appreciate your continued dialog...I understand that the focus on design should contain the ability to evolve with the patients progress. It would not be a problem for me to fabricate and replicate the PRO AFO with a plantarflexion stop.

Not to toot my own horn but I'm the inventor of Snapstop (adjustable plantarflexion stop) sold and distributed by Otto Bock. If you haven't used it you may want to incorperate it into your AFO's. It sounds like it may be a good functional fit for you CVA patients. The nice thing about this stop is that you can simply adjust it in a clinic setting as the different size bumpers snap in and out. You can dial in you sagittal alignments with this product or simply remove it all together. It can also be used to manage potential contractures by using an additional bumper in the bottom channel to create a dorsiflexion alignment for nighttime use. This allows you to get dual purpose out of your daytime AFO. See attachment.

It is amazing to me that the stoke patients seem to present with the same issues and concerns of the pediatric patients that I see. Tightness with resulting compensated alignments and gait deviations.

Another thing you may want to try if your looking for something in between a solid ankle AFO and free dorsiflexion is to have your orthotist place a Tamarack flexure joint in place of the stop. The joint acts a dynamic tether creating a dorsiflexion limiter as opposed to stop. You'll get about 5 degrees of motion before it locks out creating a little energy. It can have a nice effect on step length for patients who lack third rocker on the involved limb. Again you can just remove or cut the joint and insert Tamarack dorsi assists medially and laterally to stage the AFO and change the entire function. Just some ideas that I use for pediatrics all the time.

I have enjoyed sharing this information and look forward to utilizing this forum as an educational tool and to advance my skills in patient care.

Sincerely,

Scott Hinshon, CO