Using EDX Studies to Inform Orthotic Interventions-Dr. Munin - Using EDX Studies to Inform Orthotic Interventions

Dr. Munin - Using EDX Studies to Inform Orthotic Interventions

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Summary:<br /><br />This document discusses the case of a 66-year-old man with left leg weakness and pain. The patient experienced sudden onset groin pain that radiated to his left knee, along with difficulty walking and climbing stairs. He had a history of diabetes, hypertension, and lipid disorder, as well as recent weight loss. The physical examination revealed weakness in the left leg, diminished sensation in the toes, and unobtainable reflexes in the left knee and both ankles.<br /><br />Based on an electrodiagnostic study, the diagnosis was left lumbar radiculoplexus neuropathy with active denervation. The suggested treatment for this condition is IV methylprednisolone to treat microvasculitis. To address the patient's severe knee extensor weakness and frequent falls, a knee ankle foot orthosis (KAFO) was recommended. The KAFO will stabilize the knee joint during the stance phase of gait and provide stability to prevent knee buckling.<br /><br />KAFOs can vary in style and design, with different types of knee joints including locked knee, posterior offset knee joint, free knee joint, straight knee joint with drop-lock, and step lock/ratchet lock. Knee orthoses (KO) are less bulky and provide good support but are not as rigid as KAFOs.<br /><br />The document emphasizes the importance of determining that knee extensor weakness is not improving and that it is the cause of frequent falls before ordering a KAFO/KO. It also suggests working with a certified orthotist to determine the best design options and to ensure patient compliance. In this specific case, a lightweight double aluminum upright KAFO with Velcro enclosures, a standard knee with drop locks, and free ankle range of motion were ordered for the patient.<br /><br />Overall, the patient's primary goals were to eliminate the use of a walker and stop falling, and the prescribed KAFO was believed to help achieve those goals.

Keywords

left leg weakness

groin pain

diabetes

hypertension

lipid disorder

KAFO

knee joint

frequent falls

certified orthotist

patient compliance