Jayesh travelled by bus for 2 hours from her small village to come to see the Samuha Samartha’s technical staff. Because she had travelled so far and had made an appointment, she became a priority in the shop, which frequently has people stopping by unannounced. Although Jayesh was made felt like a priority, she had taken a day off from her work as a school teacher to see if changes could be made to her calliper (KAFO) in order to decrease the chronic knee pain she has been feeling. Jayesh has used a calliper on her left leg ever since she had been diagnosed as an infant with polio. She is currently 32 years old and received a surgery a year ago to correct a 30 degree knee contracture she developed on her left leg. The X-rays that were taken a year ago of her knee showed signs of arthritis.
With her friendly attitude and passion for education, Jayesh was a great candidate to use to demonstrate how a patient assessment can help guide a clinical decision towards which orthoses can be made. From the patient assessment we found that Jayesh could not get to the full knee extension range that her current calliper was designed for, performed at a grade 2 score for both dorsiflexion and hip flexion, and her main gait deviation was drop foot. Based on her presentation and the current well maintained state of her calliper, our group discussion concluded that this was an appropriate orthoses. To help with knee pain, the upper thigh shell was rotated 10 degrees in order to match the patient’s range of motion. Two additional straps were used to distribute the force away from the knee cage, which was aggravating Jayesh’s knee pain. Before leaving the workshop Jayesh was told about the importance of keeping an eye on a callus that was discovered during the physical assessment, as well as the importance of stretching her hamstrings to make sure her surgery doesn’t go to waste. Jayesh was excited to leave with her modified calliper to see if the new position of her knee and new straps would decrease her pain.
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