Hemiplegic patient have a common gait deviation during their gait training is hyper-extension of knee or genu recurvatum.
Cause of genu recurvatum are,
1. in case of weakness of platar flexors , . flail foot & weakness in whole limb use HIGH AFO. That is the posterior strap of the AFO is hiogh enough up the lower margine of popliteal fossa.this long leverage prevents it from going backward.
2.But this will not work in patients who walk with forward lurch posture or those who take bigger step length of opposite unaffected leg.the solution for this is very simple reduce the step length of opposite leg and allow him to step by the affected leg instead of going ahead. this will pull back the line of gravity which was falling forward to knee and reduce hyper extension.
3. in hte patients having sever hyeperextension and canr be corerected by all these measures then the last solution is use KAFO for walking.
4. knee surgery are not successful for preventing hyperextesnion.
5. In TA tightness -do stretching but the effect doesn't last longer in the functional activity of walking. so we should give functional stretching. for this use modified AFO{FRO} : shift the calf bad of AFO anteriorly this produces good three point pressure phenomenon and helps in stretching the TA in functional activity of walking and helps in reducing recurvatum.
6. In cases Poor trunk control and imbalance or low postural tone ( Down & hypotonic CP. wok on postural tone , trunk control in addition give AFO & walker with forearm support this reduces the forward flexion of trunk
Cause of genu recurvatum are,
1. in case of weakness of platar flexors , . flail foot & weakness in whole limb use HIGH AFO. That is the posterior strap of the AFO is hiogh enough up the lower margine of popliteal fossa.this long leverage prevents it from going backward.
2.But this will not work in patients who walk with forward lurch posture or those who take bigger step length of opposite unaffected leg.the solution for this is very simple reduce the step length of opposite leg and allow him to step by the affected leg instead of going ahead. this will pull back the line of gravity which was falling forward to knee and reduce hyper extension.
3. in hte patients having sever hyeperextension and canr be corerected by all these measures then the last solution is use KAFO for walking.
4. knee surgery are not successful for preventing hyperextesnion.
5. In TA tightness -do stretching but the effect doesn't last longer in the functional activity of walking. so we should give functional stretching. for this use modified AFO{FRO} : shift the calf bad of AFO anteriorly this produces good three point pressure phenomenon and helps in stretching the TA in functional activity of walking and helps in reducing recurvatum.
6. In cases Poor trunk control and imbalance or low postural tone ( Down & hypotonic CP. wok on postural tone , trunk control in addition give AFO & walker with forearm support this reduces the forward flexion of trunk
