Conventional and Plastic/Metal KAFO's -- I. Subjective Comparisons

JOAN EDELSTEIN, RPT*New York, New York


Fifteen paraparetic children were fitted bilaterally with plastic/metal (PM) knee-ankle-foot orthoses (KAFOs), then with leather/metal (LM) KAFOs. PMs had solid ankles while LMs included limited-motion ankles. Knee control was determined individually for each child and was identical in both orthoses. The subjects, nine of whom are female, ranged from 5 to 21 years, the average being 9 years. Twelve have spina bifida (8 at the L3 level, and the remainder L4), and one each has cerebral palsy, arachnoiditis and nemaline myopathy.

Subjects and/or parents assessed the attributes of each orthotic design independently and then compared orthoses. Respondents rated the comfort, function and appearance of the PMs significantly higher. Twenty-one positive comments were volunteered regarding the PMs, particularly relating to light weight, gait improvement, shoe choice and donning ease, as compared with only 8 positive comments on LMs. PMs provoked somewhat fewer negative comments (PM 10, LM 14), primarily concerning discomfort.

Six months after fitting, ten children wear only PMs, two wear only LMs, while three use both types alternately.

*Prosthetics and Orthotics, New York University, 317 East 34th Street, New York, NY 10016