Neuro-tronic Training in Germany

LOC welcomes a new, bespoke in-house service to their Kingston clinic. Earlier this year, LOC technician Simon and orthotists David and Sam underwent the three-day workshop with Fior & Gentz, global leaders in the development and distribution of orthopaedic systems, based in Lüneburg, Germany.

What is a knee ankle foot orthosis?

KAFOs are used to help those with a range of muscle-weakening conditions such as muscular dystrophy, post-polio syndrome, multiple sclerosis and spinal cord injury. They provide stability to the knee and lower limb and realign and redistribute the pressure on the leg.

Traditionally KAFOs have been heavy, cumbersome, often made from metal. For those that rely on orthotics for support, they can be hindered by discomfort and exhausted from wearing them. Historically, KAFOs have meant a locked knee joint, locking the leg into a stiff, fully extended position. What has been needed is a free-swinging orthotic joint that allows the knee to bend and flex under the wearer’s control.

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Advancing the limitations of orthotics past and present

Walking in a brace or orthoses which locks the knee and leg straight is energy inefficient, requiring a lot more effort and often causing compensatory biomechanical correction on the opposite side, which can lead to problems further down the line. Least of all, walking with one leg that can bend and one that is totally stiff is hard to conceal for people wanting to live a normal, independent life.

Fior & Gentz have not only paved the way in orthotic technology for developing new components and materials but have also taken to teaching and re-educating orthotists on their latest developments and providing training workshops, (they have purposely created many of their products without patents in the hope that they will be copied and adopted by others and more people can be helped by the latest advancements. LOC orthotist David adds:

“In terms of stance-phase technology, Fior & Gentz entered the market and said we could do better. Why are people using outdated technology, why are people preferring to be in a wheelchair when the technology is available to help get them out of the chair and stable enough to walk? They reverse-engineered the problem and designed new technology to improve function and manufacturing technologies. They wanted to create a manufacturing process for a person with 12 months experience and one with 12 years of experience to be able to achieve the same high standard with ease.”

Better technology, better manufacture, better function

The new KAFOs are built using sensors containing gyroscopes that measure the knee, ankle and foot position relative to one another and take a precise digital reading which acts as a reference moving forward. That initial set-up and alignment are referred back to when bending metalwork, setting up bench alignment and eventually fitting the brace. It allows an orthotist to see how static bench technical alignment changes in a dynamic scenario.

Making the most of neuro-tronic technology

The joint sensors and microprocessor understand when a person is standing on the leg and it needs to be locked, and then when the leg is lifted off the ground and swinging through the air, it is therefore required to be unlocked. This means that the knee joint is mechanically stable when standing – stance phase – and releases when the leg is in the air – swing phase. They are generally lighter too, with all joints being made from direct-milled titanium, replacing the conventional two joints with one. The results mean the gait cycle is smoother, it’s easier to walk and requires less energy.

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