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Tuesday, May 21, 2013
How to Choose a Knee Brace
I am a post stroke hemiplegiac. I can walk a little with asistive devices ie stoke walker, hemi walker. my knee keeps buckling when I do weight bearing. It really impedes my progress because I am not doing all that I actually can because I am afraid my knee will buckle. It goes forward. It does not hyper extend. My question is what type of a brace can I get off the shelf that will help my knee support the weight and not buckle?
The most appropriate and effective solution to the problem with your knee buckling forward would be based on its cause, which requires a physical examination by your physician, and/or reconsulting with whichever physician oversaw or directed your rehabilitation after your stroke, and/or a referral to a PM&R (Physical Medicine and Rehabilitation) physician.
Potential causes for this include weakness (for example, in the quadriceps muscles in the front part of the thigh), impaired awareness of where your leg and foot are positioned in space, and/or pain or derangement in the hip or knee joint on that side.
Regarding bracing options:
- A "knee immobilizer" is one extreme... this would certainly prevent your knee from buckling - or moving at all - but would necessitate significant and energy-consuming changes to your gait pattern such as swinging the braced leg out to the side to get the foot to clear the ground each time you advance that leg forward;
Another option is a knee brace with adjustable hinges that can be set such that they allow no more than a certain amount of knee motion (for example, preventing the knee from bending more than 15 degrees starting from straight);
Alternatively, a short leg brace called an AFO (ankle-foot orthosis) can be designed to control a knee which tends to buckle forward... such a device is called a "floor reaction AFO" and usually takes the form of a plastic brace with:
- a vertical portion with the lower part open in front of the ankle and lower shin, but whose upper end has a horizontal, rigid section across the front of the upper shin which provides controlling force to an area a few inches below the patella (kneecap) and...
- a sole plate which goes inside the shoe.
Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University