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Lower Extremity
Neuro-Orthotic
Solution Portfolio
Prescription Guideline
Lower Extremity Neuro-Orthotic Solution Portfolio
Introduction
This Lower-extremity Neuro-Orthotic Solution Portfolio
from Ottobock is a concise illustration of the rehabilitation
solutions that we recommend to patients in India.
It’s purpose is to assist practitioners and patients to
understand the very many design and hardware options
available to them, ensuring that the most appropriate
solution is provided to each individual.
The solution portfolio is designed to give you prescription
guidelines based on clinical presentations: muscle picture
and deformities that need corrections. At present we cover
solutions for two categories: KAFOs & AFOs.
The benefits of following this approach are:
• The correct prescription for each individual.
• Avoids dissatisfaction due to unrealistic or
inappropriate selections.
• Consistency in the prescriptions offered throughout
the Ottobock national clinical network.
• A clinical approach illustrates our ethical standards
and honest, transparent conduct.
• The required components are always available to
provide a prompt service.
• All colleagues are familiar with the solutions and
have the correct clinical training.
1
Lower Extremity Neuro-Orthotic Solution Portfolio
Arriving at a Prescription
KAFOs					
	 Step I : Selecting a Shell Design		 3
	 Step II : Selecting Knee Function for
		 a. Enhanced Mobility		 4
		 b. Safe Performance		 5
AFOs
	 a. AFOs for Adults			 6
	 b. AFOs for Children			 7
2
Shell Design based on Deformity Correction
Required at the Knee
Knee Valgus
with Flexion
Knee Varus
with Flexion
Knee Valgus with
Hyperextension
Knee Varus with
Hyperextension
3
17B202N2
E-Mag Active
Knee
17Y128
Lamination Joint
Bars
17B66
Multifunctional
Ankle with Relevant
Stops/Assists
17B113
Foot Stirrups, Fish
Tail Design
Laminated Shells
with Blue Fabric
Padding
17B26
Offset Knee Joint
17B28
Side Bar Set, SS
17B66
Multifunctional
Ankle with Relevant
Stops/Assists
17B113
Foot Stirrups,
Fish Tail Design
Thermoplastic Shells
with Thermopaper &
Pedilin Padding
Stance Control KAFO
Indications
• Hip extensors and flexors > 3+
• Plantarflexors > 4
Contraindications
• Knee Flexion Contractures > 15°
• Genu Varum/Valgum Deformities > 15°
• User weight > 85 Kgs
• No possibility of influencing Knee
Extension with a Dorsal Stop
KAFO with Offset Knee Joints
Indications
• Knee hyperextension that can be
deliberately used to stabilize the knee
Contraindications
• Knee/Hip Flexion Contracture
• Limit of Plantarflexion movement
Note
• Patient has to be especially aware to avoid
falls on uneven surfaces
• Knee Hyperextension check to be
incorporated in shell design (Posterior
Calf Shell Design)
Solutions for Enhanced Mobility
KAFOs with Stance Control/Free Knee Joints
Indications: Two Extensor Groups affected KAFO with Stance
Control Knee Joint
KneeSideBarsAnkleStirrups
Shell
Material
KAFO with Offset Knee
Joint
Hip Extensors
3-5
Knee Flexors
0-2
Plantarflexors
0-2
Hip Flexors
3-5
Knee Extensors
0-2
Dorsiflexors
0-2
4
17PK1
CarbonIQ Wedge
Lock Knee
605P8
Profile Bar Stock, Al
17PA1
CarbonIQ
Multifunctional
Ankle with Relevant
Stops/Assists
17PF1
Foot Stirrups
Thermoplastic Shells
with Thermopaper &
Pedilin Padding
Carbon IQ KAFO
17B105
Wedge Lock
Knee,Titan
17Y128
Lamination Joint
Bars
17B66
Multifunctional
Ankle with
Relevant Stops/
Assists
17B113
Foot Stirrups,
Fish Tail Design
Laminated Shells
with Blue Fabric
Padding
17B20
Ring Lock Knee
17B38
Side Bar Set,
SS
17B62
Free-Motion
Ankle* with
Relevant Stops
17B55
Split Stirrups
Thermoplastic Shells
with Thermopaper &
Pedilin Padding
Solutions for a Safe Performance
KAFOs with Locked Knee Joints
Indications: Entire Extensor Loop affected KAFO with Lightweight
Wedge-Lock Knee Joint
KneeSideBarsAnkleStirrups
Shell
Material
Standard Solution
KAFO
Hip Extensors
0-2
Knee Flexors
0-2
Plantarflexors
0-2
Hip Flexors
0-2
Knee Extensors
0-2
Dorsiflexors
0-2
*In case of considerable flexion
tendency, use 17B66 and 17B113
17B97
Short Bail Lock
Knee
17Y128
Lamination Joint
Bars
17B66
Multifunctional
Ankle with
Relevant Stops/
Assists
17B113
Foot Stirrups,
Fish Tail Design
Laminated Shells
with Blue Fabric
Padding
KAFO with Bail Lock
Knee Joint
5
AFOs for Adults
28U23 Walk On Thermoplastic Shell
with Thermopaper &
Pedilin Padding
17B4
Upper Side Bar
17B66
Multifunctional
Ankle with DF/PF
Stops
17B113
Foot Stirrups,
Fish Tail Design
Thermoplastic Shell
with Thermopaper &
Pedilin Padding
17CF1
Carbon Ankle
Seven
Thermoplastic Shell
with Thermopaper &
Pedilin Padding
AFO for Mild Foot-Drop
• Isolated DF weakness
(DF 0-2)
• No instability of Ankle/
Forefoot
• No oedema or sensory loss
• Moderate to severe Foot-
Drop with instability of
Ankle/Foot
• Conditions requiring stop/
assist or stop & assist
Plantar and/or Dorsiflexion
• Need for a Hip and Knee
Extension moment
• Other nontypical clinical
presentations e.g. Cerebral
Palsy or exaggerated tone
AFO for moderate to severe
control at Foot & Ankle
Rigid Ankle AFOAFO for weakness of
Dorsi & Plantarflexors
SideBarsIndicationsAnkleStirrups
Shell
Material
6
• Moderate to severe Foot-
Drop with instability of
Ankle/Foot
• Conditions requiring stop/
assist or stop & assist
Plantar and/or Dorsiflexion
AFO for moderate to severe
control at Foot & Ankle
AFOs for Children
Thermoplastic Shell
with Thermopaper &
Pedilin Padding
17M1=2
Active Contour Ankle
with DF/PF Stops
Thermoplastic Shell
with Thermopaper &
Pedilin Padding
17CF1
Carbon Ankle Seven
Thermoplastic Shell
with Thermopaper &
Pedilin Padding
• Need for a Hip and Knee
Extension moment
• Other nontypical clinical
presentations e.g. Cerebral
Palsy or exaggerated tone
Rigid Ankle AFOAFO for weakness of
Dorsi & Plantarflexors
Ankle
Shell
Material
Indications
7
©OttobockQuickStart=GB-04-2013.V1.IND/LENeuroOrthotics
Corporate Address
Otto Bock HealthCare
Behind FairLawn Housing Society
Sion-Trombay Road, Chembur
Mumbai 400071 India
T +91 (22) 2520 2014
F +91 (22) 2520 1267
information@indiaottobock.com
www.ottobock.in
Join us on: facebook.com/ottobockindia
•	 Only Qualified Clinical Professionals trained by Ottobock
•	 Appropriate Individual Solutions designed to meet your needs
•	 International Standard Service Facilities
•	 Contemporary Rehabilitation Processes & Techniques
•	 Quality German Engineered components
•	 Continuing care through a National Clinical Network
•	 Personal Care with Respect & Dignity
•	 Honesty, Transparency, Accountability
The Ottobock
Quality Commitment

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Neuro-Orthotic Solution - Ottobock (Artificial Leg)

  • 2.
  • 3. Lower Extremity Neuro-Orthotic Solution Portfolio Introduction This Lower-extremity Neuro-Orthotic Solution Portfolio from Ottobock is a concise illustration of the rehabilitation solutions that we recommend to patients in India. It’s purpose is to assist practitioners and patients to understand the very many design and hardware options available to them, ensuring that the most appropriate solution is provided to each individual. The solution portfolio is designed to give you prescription guidelines based on clinical presentations: muscle picture and deformities that need corrections. At present we cover solutions for two categories: KAFOs & AFOs. The benefits of following this approach are: • The correct prescription for each individual. • Avoids dissatisfaction due to unrealistic or inappropriate selections. • Consistency in the prescriptions offered throughout the Ottobock national clinical network. • A clinical approach illustrates our ethical standards and honest, transparent conduct. • The required components are always available to provide a prompt service. • All colleagues are familiar with the solutions and have the correct clinical training. 1
  • 4. Lower Extremity Neuro-Orthotic Solution Portfolio Arriving at a Prescription KAFOs Step I : Selecting a Shell Design 3 Step II : Selecting Knee Function for a. Enhanced Mobility 4 b. Safe Performance 5 AFOs a. AFOs for Adults 6 b. AFOs for Children 7 2
  • 5. Shell Design based on Deformity Correction Required at the Knee Knee Valgus with Flexion Knee Varus with Flexion Knee Valgus with Hyperextension Knee Varus with Hyperextension 3
  • 6. 17B202N2 E-Mag Active Knee 17Y128 Lamination Joint Bars 17B66 Multifunctional Ankle with Relevant Stops/Assists 17B113 Foot Stirrups, Fish Tail Design Laminated Shells with Blue Fabric Padding 17B26 Offset Knee Joint 17B28 Side Bar Set, SS 17B66 Multifunctional Ankle with Relevant Stops/Assists 17B113 Foot Stirrups, Fish Tail Design Thermoplastic Shells with Thermopaper & Pedilin Padding Stance Control KAFO Indications • Hip extensors and flexors > 3+ • Plantarflexors > 4 Contraindications • Knee Flexion Contractures > 15° • Genu Varum/Valgum Deformities > 15° • User weight > 85 Kgs • No possibility of influencing Knee Extension with a Dorsal Stop KAFO with Offset Knee Joints Indications • Knee hyperextension that can be deliberately used to stabilize the knee Contraindications • Knee/Hip Flexion Contracture • Limit of Plantarflexion movement Note • Patient has to be especially aware to avoid falls on uneven surfaces • Knee Hyperextension check to be incorporated in shell design (Posterior Calf Shell Design) Solutions for Enhanced Mobility KAFOs with Stance Control/Free Knee Joints Indications: Two Extensor Groups affected KAFO with Stance Control Knee Joint KneeSideBarsAnkleStirrups Shell Material KAFO with Offset Knee Joint Hip Extensors 3-5 Knee Flexors 0-2 Plantarflexors 0-2 Hip Flexors 3-5 Knee Extensors 0-2 Dorsiflexors 0-2 4
  • 7. 17PK1 CarbonIQ Wedge Lock Knee 605P8 Profile Bar Stock, Al 17PA1 CarbonIQ Multifunctional Ankle with Relevant Stops/Assists 17PF1 Foot Stirrups Thermoplastic Shells with Thermopaper & Pedilin Padding Carbon IQ KAFO 17B105 Wedge Lock Knee,Titan 17Y128 Lamination Joint Bars 17B66 Multifunctional Ankle with Relevant Stops/ Assists 17B113 Foot Stirrups, Fish Tail Design Laminated Shells with Blue Fabric Padding 17B20 Ring Lock Knee 17B38 Side Bar Set, SS 17B62 Free-Motion Ankle* with Relevant Stops 17B55 Split Stirrups Thermoplastic Shells with Thermopaper & Pedilin Padding Solutions for a Safe Performance KAFOs with Locked Knee Joints Indications: Entire Extensor Loop affected KAFO with Lightweight Wedge-Lock Knee Joint KneeSideBarsAnkleStirrups Shell Material Standard Solution KAFO Hip Extensors 0-2 Knee Flexors 0-2 Plantarflexors 0-2 Hip Flexors 0-2 Knee Extensors 0-2 Dorsiflexors 0-2 *In case of considerable flexion tendency, use 17B66 and 17B113 17B97 Short Bail Lock Knee 17Y128 Lamination Joint Bars 17B66 Multifunctional Ankle with Relevant Stops/ Assists 17B113 Foot Stirrups, Fish Tail Design Laminated Shells with Blue Fabric Padding KAFO with Bail Lock Knee Joint 5
  • 8. AFOs for Adults 28U23 Walk On Thermoplastic Shell with Thermopaper & Pedilin Padding 17B4 Upper Side Bar 17B66 Multifunctional Ankle with DF/PF Stops 17B113 Foot Stirrups, Fish Tail Design Thermoplastic Shell with Thermopaper & Pedilin Padding 17CF1 Carbon Ankle Seven Thermoplastic Shell with Thermopaper & Pedilin Padding AFO for Mild Foot-Drop • Isolated DF weakness (DF 0-2) • No instability of Ankle/ Forefoot • No oedema or sensory loss • Moderate to severe Foot- Drop with instability of Ankle/Foot • Conditions requiring stop/ assist or stop & assist Plantar and/or Dorsiflexion • Need for a Hip and Knee Extension moment • Other nontypical clinical presentations e.g. Cerebral Palsy or exaggerated tone AFO for moderate to severe control at Foot & Ankle Rigid Ankle AFOAFO for weakness of Dorsi & Plantarflexors SideBarsIndicationsAnkleStirrups Shell Material 6
  • 9. • Moderate to severe Foot- Drop with instability of Ankle/Foot • Conditions requiring stop/ assist or stop & assist Plantar and/or Dorsiflexion AFO for moderate to severe control at Foot & Ankle AFOs for Children Thermoplastic Shell with Thermopaper & Pedilin Padding 17M1=2 Active Contour Ankle with DF/PF Stops Thermoplastic Shell with Thermopaper & Pedilin Padding 17CF1 Carbon Ankle Seven Thermoplastic Shell with Thermopaper & Pedilin Padding • Need for a Hip and Knee Extension moment • Other nontypical clinical presentations e.g. Cerebral Palsy or exaggerated tone Rigid Ankle AFOAFO for weakness of Dorsi & Plantarflexors Ankle Shell Material Indications 7
  • 10. ©OttobockQuickStart=GB-04-2013.V1.IND/LENeuroOrthotics Corporate Address Otto Bock HealthCare Behind FairLawn Housing Society Sion-Trombay Road, Chembur Mumbai 400071 India T +91 (22) 2520 2014 F +91 (22) 2520 1267 information@indiaottobock.com www.ottobock.in Join us on: facebook.com/ottobockindia • Only Qualified Clinical Professionals trained by Ottobock • Appropriate Individual Solutions designed to meet your needs • International Standard Service Facilities • Contemporary Rehabilitation Processes & Techniques • Quality German Engineered components • Continuing care through a National Clinical Network • Personal Care with Respect & Dignity • Honesty, Transparency, Accountability The Ottobock Quality Commitment