Posterior leaf spring orthosis

A plastic or carbon fibre orthosis designed to assist in dorsiflexion in swing phase.

1. POSTERIOR LEAF SPRING ORTHOSIS Dr joe antony Md (Physical medicine and rehabilitation) kgmu,lucknow 1

2. Posterior leaf spring orthosis A plastic or carbon fibre orthosis designed to assist in dorsiflexion in swing phase 2

3. Indications 3 CVA Cerbral Palsy Traumatic Brain injury Meningoencaphalitis Spinal cord injury SOL of SC and Cranium GBS Conus medularis Transverse myelitis ALS Multiple sclerosis Cauda equina syndrome PIVD with root compression Sciatic nerve injury Common peroneal nerve injury OP induced delayed neuropathy Lead poisoning DM neuropathy Charcot Marie tooth disease Local injury to Peroneal tendons Muscular dystrophies

4. Role of Dorsiflexors AAOS Atlas of orthosis and Assistive devices 4

5. Mechanism Trimmed slim upright at the level of malleoli Allows plantar flexion at various phases of stance phase Especially in toe off Keep the foot in Dorsiflexion during Swing phase Facilitates the clearance of toes during swing phase AAOS Atlas of orthosis and Assistive devices 5

6. Contraindications Equinus deformity Spasticity of Plantar flexors Heavy patient 6

7. Advantages Light weight and compact Off the shelf orthosis Can be used immediately when needed while waiting on custom made orthosis Can be used with personal shoes 7

8. Evidence for PLS 8

9. Thank you REFERENCES The HELP guide to cerebral palsy AAOS Atlas of orthosis and Assistive devices Braddoms textbook of PMR Böhm H, Matthias H, Braatz F, Döderlein L. Effect of floor reaction ankle-foot orthosis on crouch gait in patients with cerebral palsy: What can be expected? Prosthet Orthot Int. 2018 Jun;42(3):245-253. doi : 10.1177/0309364617716240. Epub 2017 Jul 11. PMID: 28693377. Arazpour M, Gholami M, Bahramizadeh M, Sharifi G, Bani MA. Influence of Reciprocating Link When Using an Isocentric Reciprocating Gait Orthosis (IRGO) on Walking in Patients with Spinal Cord Injury: A Pilot Study. Top Spinal Cord Inj Rehabil . 2017 Summer;23(3):256-262. doi : 10.1310/sci16-00016. Epub 2017 May 4. PMID: 29339901; PMCID: PMC5562033. Campbells textbook of operative orthopedics Mueller M.J, Diamond J.E,  Sinacore  D.R, et al. Total contact casting in treatment of diabetic plantar ulcers. Controlled clinical trial.  Diabetes Care . 1989;12(6):384–388. PMID: 2659299 Armstrong DG, Nguyen HC, Lavery LA, van Schie CH, Boulton AJ, Harkless LB: Off-loading the diabetic foot wound: a randomized clinical trial. Diabetes Care. 2001;24(6):1019–1022. Messenger G, Masoetsa R, Hussain I. A Narrative Review of the Benefits and Risks of Total Contact Casts in the Management of Diabetic Foot Ulcers. J Am Coll Clin Wound Spec. 2018 Jun 7;9(1-3):19-23. doi : 10.1016/j.jccw.2018.05.002. PMID: 30591897; PMCID: PMC6304285. Cakar E, Durmus O, Tekin L, Dincer U, Kiralp MZ. The ankle-foot orthosis improves balance and reduces fall risk of chronic spastic hemiparetic patients. Eur J Phys Rehabil Med. 2010 Sep;46(3):363-8. Epub 2010 Jul 1. PMID: 20927002. 9