Rancho ROADMAP

[Crystal Ramsey]

Christina,

In the ROADMAP, it refers to use of DF stop to address excessive DF or excessive PF. Of course I understand the excessive DF component but would you elaborate on the PF component of the document? Thank you!

[Chrissy Durrough Lugge]

Hi Crystal,

Good question! My best understanding of this part of the algorithm is this: If someone has excessive plantarflexion/knee extension, they likely have knee instability/quad weakness that places them at risk for knee buckling. The dorsiflexion stop provides a guard against potential buckling. Hope this helps!

[Crystal Ramsey]

Thank you! That was my rationale as well!

[Amanda Seneri]

According to this why is it that on exam 2 there is a question that asks which orthoses can reduce knee hyperextension during stance phase. The correct answer on the test is PF stop however DF stop is also an answer choice. According to your reasoning above it seems that DF stop would also be correct. Can you explain this to me because I am getting confused.

[Chrissy Durrough Lugge]

Hi Amanda!

Plantarflexion and knee hyperextension often occur together because they involve posterior translation of the tibia and are both part of the extensor synergistic pattern. By limiting plantarflexion at the ankle via a PF stop, decreased knee extension may also occur.

Excess ankle dorsiflexion would not be expected with knee hyperextension, so a dorsiflexion stop would not reduce knee hyperextension. As theorized above, a dorsiflexion stop may provide some protection against knee buckling that could occur due to the expected knee weakness/instability associated with knee hyperextension but would not change the hyperextension itself.

Hope this helps!

Chrissy

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