CDS (Controlled Dynamic Stretch) orthoses are widely considered to be the leading active dynamic braces for managing contractures in orthopaedic and neurological applications, as well as others (burns & plastics etc.). Their spring-loaded hinges allow the application of a constant, quantifiable torque around joints throughout the period of application. At the same time, the application of these braces does not hinder function and participation in ADL’s (as with static braces). The braces are available in a wide variety of sizes, from large adult, all the way to infant. The large, anatomically shaped, padded shells can be readily adjusted in shape and position by hand, ensuring a nearly customised fit and therefore minimising pressure by offering large surface areas over which the forces are applied on the skin. This reduces the risk for pressure sores and maximises comfort and compliance with patients. A wealth of other unique features allows clinicians to limit ROM in both flexion and extension, even at single degree increments if required. The braces are easy for patients or carers to apply and remove, by using simple on/off switches to engage/ disengage the torque, as well as special clips to prevent doing and undoing the hook and loop straps repetitively.
One of the most difficult types of contractures to manage are the knee flexion contractures in below-knee amputees. Many of those patients are dysvascular with long-standing mobility problems and other co-morbidities. As a result, some of them already present with knee flexion contractures before the amputation, while others often develop contractures post-operatively. Managing this type of contracture can be very difficult due to many different factors: manipulating a short stump in a proximal-third amputation to stretch the joint can be difficult, the patients often have poor motivation following surgery, assistance from family/ carers may be limited, etc.. Surgery is often not an option for those dysvascular patients, which can leave the w/c stump board as the most advanced technology used! Once established, a knee flexion contracture will usually further increase the energy cost of prosthetic ambulation. In some cases patients are fitted with special bent-knee prostheses, with poor functional and cosmetic outcomes. In other cases the flexion contracture will simply prevent prosthetic ambulation, with all the repercussions in terms of quality of life and extra cost of care.
A new CDS brace has recently been developed by our manufacturing partner Albrecht GmbH in Germany, for below-knee amputees with knee flexion contractures. It offers the same usual features and benefits of a CDS knee extension brace, but the part distal to the knee joint incorporates a shell that fits around the stump and can be adjusted in position as to how distally it extends. The shell can also be removed and the distal part of the brace can attach directly onto a prosthetic socket. As with standard CDS knee extension braces, this brace will also assist knee extension during sitting-to-standing and mid-stance, offering further functional benefits during gait. The CDS knee amputation brace was presented last week at the BACPAR (British Association of Chartered Physiotherapists in Amputee Rehabilitation) annual conference in Wolverhampton, where physiotherapists, prosthetists, orthotists and physicians had the chance to see it and consider its value for their patients.
If you would like to learn more about any of the Brace Orthopaedic portfolio of products, or to arrange a product presentation, please call Customer Services on 0191 258 8944 or alternatively visit www.braceorthopaedic.co.uk/products/