David M. was assessed by his Orthotist Mhairi Friel of the Foot and Leg Clinic in Glasgow and fitted with a CDS Knee Extension brace a few months ago, to help compensate for his quads weakness and to correct his knee hyperextension. This is his story:

“I have a background in exercise and knowledge base of sports science. I used to rock climb and was very adventurous. The increasing weakness in my quadriceps took a lot of my mobility away. The cause (as suggested by consultant neurologists at the Queen Elizabeth University Hospital) is lower spine nerve damage, likely as it branches to the left leg. The weakness manifested in 1999 and within a few years, certainly by 2005/6, I was locking out my left knee to walk. For clarity, on a standard, leg extension resistance machine, I cannot move, let alone lift the lightest plate, which in my own gym is 5Kg. I stopped climbing and more recently realised that my walking range (always on a locked-out knee) was becoming far shorter due to pain.

 I literally spent weeks, if not months, trying to find a device that would offer a resistance loading that would counteract the weak extension power of my quadriceps. I chose the CDS Knee Extension. And I needed a private consultant, Mhairi Friel, to order it. Mhairi is an excellent practitioner and nothing should be taken away from her knowledge and service. Without her amazing help and understanding, I’m not sure how things would have been.

 Prior to wearing the CDS Knee Brace, I would find my left knee painful after minimal walking distances (even on flat terrain), all due to the locking out of the joint. Although I also suffer from a weak gastrocnemius, the resistance of the mechanism allows me to walk with a more natural cadence. With the brace on, I found that there was no symptom of discomfort in my knee. In fact, it has been of great benefit to increase some functional performance in my gastrocnemius, especially from an endurance perspective. I have managed to walk up and down hills, even in rough terrain, without any major issue. Of course, I still fatigue but the pain is gone and that allows me to plan for a long journey. The CDS Knee Brace has given me the ability to place weight on a bent knee, taking away the need to constantly lockout. I use the tension function set at a relatively high level – 10. But that has given me tremendous support and confidence when walking. As mentioned, my walking style had also reduced the use of my lower leg muscles but with the brace forcing me to use plantar flexion, I have noticed slight growth and increased endurance, especially in the medial head of my gastrocnemius.

 This was essential for my recent trip to Canada where I knew I would be walking more than normal. Without the brace, I would not have been able to enjoy the sights I saw in my three-week adventure. In fact, without the brace, I have no doubt I could not have even reached those sights – and that is not an exaggeration. Apart from the functionality of the brace, it is remarkably comfortable, considering how much of my leg it covers. It is an invaluable part of my mobility. I literally cannot get far without it.”

Brace Orthopaedic are proud to be sponsoring the “Orthotic Management of Contractures” course taking place at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry today. The course run by the ORLAU (Orthotic Research & Locomotor Assessment Unit) is organised in conjunction with the Orthopaedic Institute.

Brace Orthopaedic distribute the leading range of active dynamic orthoses (utilising spring-loaded hinges) for contractures management in the upper and lower limb, called CDS (Controlled Dynamic Stretch), manufactured in Germany by Albrecht GmbH. The CDS range of orthoses are being used in a variety of pathologies including orthopaedic or neurological lesions, burns & plastics, etc. and cover all sizes of users from large adults to small children. The range includes orthoses for the wrist and hand, elbow, knee and ankle joints, with a recent addition of the only active dynamic orthosis to manage knee flexion contractures of below-knee amputees.

CDS orthoses allow clinicians to quantify the exact amount of force applied on the contracted tissues and define the exact range of movement allowed (with increments as little as one degree and even allowing hyperextension, if required). Features like the easy shaping of the aluminium shells around the limb without the need for a heat gun and the positional adjustment of each shell proximally-distally ensure an optimal fit for users of very different shapes and sizes. User compliance is maximised not only through the careful adjustment of the forces utilised, but also by features such as the large, anatomically shaped shells to minimise applied pressures, the air permeability of the shells, the simple on-off switches for the spring tension and the ski boot-type clips for easy donning-doffing. Significantly, unlike static methods of contractures management, the functional use of the limb treated is being maintained and even enhanced by the use of the forces which can supplement the function of weakened muscles, in order to assist the user to participate in activities of daily living (ADLs).

The Orthopaedic Institute is a charity, in existence since the 1970s and was formed to provide funds for Education and Research in the various Departments of the Robert Jones & Agnes Hunt Orthopaedic Hospital. If you are interested in reading about the research and education projects they have supported then please visit www.orthopaedic-institute.org.

If you would like to hear more about Brace Orthopaedic’s range of CDS active dynamic orthoses or indeed arrange a product demonstration, then please call Customer Services on 0191 258 8944 where Cathryn or Iain would be delighted to help. Alternatively, please visit our website at www.braceorthopaedic.co.uk

The Brace Orthopaedic September featured product is focusing on the CDS® Knee Brace Extension. This product from the Brace Orthopaedic range, functions according to the principle of Controlled Dynamic Stretch and has been designed to treat an extension deficit of the knee.

If you are a UK based clinician and would like to find out more about the CDS® Knee Brace Extension or indeed any of our products, then please contact Iain or Cathryn at sales@braceorthopaedic.co.uk or call 0191 258 8944 for further information or to arrange a product presentation.

#cds #contracture #knee #bracing #orthotics

A couple of weeks ago Alex Falkonakis, Sales Manager and Clinical Specialist, visited the Foot & Leg Clinic in Glasgow run by Mhairi Friel, a Biomechanics Clinical Specialist and Senior Orthotist. Mhairi had a patient who was struggling with functional problems and pain in his left knee. This man was in his fifties, with a suspected lower motor neuron lesion following a back injury when he was in his teens. Over the years this resulted in significant muscle atrophy and weakness in his (L) leg. He had been experiencing functional problems due to increased quads weakness, with his knee buckling when walking down steps or a slope, or if he stepped with his heel on a stone. As a compensation, he got used to locking his knee into full extension during walking which started creating pain at the posterior structures, without however any hyperextension as yet.

Alex assisted Mhairi to fit a CDS knee brace with extension assist on this man. Despite the extensive muscle atrophy, the pliable aluminium shells which can be adjusted in height individually, helped to achieve a perfect fit. The extension assist was adjusted to a level that was supporting his knee extensors adequately, without feeling too stiff during gait. The end result was that the patient was able to walk on even ground and climb up/down stairs without the need to lock his knee, while feeling confident about his knee stability.

If you would like to hear more about Brace Orthopaedic’s range of CDS active dynamic orthoses or indeed arrange a product demonstration, then please call Customer Services on 0191 258 8944 where Cathryn or Iain would be delighted to help. Alternatively, please visit our website at www.braceorthopaedic.co.uk

Brace Orthopaedic was recently contacted by Jean-Richard Wohi, an American Football professional playing for the fourth best team in Europe, Frankfurt Universe. During this season he sustained a season ending injury, rupturing his triceps tendon and required surgery.

His surgery was successful, and he was then placed in a cast for three days. After that, German doctors supplied a CDS (Controlled Dynamic Stretch) Elbow Extension brace and he was told to wear the brace for the next six weeks. CDS works on the principle of low load prolonged stretch and offers a dynamic assistance which can be fine-tuned to the patient, both in terms of force and range of movement adjustment.

Richard, like most professional athletes, has sustained a number of injuries over the years, but commented “This is by far the best product I have ever used and has been a godsend in my recovery. What makes this brace special, is the mechanics contained within it. It assists extension and so it helps my triceps to work easier while it’s healing. It’s also made to restrict movement in the joints to set angles, which in my case were 60, 90 and 120 degrees, which had to be set every two weeks. The first adjustment was done by a Physiotherapist in Germany who had experience adjusting the brace, but then I returned to the UK and was concerned I may not find the same assistance. I contacted Brace Orthopaedic, the distributors of the product, and asked if they had someone in the West Midlands who could assist. I was helped by a lovely lady on the phone called Cathryn who organised for Alex Falkonakis to come and adjust my brace. It was a very professional and prompt service and I could not recommend this product or company more highly.”

If you would like to hear more about Brace Orthopaedic’s range of CDS braces or indeed arrange a product demonstration then please call Customer Services on 0191 258 8944 where Cathryn or Iain would be delighted to help. Alternatively, please visit our website at www.braceorthopaedic.co.uk