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Post by deejay on Feb 10, 2019 21:30:09 GMT
Just a small question. My kafo has a removable knee pad. (Velcro straps). If the knee joints are locked, i like the knee pad to be quite tight to hold the leg firmly straight. However, if i want to release the knee locks, the knee pad almost totally stops my knee bending anyway. Sometimes I prefer to remove the knee pad so i can release the knee locks for walking or to sit down.
So my question is...Originally would a knee pad have been fitted to kafos with releasable knee locks? It seems to me that few people would have released the knee locks AND taken off the knee pad to be able to sit down. Especially whilst wearing trousers.
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Post by castmenow on Feb 10, 2019 22:02:41 GMT
My knee pads are reasonably tight when I am stood up with the knee locks engaged in that I do feel some pressure on my knee cap, but when I sit down, they relax slightly as my knee bends but still touch my knee caps so they remain in the correct place for when I stand up again. I believe that this is how they should be set up so that they do not have to be loosened off to sit down and then re-tightened when standing up. I expect that this is all about where the upright bars and knee joints sit in relation to your leg and actual knee joint, which is not a simple hinge. If the hinge is not at the right height or too far forward or too far backward then there may be problems and the knee pads will not relax at all or relax too much. I recall from your other posts that your braces were not made for you but have just had new leather on, so the knee joint and upright position may not be entirely accurate for you. Photos show how mine work, both photos taken at the same time without any adjustments between. Attachments:
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rk52
Junior Member
Posts: 79
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Post by rk52 on Feb 11, 2019 9:46:29 GMT
Yes, the hinge needs to be in the correct position relative to your knee joint for things to work properly. For example, if the hinge is too low, when you sit down the top half of the uprights will sit lower than it should, hence it will pull on the top straps of the knee pad. Similarly if it is too high and you adjust the straps when sitting, when you stand up the knee pad will be too tight. I found this out very soon after getting my first (right leg) brace; the lower half of the uprights was an inch or so too short and I was unable to bend my knee very far without straining the knee pad. I lengthened the lower section with a couple of metal strips - problem solved!
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Post by deejay on Feb 11, 2019 18:41:02 GMT
Yes, I see what you mean. In fact the hinges do seem to be at exactly the right height but perhaps are very slightly back when bent. That would, of course pull a bit more on the kneecap. The other difference between mine and yours is that the leather on mine goes around the back as well, although it is narrower at the back. There are three pairs of velcro straps. The first pair on the left upright, then the leather goes behind the knee. The next straps are on the right upright, then the leather passes aver the front of the kneecap and the last straps attach to the left upright again to keep it tight across the front. ( I will see if I can take a pic when I have time ). Of course that means that it gets tighter when the knee is bent, hence the puzzle. If I don't want the locks to be released, it does a great job of keeping the knee firmly straight though.
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Post by deejay on Feb 11, 2019 20:16:15 GMT
Pics: Having to add these separately as I am not enough of an expert!
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Post by deejay on Feb 11, 2019 20:18:46 GMT
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Post by deejay on Feb 11, 2019 20:19:58 GMT
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Post by deejay on Feb 11, 2019 20:20:58 GMT
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Post by deejay on Feb 11, 2019 20:24:02 GMT
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Post by deejay on Feb 11, 2019 20:25:35 GMT
6 Sorry, sending multiple shots but I couldn't see any other way to do it. (or how to put them the right way up!) Attachments:
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rk52
Junior Member
Posts: 79
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Knee pads
Feb 11, 2019 20:30:32 GMT
via mobile
Post by rk52 on Feb 11, 2019 20:30:32 GMT
It looks to me as if the hinges are too low, particularly the inner one. The photo where your knee is bent especially shows that I think.
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Post by castmenow on Feb 11, 2019 20:30:33 GMT
I know the type of knee pads you mean, sometimes called 5 buckle knee pads. These obviously are more critical of the knee hinge location plus the location of the upright bars between the front and back of the leg. I bought a second hand left KAFO from ebay once that had such a knee pad with Velcro straps. The calf section had adjustable height screws so I got the hinge spot on and the placement of the uprights was also good. I did not need to adjust the pad between standing and sitting. I sold this on several years ago before buying my current braces.
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Post by castmenow on Feb 11, 2019 20:38:21 GMT
I also wonder if the uprights are too far towards the front of your leg, this means that the knee pad straps are short when standing, but when you bend your leg, they need to be longer, which the low knee hinge will exacerbate, because the thigh upright is now held towards the back (bottom) of the thigh by the low knee hinge. I have some references to the correct knee hinge location but I am away from home tonight on my tablet so can not post them. I may also have some more photos at home of the left KAFO with a straight leg for comparison.
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Post by deejay on Feb 11, 2019 22:30:11 GMT
Yes I just took the photos for interest really. I know it looks like the hinge is too low in the picture but it isn't really. It does come exactly where you can put your finger at either side off the knee and imagine the hinge-point.
Anyway, really I know its the fact that the pad surrounds the knee that stops it from bending. I don't really mind as if I want it to be absolutely rigid, I fit the knee pad. If I want a mixture of locked and unlocked, I don't fit it.
If (when) I ever get to wear it in public, I would not fit the knee pad and can then unlock to sit down.
When I get around to it, I will modify the shape of the outer upright to make it sit a little closer to the knee. It will just look a bit better esp if it is under trousers.
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Deleted
Deleted Member
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Post by Deleted on Feb 12, 2019 14:41:56 GMT
Deejay, that's a nice neat looking KAFO. Despite the queries about knee hinge position, it looks like a reasonable fit to me. Certainly much better than mine! My KAFO was second hand and I think had been refurbished at some stage in its life. I had to do a fair amount of modification to get it to fit me - including re-positioning the inner upright so I could wear it under trousers. What I did find was that it is important that the uprights do not exert any pressure (directly or via the leatherwork) on the sides of the knee as, for me, it became quite painful with prolonged wearing.
Mine has two corset type cuffs, one for the thigh and the other for the lower leg. It has no knee pad. Getting the thigh cuff just right is easy but I find it really difficult to adjust the lower cuff. If it is tight enough to hold my leg rigidly then there's tendency for my foot to go to sleep! I think this is because the hinges are in the wrong place but also the lack of a knee pad. I prefer to wear mine so it holds my leg as rigid as possible.
I did ask VB to quote for a new knee pad but they wanted more than I paid for the KAFO itself. Instead, I have a single strap with gel pad attached which is positioned above the hinges. With careful tightening, this seems to hold my leg straight when the locks are engaged but also allows me to sit down with my knee bent without the strap moving out of position. If (when!) I get a made-to-measure from VB, I'll almost certainly be specifying a 5-buckle knee pad.
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