Overview Guide ii - Becker Orthopedic
Overview Guide ii - Becker Orthopedic
Overview Guide ii - Becker Orthopedic
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Stance control<br />
<strong>Overview</strong> <strong>Guide</strong> <strong>ii</strong>
2<br />
Taking the Step into Stance Control<br />
Gary G. Bedard, B.Sc., co, FaaoP<br />
In his paper on the Biomechanics of Ankle-Foot Orthoses: Prescription and Design, Justin<br />
Lehmann, MD, outlined three basic considerations for prescribing an AFO. His first consideration<br />
suggested, “One must recognize that these orthoses are worn by many patients who can walk<br />
without them, but who cannot walk safely.” Those are good words not only for the application<br />
of an ankle foot orthosis, but are logical words to follow when finding your first candidate patient<br />
for stance control knee ankle foot orthoses (SCKAFO).<br />
Stance control as a viable clinical tool has been around for approximately four years. The<br />
majority of practitioners have fitted less than ten patients with this technology and many have<br />
not found their first patient. The ideal first patient is one that presents with an isolated quadriceps<br />
muscle deficit. These patients, as in the opinion of Lehmann, can usually walk, but will often<br />
have episodes of falling or high instability. It is not uncommon to find that these patients have<br />
censored their ambulatory time to reduce their risk of falling. The referring physician and the<br />
patient are both looking for an Orthotist who can suggest an orthosis that will stabilize their<br />
affected limb in stance phase and offer safe ambulation.<br />
The patient who presents with a femoral mononeuropathy (FMN) is a good first candidate for a<br />
SCKAFO. The gait normalizing affect of the orthosis will offer them a secure stance phase and will<br />
avoid the circumduction and hip hiking pathomechanics that are common to a static drop lock<br />
KAFO. Once you have successfully managed a FMN case, then you will begin to develop the<br />
ability to find more challenging patients who have multiple pathologic factors but still can be<br />
candidates for successful SCKAFO intervention.<br />
In the majority of these cases, the patients are relatively young, in their middle years, present<br />
with full cognition, and have no secondary restrictions in the affected limb such as an arthroblock<br />
or ligament restriction on the ROM of the knee or ankle, and usually have 5/5 muscle<br />
strength for all the other components of the limb.<br />
Full cognition is also an important factor as a SCKAFO is more complicated than a simple drop<br />
lock or bail lock orthotic knee joint. The patient will need training in the operating mechanism of<br />
the SCKAFO. The patient needs to understand maintenance procedures and the understanding<br />
of the operating mechanism will help in the gait training required to modify their gait to actuate<br />
the orthosis during ambulation.<br />
referenCeS:<br />
Biomechanics of ankle-Foot orthoses: Prescription and Design, lehmann, J.; arch Phys Med rehab, Vol 60, May 1975<br />
Update on nerve palsy associated with total hip replacement. Schmalzried tP, noordin S, amstutz Hc. clin orthop 1997<br />
nov;(344):188-206
TABLe Of COnTenTS<br />
Stance Control Matrix 4<br />
Patient Assessment form 5<br />
Model 9000 6<br />
GX-Knee<br />
Model 9001 8<br />
e-Knee <br />
Model r9001 10<br />
rehab e-Knee <br />
Model Lr 9002 12<br />
load response<br />
Model 9004 14<br />
UtX ®<br />
Model 9005 16<br />
SafetyStride <br />
Model 9006 18<br />
FullStride <br />
Stance Control Orthometry form 20<br />
Stance Control Options 21<br />
uTX ® Orthosis Selection Protocol form 22<br />
uTX ® Orthosis Measurement form 23<br />
Phone: (800) 521-2192 (248) 588-7480<br />
fax: (800) 923-2537 (248) 588–2960<br />
<strong>Becker</strong><strong>Orthopedic</strong>.com
<strong>Becker</strong> Stance Control Knee Joint Matrix<br />
the following matrix can be used as a quick reference guide to help determine your patient’s<br />
compatibility with our Stance control Systems. We also recommend you take the time to review our<br />
Patient assessment Form on the following page to accurately assess your patient before purchasing any<br />
of these products. If you would like to speak with one of our Stance control experts, please complete<br />
and fax the Patient assessment Form to either <strong>Becker</strong> orthopedic or <strong>Becker</strong> oregon prior to scheduling<br />
your private consultation. It will serve as a common point of reference for us to understand your patient<br />
and help assist you in selecting the best product to suit their needs. nOTe: A reference chart for Manual<br />
Muscle Testing can be found on page 5.<br />
univerSAL COnTrAindiCATiOnS fOr ALL Our STAnCe COnTrOL SySTeMS inCLude:<br />
• Significant impairment in the patient’s cognition and/or motivation.<br />
• Significant knee spasticity.<br />
• Knee flexion contractures greater than 10°.<br />
• If follow-up, or compliance on the part of the patient is uncertain.<br />
LOCKinG AnGLe<br />
And MeCHAniSM<br />
HiP eXTenSOr<br />
STrenGTH<br />
(MiniMuM reQuired)<br />
HiP fLeXOr<br />
STrenGTH<br />
(MiniMuM reQuired)<br />
AnKLe r.O.M.<br />
(MiniMuM reQuired)<br />
Knee eXTenSiOn<br />
r.O.M. reQuired<br />
4<br />
Load response GX-Knee uTX ® e-Knee fuLLSTride SAfeTySTride <br />
Allows 18° of<br />
resisted knee<br />
flexion at heel<br />
strike. Positive<br />
stop at 18°.<br />
Provides knee<br />
extension assist in<br />
swing phase. no<br />
positive stop in<br />
stance phase.<br />
requires full knee<br />
R.O.M. to 180°<br />
for locking<br />
mechanism to<br />
engage.<br />
Provides positive<br />
lock in<br />
increments of<br />
8° at any flexion<br />
angle.<br />
requires full<br />
extension of the<br />
orthotic knee<br />
joint mechanism<br />
to engage.<br />
Mechanical<br />
locking<br />
mechanism will<br />
resist knee flexion<br />
at any angle.<br />
no requirement Grade 4 Grade 3 *no requirement *no requirement *no requirement<br />
no requirement Grade 4 Grade 3 no requirement *no requirement *no requirement<br />
no requirement no requirement<br />
not<br />
recommended<br />
with a knee<br />
flexion<br />
contracture.<br />
Metal uprights<br />
can be contoured<br />
to accommodate<br />
contractures of<br />
10° or less.<br />
weiGHT LiMiT 105 - 220 lbs. 220 lbs.<br />
Genu<br />
vAruS/vALGuS<br />
Bi-LATerAL uSe<br />
Yes –<br />
For correctible<br />
valgus only if<br />
less than 15°.<br />
Yes - caution<br />
advised<br />
Yes<br />
Yes - caution<br />
advised<br />
5° of passive<br />
dorsiflexion in any<br />
range.<br />
Metal uprights<br />
can be contoured<br />
to accommodate<br />
contractures of<br />
10° or less.<br />
265 lbs. (220<br />
lbs. for Swing FS<br />
models)<br />
Varus – Yes, if less<br />
than 10°.<br />
Valgus - Yes<br />
Yes<br />
no requirement<br />
no requirement<br />
Sufficient (3-5°)<br />
ankle and/or<br />
forefoot<br />
movement to<br />
generate 4 mm<br />
of cable<br />
excursion.<br />
Metal<br />
uprights can be<br />
contoured to<br />
accommodate<br />
contractures of<br />
10° or less.<br />
Sufficient (3-5°)<br />
ankle and/or<br />
forefoot<br />
movement to<br />
generate 4 mm<br />
of cable<br />
excursion.<br />
no requirement<br />
220 lbs. 220 lbs. 220 lbs.<br />
Yes –<br />
For correctible<br />
varus or valgus<br />
less than 10°.<br />
not<br />
recommended<br />
unless patient is<br />
an advanced<br />
e-Knee user.<br />
Yes Yes<br />
Yes Yes<br />
* a walking aid may be necessary if patient is less than Grade 3,<br />
consider adding GX-assist option. See pages 17 and 19 for details.
Patient Assessment form<br />
today’s Date: orthotist:<br />
Facility:<br />
Street: city: State: Zip:<br />
Phone number: Fax number:<br />
DateS: assessment: Delivery: Follow-up:<br />
Patient ID: affected Side: left right Bilateral<br />
Height: Weight: age: Gender: M F<br />
Diagnosis:<br />
Gait Description:<br />
Previous type of orthosis (ankle joints, knee joints, trimlines):<br />
type of walking aid:<br />
treatment goal:<br />
Proprioception:<br />
Sensation:<br />
other circumstances (e.g. upper extremity weakness):<br />
rAnGe Of MOTiOn (Limits, specified, WNL, contracture)<br />
Hip: Knee: ankle:<br />
Genu valgum: º Genu varum: º Genu recurvatum: º<br />
ankle valgus: º ankle varus: º<br />
toe in: º toe out: º<br />
MAnuAL MuSCLe TeSTinG<br />
Use grading from chart on right.<br />
Hip Flexors:<br />
Hip extensors:<br />
Hip aBductors:<br />
Hip aDductors:<br />
Quadriceps:<br />
Hamstrings:<br />
Plantarflexors:<br />
Dorsiflexors:<br />
MMT iSOMeTriC GrAdinG<br />
5 norMal Holds test position against maximal resistance<br />
4+ GooD + Holds test position against moderate to strong pressure<br />
4 GooD Holds test position against moderate resistance<br />
4- GooD - Holds test position against slight to moderate pressure<br />
3+ FaIr + Holds test position against slight resistance<br />
3 FaIr Holds test position against gravity<br />
3- FaIr - Gradual release from test position<br />
2+ Poor+<br />
Moves through partial roM against gravity or moves through<br />
complete roM gravity eliminated and holds against pressure<br />
2 Poor able to move through full roM gravity eliminated<br />
2- Poor - Moves through partial roM gravity eliminated<br />
1 trace<br />
no visible movement; palpable or observable tendon<br />
prominence/flicker ctx<br />
0 0 no palpable or observable muscle ctx<br />
5
6<br />
MOdeL 9000: GX-Knee<br />
Based on the design of a traditional highquality,<br />
<strong>Becker</strong> knee joint, the GX-Knee comes<br />
equipped with a pneumatic spring on the lateral<br />
joint to assist in knee extension. a medial knee<br />
joint is also included to control knee alignment.<br />
the GX-Knee is available with your choice<br />
of a 125n pneumatic spring (for standard<br />
applications), or 175n (for high activity patients).<br />
the GX-Knee incorporates a pneumatic<br />
spring on the lateral joint, which assists in knee<br />
extension during the swing phase of gait. the<br />
GX-Knee is designed to provide extension assist,<br />
not prevent knee flexion.<br />
It can be fabricated into a variety of orthotic<br />
designs including traditional metal and leather,<br />
thermoplastics, composites and prepreg.
feATureS<br />
• Free knee with pneumatic extension assist<br />
available in 125n for standard applications<br />
and 175n for high activity patients.<br />
• Paired with a medial joint to control knee<br />
alignment.<br />
• Available with aluminum, stainless steel or<br />
titanium uprights.<br />
• All components come standard with a<br />
manufacturer’s warranty.<br />
indiCATiOnS<br />
• Patients with isolated quadriceps weakness.<br />
• Combined weakness of quadriceps and foot<br />
ankle complex.<br />
• Quadriceps weakness with M-L instability at<br />
the knee.<br />
COnTrAindiCATiOnS<br />
• Patient weight greater than 220 lbs.<br />
• Weakness of hip musculature.<br />
COdinG infOrMATiOn<br />
• No specific L Codes have been issued for<br />
the GX-Knee at this time. We recommend<br />
you consider coding the GX-Knee as an<br />
l2999 add-on to base KaFo code. the<br />
responsibility for accurate coding lies with<br />
the patient care facility that is billing for the<br />
product and service. the HcPcS alphanumeric<br />
System is subject to revisions and<br />
periodic updates and should be consulted<br />
prior to billing.<br />
AvAiLABiLiTy<br />
• The GX-Knee can be purchased as a<br />
component through <strong>Becker</strong> orthopedic, or<br />
fabricated into a variety of custom KaFo<br />
designs by <strong>Becker</strong> central Fabrication or<br />
<strong>Becker</strong> oregon.<br />
• Use Stance Control Orthometry Form for<br />
custom orders.<br />
Patent Pending<br />
COnverSiOnS<br />
Force<br />
(n)<br />
GX-<br />
torque<br />
(in-lbf)<br />
125 28<br />
175 39<br />
GX-Knee KAFO<br />
GX-Knee<br />
Knee Joint<br />
Order no. description<br />
9000-a GX-Knee Joints only - adult<br />
9000-B GX-Knee Joints only - Youth<br />
318 GX-Knee KaFo<br />
7
8<br />
MOdeL 9001: e-Knee <br />
the e-Knee is a foot force activated,<br />
computer controlled, electromechanical<br />
orthotic knee joint. It comes equipped with<br />
a pressure sensitive footplate that signals the<br />
microprocessor to lock the knee joint when<br />
pressure is applied and to unlock the knee joint<br />
in the absence of pressure. this technology<br />
gives users unsurpassed freedom and<br />
convenience by enhancing gait symmetry and<br />
allowing for a more efficient gait pattern with<br />
less compensation.<br />
Powered by a lithium ion battery, the e-<br />
Knee can provide users with enough power<br />
to get through a full day without the need<br />
for recharging. the system can be charged<br />
through any standard ac outlet and typically<br />
takes 4 – 6 hours to reach capacity.<br />
the e-Knee can be fabricated into a variety<br />
of orthotic designs including conventional<br />
metal and leather, composites and prepreg.<br />
to ensure that optimal joint alignment and<br />
function is maintained throughout the gait<br />
cycle, we recommend the use of inherently rigid<br />
materials when designing your e-Knee KaFo.<br />
Certified and licensed orthotists are required<br />
to attend a certification course to use this<br />
product. Please contact our customer service<br />
department for registration details on upcoming<br />
seminars. all components come standard with<br />
a manufacturer’s warranty.
feATureS<br />
• Modular design.<br />
• Battery saving power<br />
features.<br />
• Microprocessor controlled<br />
locking and unlocking.<br />
• LED bench testing and<br />
gait training indicator.<br />
• LED battery charge<br />
indicator and audible<br />
alarm.<br />
• Failsafe design locks<br />
automatically if there is<br />
a system or power failure.<br />
• Available with your<br />
choice of aluminum,<br />
stainless<br />
steel, or titanium uprights.<br />
indiCATiOnS<br />
• Quadriceps weakness as a result<br />
of Poliomyelitis.<br />
• Multiple Sclerosis.<br />
• CVA.<br />
• Femoral Nerve and Incomplete SCI.<br />
• Inclusion Body Myositis.<br />
COnTrAindiCATiOnS<br />
• Patient weight greater than 220 lbs.<br />
• Any spasticity in hip, knee or ankle<br />
musculature.<br />
• Fixed varus or valgus deformity at the knee<br />
in excess of 15°.<br />
• Knee hyperextension not controlled by<br />
the orthosis.<br />
• Passive ankle ROM with less than 5°<br />
of dorsiflexion.<br />
• Substantial leg length discrepancy where<br />
the affected side is shorter.<br />
uS Patent 6,517,503 and 10,205,714<br />
E-Knee KAFO<br />
COdinG infOrMATiOn<br />
• No specific L Codes have been issued for<br />
the e-Knee at this time. We recommend<br />
you consider coding the e-Knee as an<br />
l2999 add-on to base KaFo code. the<br />
responsibility for accurate coding lies with<br />
the patient care facility that is billing for the<br />
product and service. the HcPcS alphanumeric<br />
System is subject to revisions and<br />
periodic updates and should be consulted<br />
prior to billing.<br />
AvAiLABiLiTy<br />
• The E-Knee can be purchased as a kit<br />
through <strong>Becker</strong> orthopedic, or fabricated<br />
into a variety of custom KaFo designs by<br />
<strong>Becker</strong> central Fabrication or <strong>Becker</strong> oregon.<br />
• Use Stance Control Orthometry Form for<br />
custom orders.<br />
New updated<br />
Foot Sensor<br />
comes in one<br />
universal size<br />
and requires<br />
minimal<br />
adjustment.<br />
Microprocessor with LED<br />
feedback provides cues for<br />
bench testing and gait training,<br />
as well as battery status.<br />
Order no. description<br />
9001-a6 e-Knee - Knee Joint Kit<br />
320 e-Knee KaFo<br />
E-Knee <br />
Knee Joint Kit<br />
Complete Molding Dummy Kit<br />
provided, free of charge, with<br />
initial E-Knee Kit purchase.<br />
<br />
9
MOdeL r9001: rehab e-Knee <br />
10<br />
Assessment and Gait Training KAfO<br />
an important aspect of expert care for individuals<br />
with neuromuscular deficit is the early initiation<br />
of intensive rehabilitation that includes physical<br />
therapy, occupational therapy and orthotic<br />
management.<br />
the assessment and Gait training rehab e-Knee <br />
is a modular and fully adjustable KaFo that<br />
provides knee joint stability and control for<br />
individuals during the rehabilitation process.<br />
a hand-held switch is used by the orthotist or<br />
therapist to selectively lock and unlock the<br />
electromechanical orthotic knee joint during gait<br />
training activities.<br />
Intended to enhance recovery, substitute for<br />
functional deficits and improve walking efficiency,<br />
the rehab e-Knee can also be used as a tool to<br />
effectively evaluate patients for definitive E-Knee <br />
and other Stance control KaFo’s.
feATureS<br />
• Fully adjustable modular design.<br />
• Medial joint can be locked, or<br />
configured to provide minimum/<br />
maximum extension<br />
assist/flexion resist.<br />
• Available for the left or<br />
right leg.<br />
• Powered by 6 AA batteries.<br />
• Can be used to effectively<br />
assess candidacy for definitive<br />
e-Knee or other Stance<br />
control KaFo.<br />
indiCATiOnS<br />
• Lower extremity weakness<br />
secondary to stroke.<br />
• Incomplete SCI and other<br />
neuromuscular deficits.<br />
COnTrAindiCATiOnS<br />
• Patient weight greater than 220 lbs.<br />
• Fixed varus or valgus deformity at the knee in<br />
excess of 15°.<br />
• Knee hyperextension not controlled by<br />
the orthosis.<br />
• Substantial leg length discrepancy where the<br />
affected side is shorter.<br />
AvAiLABiLiTy<br />
• The Rehab E-Knee can be purchased as a kit<br />
through <strong>Becker</strong> orthopedic.<br />
uS Patent 6,517,503 and 10,205,714<br />
Fully adjustable modular<br />
Rehab E-Knee KAFO<br />
attaches to either a<br />
standard/universal or<br />
custom AFO.<br />
Standard/Universal AFO<br />
with Rehab E-Knee <br />
interface.<br />
Order no. description<br />
r9001 rehab e-Knee Kit<br />
Hand-held controlled<br />
locking and unlocking.<br />
Custom AFO with<br />
Rehab E-Knee <br />
interface.<br />
<br />
11
MOdeL Lr-9002: load response<br />
12<br />
the load response knee joint, model lr-9002,<br />
allows 18° of resisted knee flexion during<br />
the stance phase of gait. the lateral joint is<br />
equipped with a preloaded spiral torsional<br />
spring that mimics the ability of the quadriceps<br />
muscle to absorb ground reaction forces from<br />
heel strike to mid-stance.<br />
the lr-9002 can be a good alternative for<br />
patients who are experiencing back pain and<br />
component failure due to shock loading at heel<br />
strike in a ring lock, or bail lock KaFo.<br />
the load response can be fabricated<br />
into a variety of orthotic designs including<br />
conventional metal and leather, thermoplastics,<br />
composites and prepreg. to ensure that<br />
optimal joint alignment and function is<br />
maintained throughout the gait cycle, we<br />
recommend the use of inherently rigid materials<br />
when designing your load response KaFo.
feATureS<br />
• Allows 18° of resisted knee flexion.<br />
• Compatible with <strong>Becker</strong> HD Lever<br />
release System.<br />
• Available with aluminum, stainless steel, or<br />
titanium uprights.<br />
• All components come standard with a<br />
manufacturer’s warranty.<br />
indiCATiOnS<br />
• Multiple Sclerosis.<br />
• Post Polio.<br />
• Incomplete SCI/TBI.<br />
COnTrAindiCATiOnS<br />
• Patient weight less than 105 lbs, or greater<br />
than 220 lbs.<br />
COdinG infOrMATiOn<br />
• We recommend you consider coding the<br />
load response as an add-on to a base<br />
KaFo using (2) l2390, (2) l2415 and (1)<br />
l2999 to describe the pre-loaded spiral<br />
torsional spring on the lateral joint unit,<br />
or as a complete KaFo using l2005. the<br />
responsibility for accurate coding lies with<br />
the patient care facility that is billing for the<br />
product and service. the HcPcS alphanumeric<br />
System is subject to revisions and<br />
periodic updates and should be consulted<br />
prior to billing.<br />
AvAiLABiLiTy<br />
• The Load Response knee joint can be<br />
purchased as a component through <strong>Becker</strong><br />
orthopedic, or fabricated into a variety of<br />
custom KaFo designs by <strong>Becker</strong> central<br />
Fabrication or <strong>Becker</strong> oregon.<br />
• Use Stance Control Orthometry Form for<br />
custom orders.<br />
uS Patent 6,471,664<br />
Load Response KAFO<br />
shown with optional <strong>Becker</strong><br />
HD Lever Release System.<br />
Model 9002<br />
without<br />
spiral<br />
torsional<br />
spring.<br />
Model<br />
LR-9002<br />
with sprial<br />
torsional<br />
spring.<br />
Order no. description<br />
lr-9002-a6 load response Knee Joints only<br />
319 load response KaFo<br />
13
14<br />
MOdeL 9004: UtX ®<br />
the UtX ® was designed and develop by Dr. nils<br />
van leerdam, of ambroise Holland bv. It is<br />
a lightweight, less than two pounds, knee-anklefoot-orthosis<br />
that stabilizes the knee during the<br />
stance phase of gait but enables knee flexion<br />
during swing phase. at the end of the swing<br />
phase, as the knee reaches full extension, a<br />
ratchet engages to stabilize and lock the knee.<br />
a cable runs inside the distal side member from<br />
the ankle joint to the knee joint. at the end of<br />
stance phase, as the ankle dorsiflexes, this cable<br />
linkage causes the knee joint to unlock and<br />
destabilize the knee.<br />
the UtX ® can be configured as a non-stance<br />
control KaFo model, “Stabil,” that locks and<br />
unlocks by control of the user. other models<br />
of the UtX ® are also available including an<br />
“FS” (frontal stability) model to control genu<br />
valgum and a model with posterior interfaces<br />
at the lower leg to control genu recurvatum.<br />
In addition, all UtX ® models can be equipped<br />
with a medial ankle joint to provide additional<br />
control in the coronal and transverse planes.
UTX ® Swing<br />
Thermoplastic<br />
UTX ® Swing FS<br />
Tubular<br />
Stainless Steel<br />
feATureS<br />
• Automatic, mechanical, locking<br />
and unlocking.<br />
• Comfortable to wear while sitting due to<br />
the lack of rigid structures on the posterior<br />
aspect of the orthosis.<br />
• Manual unlocking option.<br />
• Easy adjustment of dorsiflexion and stirrup<br />
upright angle.<br />
• Easy height adjustment of bands/interfaces<br />
(pelottes).<br />
• Thermoplastic and laminated UTX ® options<br />
afford enhanced control of the foot-ankle<br />
complex.<br />
• Frontal Stability (FS) option can<br />
accommodate genu valgum.<br />
• Extremely lightweight – a typical UTX ®<br />
weighs less than two pounds.<br />
• All components come standard with<br />
a manufacturer’s warranty.<br />
indiCATiOnS<br />
• Quadriceps weakness as a result<br />
of Poliomyelitis.<br />
• Multiple Sclerosis.<br />
• CVA.<br />
• Femoral Nerve and Incomplete SCI.<br />
• Inclusion Body Myositis.<br />
• Genu recurvatum (use posterior lower leg<br />
interfaces for maximum control).<br />
• Successful users will typically have hip<br />
extensor/flexor strength (Grade 3) and<br />
passive ankle dorsiflexion.<br />
• A full selection protocol outlining indications<br />
and contraindications is available upon request.<br />
UTX ® Swing<br />
Tubular<br />
Stainless Steel<br />
UTX ® Swing<br />
Laminated<br />
(<strong>Becker</strong> Oregon Only)<br />
COnTrAindiCATiOnS<br />
• Patient weight greater than 265 lbs.<br />
• Any spasticity in hip, knee or ankle<br />
musculature.<br />
• Uncorrectable valgus/varus instability at<br />
the knee of more than 10°.<br />
• Substantial leg length discrepancy where<br />
the affected side is shorter.<br />
COdinG infOrMATiOn<br />
• We recommend you consider coding<br />
the UtX ® with a base code of l2005. the<br />
responsibility for accurate coding lies with<br />
the patient care facility that is billing for the<br />
product and service. the HcPcS alphanumeric<br />
System is subject to revisions and<br />
periodic updates and should be consulted<br />
prior to billing.<br />
AvAiLABiLiTy<br />
• The UTX ® is exclusively available through<br />
<strong>Becker</strong> orthopedic and <strong>Becker</strong> oregon in<br />
the United States, Canada and Central/<br />
South america as a custom made orthosis.<br />
• The UTX ® Swing laminated is available<br />
through <strong>Becker</strong> oregon only.<br />
• Use UTX ® orthosis Selection Protocol Form<br />
and Measurement Form to order.<br />
Order no. description<br />
9004-S UtX ® Swing<br />
9004-Stabil UtX ® Stabil<br />
9004-FS UtX ® Frontal Stability<br />
uTX®<br />
15
the SafetyStride is a mechanical stance<br />
control orthotic knee joint that utilizes a lowprofile<br />
cabling system to automatically unlock<br />
itself at the end of stance phase. the key<br />
feature of the SafetyStride is its ability to resist<br />
knee flexion at any angle. The SafetyStride<br />
does not require full 180° knee extension to<br />
resist knee flexion in stance phase. Designed<br />
to unlock at terminal stance, an internal lever<br />
re-engages during swing phase to ensure knee<br />
joint stability prior to heel contact. Individuals<br />
who intermittently fail to reach full extension will<br />
now have the added security and stability they<br />
require while ambulating.<br />
the SafetyStride works in conjunction with<br />
the FullStride and can be easily installed on<br />
a FullStride equipped KaFo. It’s innovative<br />
and straightforward design minimizes the use of<br />
specialized components to reduce component<br />
costs and ongoing maintenance, while also<br />
easing fabrication and the patient fitting process.<br />
the SafetyStride can be fabricated into<br />
a variety of orthotic designs including<br />
conventional metal and leather, composites<br />
and prepreg. to ensure that optimal joint<br />
alignment and function is maintained<br />
throughout the gait cycle, we recommend the<br />
16<br />
MOdeL 9005: SafetyStride <br />
use of inherently rigid materials when designing<br />
your SafetyStride KaFo.<br />
no specialized practitioner or technician<br />
training/certification is required for purchase.<br />
all components come standard with a<br />
manufacturer’s warranty.<br />
An internal lever within the<br />
SafetyStride disengages<br />
at terminal stance to allow<br />
for free knee flexion.<br />
At mid swing, the lever<br />
re-engages permitting only<br />
knee extension.<br />
feATureS<br />
• Automatic, mechanical locking and<br />
unlocking will resist knee flexion at any angle.<br />
• Designed to unlock at terminal stance, an<br />
internal lever will re-engage during swing<br />
phase ensuring knee joint stability prior to<br />
heel contact.<br />
• Interchangeable with the FullStride knee<br />
joint.<br />
• Durable, straightforward, modular design.<br />
• Available with aluminum, stainless steel, or<br />
titanium uprights.<br />
nOTe: To optimize gait and enhance knee<br />
stability, special consideration should be<br />
given to ankle joint selection. we would<br />
strongly recommend that you select<br />
an ankle joint configuration that limits<br />
dorsiflexion and allows accurate alignment<br />
of the foot ankle complex in the sagittal<br />
plane.
indiCATiOnS<br />
• Quadriceps weakness as<br />
a result of Poliomyelitis.<br />
• Multiple Sclerosis.<br />
• CVA.<br />
• Femoral Nerve and<br />
Incomplete ScI.<br />
• Inclusion Body Myositis.<br />
• Genu recurvatum.<br />
SafetyStride<br />
COnTrAindiCATiOnS<br />
• Patient weight greater than 220 lbs.<br />
• Any spasticity in hip, knee or ankle<br />
musculature.<br />
• Substantial leg length discrepancy where<br />
the affected side is shorter.<br />
<br />
KAFO<br />
COdinG infOrMATiOn<br />
• We recommend you consider coding the<br />
SafetyStride with a base code of l2005.<br />
the responsibility of accurate coding lies<br />
with the patient care facility that is billing for<br />
the product and service. the HcPcS alphanumeric<br />
System is subject to revisions and<br />
periodic updates and should be consulted<br />
prior to billing.<br />
MOdeL 9005-GX: SafetyStride <br />
with GX-assist<br />
For individuals with significant weakness of<br />
hip musculature, the SafetyStride may<br />
also be ordered with a GX-assist option that<br />
incorporates a pneumatic spring on the medial<br />
joint unit to assist in knee extension during the<br />
swing phase of gait. available with your choice<br />
of a 125n pneumatic spring (for standard<br />
applications), or 175n (for high activity<br />
patients), the GX-Assist can also be retrofit to<br />
existing SafetyStride KaFo’s.<br />
Patent Pending<br />
AvAiLABiLiTy<br />
• The SafetyStride can be purchased as a<br />
kit through <strong>Becker</strong> orthopedic, or fabricated<br />
into a variety of custom KaFo designs<br />
by <strong>Becker</strong> central Fabrication or<br />
<strong>Becker</strong> oregon.<br />
• Use Stance Control Orthometry Form for<br />
custom orders.<br />
uS Patent no. 7,462,159 B1<br />
Order no. description<br />
9005-a6 SafetyStride Knee Joint Kit<br />
321 SafetyStride KaFo<br />
SafetyStride <br />
with GX-Assist Kit<br />
SafetyStride Kit<br />
GX-Assist Kit<br />
Standard kit<br />
will include<br />
(1) FullStride <br />
(medial) & (1)<br />
SafetyStride <br />
(lateral) knee<br />
joint.<br />
COnverSiOnS<br />
Force (n) torque (in-lbf)<br />
125 28<br />
175 39<br />
Order no. description<br />
9005-GX-a6 SafetyStride Knee Joint Kit w/ GX-Assist<br />
321-GX SafetyStride KAFO w/ GX-Assist<br />
9000-GX GX-assist Kit only<br />
17
MOdeL 9006: FullStride <br />
the FullStride is a mechanical stance control<br />
orthotic knee joint that utilizes a low-profile<br />
cabling system to automatically unlock at the<br />
end of stance phase. at the end of swing<br />
phase, when the orthotic knee joint reaches full<br />
extension, the locking mechanism re-engages to<br />
provide knee stability.<br />
the FullStride<br />
18<br />
can also be easily converted into<br />
an automatic spring lever lock knee joint if the<br />
needs of the patient change over time. When<br />
necessary, the stance control capability can<br />
be converted into a traditional spring (bail) lock<br />
mechanism by simply unscrewing the modular<br />
knee joints from the uprights and swapping the<br />
medial and lateral joints.<br />
the innovative design of the FullStride utilizes<br />
fewer specialized components to ease<br />
fabrication, reduce component costs and<br />
reduce follow-up maintenance. It can be<br />
fabricated into a variety of orthotic designs<br />
including conventional metal and leather,<br />
composites and prepreg. to ensure that optimal<br />
joint alignment and function is maintained<br />
throughout the gait cycle, we recommend the<br />
use of inherently rigid materials when designing<br />
your FullStride KaFo.<br />
no specialized practitioner or technician<br />
training/certification is required for purchase.<br />
all components come standard with a<br />
manufacturer’s warranty.<br />
feATureS<br />
• Automatic, mechanical locking and<br />
unlocking.<br />
• Flexible, adaptive, modular design allows<br />
joint to be configured as an automatic<br />
spring lever lock knee joint if the needs of the<br />
patient change.<br />
• Durable, straightforward design.<br />
• Cost effective.<br />
• Available with aluminum, stainless steel, or<br />
titanium uprights.<br />
nOTe: To optimize gait and enhance knee<br />
stability, special consideration should<br />
be given to ankle joint selection. we<br />
would strongly recommend that you<br />
select an ankle joint configuration that limits<br />
dorsiflexion and allows accurate alignment<br />
of the foot ankle complex in the sagittal<br />
plane.<br />
indiCATiOnS<br />
• Quadriceps weakness as a result of<br />
Poliomyelitis.<br />
• Multiple Sclerosis.<br />
• CVA.
• Femoral Nerve and<br />
Incomplete ScI.<br />
• Inclusion Body Myositis.<br />
• Genu recurvatum.<br />
COnTrAindiCATiOnS<br />
• Patient weight greater<br />
than 220 lbs.<br />
• Any spasticity in<br />
hip, knee or ankle<br />
musculature.<br />
• Substantial leg length<br />
discrepancy where<br />
the affected side<br />
is shorter.<br />
FullStride KAFO<br />
in stance control<br />
configuration.<br />
COdinG infOrMATiOn<br />
• We recommend you consider coding the<br />
FullStride with a base code of l2005. the<br />
responsibility for accurate coding lies with<br />
the patient care facility that is billing for the<br />
product and service. the HcPcS alphanumeric<br />
System is subject to revisions and<br />
MOdeL 9006-GX: FullStride <br />
with GX-assist<br />
For individuals with significant weakness of<br />
hip musculature the FullStride may also<br />
be ordered with a GX-assist option that<br />
incorporates a pneumatic spring on the lateral<br />
joint unit to assist in knee extension during the<br />
swing phase of gait. available with your choice<br />
of a 125n pneumatic spring (for standard<br />
applications), or 175n (for high activity<br />
patients), the GX-Assist can also be retrofit to<br />
existing FullStride KaFo’s.<br />
Patent Pending<br />
periodic updates and should be<br />
consulted prior to billing.<br />
AvAiLABiLiTy<br />
• The FullStride can be purchased<br />
as a kit through <strong>Becker</strong><br />
orthopedic, or fabricated into a<br />
variety of custom KaFo designs<br />
by <strong>Becker</strong> central Fabrication<br />
or <strong>Becker</strong> oregon.<br />
• Use Stance Control Orthometry<br />
Form for custom orders.<br />
FullStride with<br />
GX-Assist Kit<br />
GX-Assist Kit<br />
COnverSiOnS<br />
FullStride Kit<br />
Force (n) torque (in-lbf)<br />
125 28<br />
175 39<br />
Order no. description<br />
9006-GX-a6 FullStride Knee Joint Kit w/ GX-Assist<br />
322-GX FullStride KAFO w/ GX-Assist<br />
9000-GX GX-assist Kit only<br />
FullStride KAFO<br />
in automatic<br />
spring lever lock<br />
configuration.<br />
Order no. description<br />
9006-a6 FullStride Knee Joint Kit<br />
9006-B6 FullStride Knee Joint Kit (B Size)<br />
322 FullStride KaFo<br />
19
10/09<br />
Phone: (800) 521-2192 (248) 588-7480<br />
fax: (800) 923-2537 (248) 588–2960<br />
CenTrAL fABriCATiOn<br />
fax: (248) 588-4555<br />
Imagination Driving Innovation<br />
Phone: (800) 866-7522 (541) 967-1821<br />
fax: (541) 967-1891