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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

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