K

N
E
E

A
N

KAFO Desain, K
L

Komponen dan
E

Fungsi
O
O
T

O
R
T
H
O
S
I
ANISSA EKA SEPTIANI, S.TR.OP., M.K.M S
 IWB KAFO Moulded KAFO

K
N
E
E

A
N
K
L
E

F
O
O
T

O
R
T
H
O
S
I
S
Conventional KAFO
Hybrid KAFO
Conventional KAFO 1 K
N
E
1. Thigh cuff 2
E

2. Strap A
N
3 K
3. Knee joint L
E

4. Calf band F
4 O
5. Side bar/ upright O
T
5
6. Ankle joint O
R
7. Stir up 6 T
H
7 O
8. shoes S
8 I
S
 K
N
E
E

Kelebihan (+) A
N
K
L
• Murah E
• cocok untuk pasien yang mudah berkeringat
F
• Materialnya mudah didapat O
O
• Cocok untuk pasien dengan fluktuatif volume T

O
Kekurangan (-) R
T
H
O
▪ Sepatu langsung terpasang pada KAFO S
I
▪ Tidak dapat dipakai tanpa sepatu S
▪ Penekanan besar karena area yang kontak kecil
 Moulded KAFO K
N
E
E
1
1. Strap A
N
2 K
2. Thigh cuff/shell L
E

3 3. Knee joint F
O
4. Side bar/ upright O
T

4 5. Calf band/shell O
5 R
6. Foot plate T
H
O
S
I
S

6
 K
N
E
E

Kelebihan (+) A
N
K
L
• Penekanan merata, karena area kontak lebar E

• Dapat bergonta-ganti sepatu atau dipakai tanpa F

sepatu O
O
T

Kekurangan (-) O
R
T
H
• Tidak cocok untuk pasien dengan keringat berlebih O
S
dan mempunyai gangguan kulit I
S
• Tidak cocok untuk pasien dengan fluktuatif volume
Komponen KAFO K
N
E
E

1) Thigh Section A
N
K
2) AFO Section L
E
3) Knee Joint F
O
4) Ankle Joint O
T

5) Knee Control O
R
6) Foot Trimline T
H
O
S
I
S
 K
Standart Quadrilateral N
E
E

A
N
K
L
E

F
O
O
T

O
R
T
H
O
S
I
S
 AFO Section K
N
E
E
• Ditentukan sesuai dengan kondisi pasien dan
A
goal yang akan dicapai. N
K
• Posisi ankle dan tibia yang ideal adalah ankle L
dan tibia harus segaris dengan trocantor E
mayor dan garis jatuh di antara malleolus dan F
navicular saat midstance. O
O
T
✓ Jika AFO di dorsi fleksikan, maka akan
O
mendorong knee dan hip fleksi R
T
H
✓ Jika AFO di plantar fleksikan , maka akan O
S
I
mendorong knee ekstensi S
 Knee Joint K
N
E
E
Single Axis Free Motion
A
Polycentric Free Motion N
K
• Free motion in sagittal L
E
plane • Punya 2 axis, mengikuti
F
• Stop ekstensi 0˚ pererakan dari O

• Indikasi untuk px yang tibiofemoral joint. O

T
membutuhkan coronal • Indikasi untuk px yang O
plane control dan knee membutuhkan coronal R
hyperekstensi (tanpa plane control dan knee T
H
control fleksi) hyperekstensi (tanpa O
S
control fleksi) I
S
 K
N
Drop Lock Joint E
E

• Terdapat locking A
N
mechanism dengan K
Posterior Offset Joint L
ring ketika ekstensi E

• Axis terletak diposterior (ketika ring turun). F

O
dari GRF untuk • Untuk membuka O
T
meningkatkan stabilitas. kuncian dibutuhkan O
• Cocok untuk px dengan kemampuan yang baik R
T
kelemahan knee pada tangan px H
O
ekstensor >3 dengan hip S
I
ekstensor baik S
 K
N
E
E

A
N
Bail Lock Joint K
L
E
• Mempunyai mekanisme
penguncian menggunakan F
O
tuas yang berada di O

posterior. T

O
• Untuk membuka kunci R
dapat menggunakan 1 T
H
tangan atau dengan O
diketukan kursi. S
I
S
Advance knee joint K
N
E
Extensor assist E

A
• Memberikan bantuan N
Load response joint ekstensi dari 35º -130º
K
L
E
• Memungkinkan fleksi lutut • meningkatkan F
18˚ saat berjalan. keamanan dalam O
O
• Dilengkapi dengan shock ambulasi T
absorber saat fleksi untuk
mempertahankan • Memungkinkan O
R

stabilitas individu dengan pasien menekuk lutut T

H
kelemahan ekstensor untuk duduk ke posisi O
S
knee duduk I
S
 K
N
E
E

A
N
Stance control knee joints. K
L
E
• memberikan stabilitas F
pada pasien selama fase O
O
berdiri dan kemudian T

secara otomatis beralih O

R
ke status bergerak bebas T
H
selama fase ayunan O
S
I
S
Ankle Joint K
N
E
E

• Rigid A
N
K
• Dorsiflexion stop L
E
• Plantarflexion stop F
O
O
T

O
R
T
H
O
S
I
S
Knee Control K
N
E
E

A
N
K
Knee Spider/ knee cap L
E

• Memberikan tahanan F
O
dianterior O
T

• Cocok untuk pasien O

R
dengan kelemahan T
H
ekstensor knee joint/ O
S
knee collapse I
S
 K
N
E
E

Valgus strap Varus strap A

N
K
L
E

F
O
O
T

O
R
T
H
O
S
I
S
Foot Trimline K
N
E
E

A
N
K
L
E

F
O
O
T

O
R
T
H
O
S
I
S
Fungsi K
N
E
E

o To control motion around the knee joint A

N
o To offload a joint K
L
o To prevent deformity E
o To increase stability F
o To accommodate deformity O
O
o To correct deformity T
o To assist functions O
R
T
H
O
S
I
S
 K
Material Indications Contraindications Advantages Disadvantages N
Moulded Shell - Strong corrective forces - Insensate skin (not - Can use normal shoes - Hot and sweaty E
needed absolute) - Can change shoes - More time spent in E
- Patient works in wet / - Oedema - Close fitting / cosmesis manufacture
muddy environment - Scarring in contact or high - Good control of movement - Requires workshop to A
- Patient preference pressure areas - Plastic easy to adjust repair N
- Patient concerned about - Easy to clean - Materials must be imported
cosmesis
K
- Patient doesn’t wear shoes L
E

Conventional - Insensate skin (not - Strong corrective forces - Contact areas “friendly” - Shoe must be modified F
absolute) needed - Cooler than plastic - Cannot wear without shoe O
- Oedema - Patient works in wet / - Can be repaired locally (indoors) O
- Patient preference muddy environment - Materials available locally - Leather absorbs sweat
T
- Patient concerned about and degrades
cosmesis - Difficult to clean
- Less cosmetic O
R
T
Hybrid KAFO - Patient has weight - Insensate skin( not - Can use normal shoes - More steps in manufacture H
fluctuations absolute) - Close fitting - Requires workshop to O
- Patient preference - Oedema - Good control of movement repair
- Scarring in contact areas - Plastic easy to adjust
S
- Thigh section cooler I
S
 K
N
E
Design / variation E
Ischial Weight bearing - hip, knee or ankle pain / - hip dislocation - can take weight through - very large orthosis
damage - if weight relief is not suitable structure - less sitting comfort A
- non healed fracture in required - quadrilateral proximal N
lower limb area helps to control K
rotation L
E
Anterior Shell - knee collapse - knee hyperextension - sitting comfort - difficult to don
- posterior scarring - ACL laxity - pressure on bone area
- PCL laxity - anterior scarring (tibia) F
O
Posterior Shell - knee hyperextension - knee collapse - easy to don - discomfort when sitting
O
- ACL laxity - posterior scarring - all pressures on soft tissue
- anterior scarring - PCL laxity T

O
R
T
H
O
S
I
S
Knee joints
Free motion - knee M-L instability - knee extensors < Gd 4 - normal swing phase - cannot control flexion
- knee hyperextension - hip extensors < Gd4 - simple and easy
- knee extensors > Gd 4 - light weight
- hip extensors > Gd 4 - low profile K
- little maintenance N
E
Posterior offset - knee M-L instability - knee extensors < Gd - normal swing phase - may collapse on E
- knee hyperextension 3+ - simple and easy inclines
- older patients - hip extensors < Gd4 - lightweight - not safe on uneven A
(improve stability) - little maintenance ground N
- knee extensors > Gd - requires some weight K
3+ bearing through KAFO L
- hip extensors > Gd 4 structure E

Drop Lock - knee A-P instability - poor hand function - Complete control of - Patient must lift locks F
- knee M-L instability - knee extensors > Gd knee - knee must be fully O
- knee hyperextension 3+ - low maintenance extended to engage O
- knee extensors < Gd 3 - hip extensors > Gd 3 locks T
- hip extensors < Gd 3 - Can “rattle”
- Can “jam” O
Bale lock - knee A-P instability - knee extensors > Gd - Complete control of - knee must be fully R
- knee M-L instability 3+ knee extended to engage T
- knee hyperextension - hip extensors > Gd 3 - One handed locks H
- knee extensors < Gd 3 operation possible - Can “rattle” O
- hip extensors < Gd 3 - can be unlocked with S
- poor hand function bump to posterior. I
- bulky / reduced S
cosmesis
 K
N
E
E
Control straps Indications Contraindications Advantages Disadvantages
A
Knee spider - knee collapse (when - patellofemoral jt - simple solution - reduced cosmesis N
the simple straps can problems - skin “friendly” material - can cause K
not be correct patellofemoral jt L
sufficiently) problems E
- increased pressure
when sitting F
O
Valgus strap - valgus knee position - scars in area - simple solution - bulk behind knee O
- skin “friendly” material - can put pressure on T
patella
Varus strap - varus knee position - scars in area - simple solution - bulk behind knee O
-skin “friendly” material - can put pressure on R
patella T
H
O
S
I
S