Disclosures: Alethea J. Appavu, DO: No financial relationships or conflicts of interest

Case Diagnosis: 53 year old male with past history of multiple spinal surgeries most notably an L4-S1 lumbar fusion in 2013 with extension to T8 in 2019 with LE paresis.

Case Description: This patient’s main functional deficit continued to be difficulty with ambulation. He trialed different ankle-foot orthoses (AFO) and knee-ankle-foot orthoses (KAFO) which did not provide him the stability at his knees/ankles nor the confidence. His current orthoses are helpful, but he still has difficulty walking outside, on uneven surfaces, down ramps, negotiating stairs, and independence with ADLs such as getting dressed. He is currently wearing bilateral carbon AFOs and bilateral double upright knee orthotics with extension stops to prevent knee hyperextension, falls, enhance gait mechanics, and reduce knee pain.

Setting: Outpatient Orthotics clinicAssessment/

Results: Despite multiple trials of AFOs/KAFOs/KOs, this patient was still unable to ambulate comfortably or confidently. As he was a very active individual, pre and post-surgery, he had the desire and motivation to continue physical therapy and look for a better solution. After a consultation with the orthotics department, it was decided that he would benefit from a trial of the C-brace Orthotronic mobility system. During the trial in orthotics clinic, he regained normal gait mechanics and negotiated stairs for the first time in 3 years.

Discussion: The C-brace Orthotronic is a microprocessor-controlled orthotic with similar mechanics as a microprocessor knee in an above the knee prosthetic. It is usually considered for those with neurologic conditions causing paresis or paralysis of muscles that support the knee. It has been shown to have significant improvements in ambulation and ADL performance.

Conclusion: As technology improves, there are further developments in the ability or orthotics to provide patients with the independence they strive for. As physiatrists, it is important that we are constantly assessing our patients and new technologies to achieve the best outcomes for our patients.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/lets-c-you-walk-considering-c-brace-orthotronic-for-gait-assistance-a-case-report/