Creating a Closed-Chain Biomechanical Orthotic Environment for a 52 Year Old Female to Compete in a Para-Triathlon Using the Latest Carbon Composite Technology

Background:

Multiple sclerosis (MS) is a chronic inflammatory demyelinating central nervous system disease that typically strikes young adults, especially women. In the past orthotic treatment has shown to be less than satisfactory for this patient group. Thermo-plastic AFOs created proximal deficit's due to its open-chain design. Enclosng the ankle foot complex and the lack of normal biomechanical motion of the calcaneus would restrict the stretch reflex and rotation of the tibia and femur. This will cause decreased activation of already weakened muscles groups.

Objectives:

Creating a closed-chain biomechanical orthotic environment for a 52 year old female diagnosed with MS in 2010 to compete in a Para-triathlon using the latest carbon composite technology.  

Methods:

With the use of BTS G-Walk we were able to determine biomechanical and gait deficits to design a custom fit orthoses. Using the data from our gait studies we were able to determine what the optimum alignment of lower limb segments would be to allow for her to achieve toe-off in the third rocker.

Results:

By addressing the biomechanical deficits and restoring functional gait using a custom fit ridged dynamic carbon composite AFO with carbon anterior shell.  We were able to restore muscle stability, push off in the third rocker and sufficient proprioception for running and cycling.

Conclusions:

It was evident through the use of open calcaneal and energy reflecting carbon composite designs, patients with MS can achieve a higher standard of physical activity. By not creating proximal deficits with the use of a solid AFO design. By augmenting diminishing muscle function our patient was able to run, bike and swim. This outcome was not isolated to a single outcome. She competes in multiple events throughout the year and quality of life has improved as well.