Here come the KiddieGaits

Elena got a new pair of braces!

These are called KiddieGaits. They are new to us. Our orthotist thinks they will be great for Elena, b/c they are supposed to encourage a few things that her regular DAFOs do not:

1. Pressure is on the shin, encouraging a straight-leg posture (rather than a crouch, which is a problem for E)
2. While still a rigid brace, there is a little room for movement of the foot (a small amount of dorsiflexion, plantarflexion, inversion and eversion of the foot hopefully means a stronger ankle for Elena)
3. This brace is COOLER--not suffocating plastic
4. Elena can wear short socks!! (check out these pompoms!)



These are also in 'standard sizes', meaning that they are not custom-made. I assume this means they are cheaper to manufacture, and are more easily transferable/reusable for another child.

VID--FIRST WALK

Elena's reaction to them were that they felt "different" but she liked them. The weird feeling she got was due to the pressure on the shin. She did say immediately that they were cooler to wear (it was nearly 100 degrees outside). I noticed two things right away:

1. While her legs are definitely straighter, instead of crouching, she "bends over" at the waist slightly. My guess is this is b/c her hip flexors are tight? I figure with more experience in these braces, this will be less noticeable.

2. She stands more obviously on her dominant (left) leg, and positions herself with her right leg behind her (straight leg, but with only the right toe resting on the ground). We've seen this many a time with the DAFOs, but her weight-bearing preference is very apparent. I also think this will get better, but we'll have to work on it A LOT (weight bearing on the right). She can do it, but it's not her natural stance.

Growing into another set of AFOs

This is ALWAYS a struggle...trying to get a new pair of AFOs to work when E grows out of her old pair.

So, here is my current dilemma: basically, we got her new pair, but for lots of reasons, I don't like them. We're trying out the DAFO model. E's previous pair are made of very hard plastic and have some interesting straps to keep her feet down (especially her right foot)--but they work very well. I'm putting together my best side-by-side comparison, to try to convince myself (and everyone else) that I am not crazy.

The Model: DAFO (new, pink) vs. AFO (current, purple) (this took forever to put together! Sorry the details are so small!)



As you can probably tell from the previous posts, E has issues with standing up straight and putting her feet flat. Why on Earth would you create a brace at an angle that promotes her stance in a crouch position?! E has to fight the DAFO to stay upright. The DAFO inner plastic is soft, so it is more "comfortable" but it also allows her to wiggle out of the shoe, no matter how tight you make those velcro straps. And I have put them on TIGHT. Her old AFOs are very rigid, but with the ingenious inner strap she really stays down in the brace. The same strap does put a lot of pressure on the top of her ankle, but she normally does not complain about it, and with a nice tongue to dissipate the pressure, we haven't had any problems (aside from growing out of these braces).

The Motion: DAFO (new; top vid) vs. AFO (current; bottom vid)





Tonight, I tried very hard to get E to move in both sets of braces for a comparison. She didn't want to cooperate, so this footage was shot after a long evening of bargaining. She's not at her best here. Her new braces (and shoes) are bigger and heavier than her old pair (that's always true) so she typically drags for a while. Still, I think she drags both feet, and spends more time with her knees bent (especially the right) with the DAFOs. AND, after less than 10 minutes of being upright, E is out of both the left and right DAFOs by .5 and 1.5 cm, respectively. After 10 minutes with her AFOs, she's out of the right by about .5 cm, and totally in the left one.

The Pros and Cons: DAFO vs. AFO
DAFO (new, pink): Pros--easier for school staff to understand how to take on and off, dissipates pressure well with soft plastic
Cons--heels slip out, braces are bulky and harder to fit in sneakers, badly hinged, encourages crouch (?), heavy
AFO (current, purple): Pros--light, holds E in well, fits in shoes relatively easily
Cons--difficult to put on, straps and velcro easily wear and tear

Am I crazy?

poll by twiigs.com

PT recap: working with her new DAFOs

At PT Theresa had Elena do a lot of her normal exercises wearing with her new DAFOs. I had low expectations, b/c her feet will feel very different, and her shoes are much heavier/bigger b/c to accomodate her new braces she had to go up a full shoe size.

Overall, not too bad. She spent a lot of time doing steps with her loftstrands (not shown) and going up and down the ramp.



Note how far out she puts her crutch when going up the ramp--that's so she can put her weight on her left leg (dominant leg) while doing most of the work.



Here is E walking in her new DAFOs. She might have moved a little better if she wasn't holding something. Still--she made it!

New AFOs

Two weeks ago Elena got her new AFOs. They're DAFOs, actually. Our orthotist recommended we switch to this brand b/c he thought E would stay better in the "foot cage".

PICTURES HERE

Well...I had my doubts. First of all, the entire inner portion of the DAFO is soft, and it slides into a harder shell--this was completely unlike her last pair [UPDATE LINK]. Once she put them on, she said they felt good and she liked them.

We've been trying to work our way into the switch, but it's been difficult. She says her right heel hurts sometimes--I believe she is coming out of the brace starting with the right heel, and it's rubbing her heel against the brace.

She also came home from school completely out of her DAFOs--still wearing them, but basically with only her tippy toes in the heel cups. In otherwords, the braces as is do NOT keep her heels from coming up and her feet escaping the braces. Granted, she was probably playing on the floor when she started slipping out (we hadn't had much of a problem at home with this) but the fact that she was walking so oddly and in pain was very upsetting.

I'm going to give these DAFOs a good solid try...but I have to admit, I like the way her old style performs.