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Quadriceps Femoris Muscle Assist Orthosis in Duchenne Muscular Dystrophy

Dr. Siegel is Codirector, Muscular Dystrophy Association Muscle Disease Clinic, Rush-Presbyterian-St. Luke's Medical Center, 1753 W Congress Pkwy, Chicago, IL 60612 (USA).
Oscar Silverman and Michael Silverman are Attending Orthotists, Muscular Dystrophy Association Muscle Disease Clinic, Rush-Presbyterian-St. Luke's Medical Center.

This excerpt was created in the absence of an abstract.

Weakness of the quadriceps femoris muscle is the key functional deficit leading to gait deterioration in Duchenne muscular dystrophy. Postural adaptation during stance to this debility includes forward leaning of the torso, which maintains the center of gravity anterior to the center of rotation of the knee, and ankle plantar flexion, which produces a floor reaction resulting in passive extension of the knee.¹

If the quadriceps muscle is not strong enough (manual muscle test grade Fair or better) to extend the knee independently, it can be assisted with a light sleeve support,* fabricated of 0.14-in thick closed-cell nitrogen neoprene rubber between layers of nylon tricot. Circumference measurements should be taken proximal and distal to the knee and at knee center to assure a snug fit. The orthosis features anterior stays of twisted clock-spring steel, tensed to allow flexion in swing phase and to augment extension on stance (Figure).

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