Early Knee Protocols Encourage Typical Motor Development in Young Patients

Mark Geil, PhD
Mark Geil

CHICAGO – In a study of seven children aged 3 to 5 years-old, Mark Geil, PhD, found that when given an articulating knee, as opposed to the favored locked, fully-extended knee, children present reduced clearance adaptations and — in turn— could experience a more eased transition to walking.

“We expected clearance adaptations, but it is another piece of evidence in our hopefully growing body of evidence that will change this treatment protocol,” Geil said at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium, here. “These kids do very well on an articulating knee … we can debate this point for hours and there are still folks who look at our evidence and say to us, ‘No, the kids will fall over. They don’t have the stability or the hip motor control to accommodate an articulating knee.’ We disagree and are building the evidence to show that.”

At least one of the three clearance adaptations within the study – hip-hiking, vaulting and circumduction – were present in all seven cases of the locked knee joint. In two cases, a child presented with more than one adaptation. When fitted with an articulating knee, only one case presented with a clearance adaptation.

Geil said his focus is on the long-term implications for children who do not learn to walk with an articulating knee.

“If these kids do not have a knee when they are learning to walk, they develop clearance adaptations and these are some of those gait accommodations that stick with you for a long time,” he said.

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