Abstract
Ambulation requires modulation of the center of gravity (CG) to facilitate the con version of potential to kinetic energy necessary for locomotion. Postural adaptations serve this process. The weakness and lower extremity contractures found in Duchenne muscular dystrophy (DMD) hinder these adjustments. The cascade of postural changes necessary to keep the patient upright results in primary, secondary, and compensatory deformities. These permit dynamic postural accommodations that minimize inertial forces and position body segments to maintain upright balance.
A judicious choice of orthotic aids, such as reinforced knee sleeves for quadri ceps assist, a tone balancing supramalleolar appliance designed to stimulate dorsiflex ion while inhibiting plantar flexion at the ankle, thus delaying equinus contracture requiring surgery, light tubular ankle-foot orthosis (with or without a floor reaction feature) or knee-ankle-foot orthoses, which provide support after tendon release, per mit patients to continue to utilize natural mechanisms of postural compensation in order to remain upright and ambulatory.