. Sean is a 6 year old child with very mild CP that has left him with weakness in
both lower extremities. The weakness is primarily in his quadriceps, ankle dorsi
and plantar flexors (approximately 4-/5). He is able to ambulate without an
assistive device, however, he tends to walk in a “crouch” gait. That is knees
flexed. He does have a mild knee flexion contracture bilaterally (15 degrees) but
this is improving with his PT. He has full ankle passive ROM. During gait,
Sean’s first rocker motion is fairly normal. His second rocker is much too rapid
with his knees seemingly ready to buckle with every step, though he does not
have a problem with falling. His third rocker motion is normal.

a. What musculoskeletal impairments (strength, flexibility) are responsible
for this abnormal gait and why? Explain your rationale. Do not simply restate the impairments known.
b. State three possible orthotic options for Sean, stating the
advantages/disadvantages of each. These can be the same general type
of orthotic (i.e. AFO, KAFO), but with different options, fabrication, etc.
c. Chose one of the three that you think will best meet his needs. Be very
specific stating what motions the orthotic will prevent and/or allow. I
should be able to make/order the orthosis based on what you tell me.
d. State how the orthotic makes up for his musculoskeletal impairments