1019 - Functional Recovery in Femoral Neuropathy Through Long-Term Electronic Stance and Swing Phase Control Orthosis Use

Case Diagnosis: The patient is a 36-year-old male with paroxysmal atrial fibrillation, status post cardiac ablation with catheter access through the right femoral artery. Immediately post-ablation, he presented with inability to move, numbness, and tingling throughout the entire right lower extremity. Neurological examination displayed weakness of right hip flexors and knee extensors with diminished light touch and proprioception sensation. Right groin ultrasound, MRI pelvis and majority of the neuroaxis, and EMG were unremarkable. Despite these findings, compressive femoral neuropathy was suspected.

Case Description: He began using a double upright knee-ankle-foot orthosis (KAFO), and a wide-based quad cane to aid his balance. He completed extensive outpatient physical therapy, and although he demonstrated strength gains, he sustained a fall at home, prompting trial of the Ottobock C-Brace for persistent quadriceps weakness. The C-Brace replicates eccentric contraction of the quadriceps by resisting knee flexion, functioning as dynamic gait rehabilitation and facilitating neuroplastic recovery. With consistent use over one year, the device provided consistent neuromuscular training, enabling progressive improvement in functional strength and stability. The patient has since transitioned to independent ambulation without assistive devices, requiring the C-Brace or a tricompartment unloader knee brace very minimally.

Discussions: The C-Brace was an integral part in the patient's recovery. Prior studies have shown that usage of the C-Brace in individuals requiring KAFO has been effective in increasing walking capacity and fall reduction. When comparing the two, the C-Brace overcomes the KAFO’s limitations in mobility and compensatory gait. The C-Brace assists with balance, stabilizes knee flexion under load, and enables smooth control of swing phase.

Conclusions: This case outlines the value of the C-Brace in enhancing mobility in a patient presenting with suspected compressive femoral neuropathy. The C-Brace has served as a form of continuous rehabilitation, resulting in the patient being able to ambulate independent of assistive devices.