Compensating weakness of the quadriceps muscles due to poliomyelitis using a custom-made orthopedic shoe

This case study illustrates the possibility to optimize gait in a patient with severe quadriceps weakness, using an orthopedic shoe. A knee-ankle-foot orthosis would have been a typical solution but did not suffice in this particular case. The case describes a 37-year-old woman with poliomyelitis who developed a peculiar way of walking, in which she wore a slipper only on the front part of her foot, so that her heel hung down over the back edge of the slipper. This probably moved the center of pressure anteriorly and created a greater extension moment on the knee to compensate the quadriceps weakness. Observation of the patient's gait pattern and compensating strategy led to the development of a custom-made orthopedic shoe which doubled her walking distance and enabled her to walk outside again.