Where should a pelvic band for an HKAFO be positioned?

Positioning the pelvic band for a hip-knee-ankle-foot orthosis (HKAFO) is critical for effective control and stability of the pelvis, femur, and lower extremities. The correct placement is superior to the anterior superior iliac spine (ASIS).

Placing the pelvic band in this position offers several advantages. It allows for optimal alignment with the body’s biomechanical axis, which is essential for proper weight distribution and functional movement during activities such as walking. This superior positioning also helps in providing adequate pelvic stability by anchoring the device to the bony structures above the ASIS, which are less soft tissue-rich compared to lower placements.

Moreover, when the band is positioned above the ASIS, it facilitates better hip joint control and aids in controlling the motion of the pelvis during ambulation. This enhanced control is crucial for users who require assistive devices due to deficits in muscle strength or joint stability.

In contrast, positioning the pelvic band inferiorly, level with, or superficial to the ASIS may compromise the stability and overall effectiveness of the HKAFO, since these placements can lead to increased movement or displacement of the band during gait, reducing its functional efficacy.