Polio Leg Treatment in Delhi NCR: Custom KAFO for Knee Weakness and Instability

2 days ago

7 min read

Living with leg weakness after polio can make everyday walking difficult. One of the most common and worrying problems is knee buckling—when the knee suddenly gives way while standing or walking. Some people also develop excessive backward movement of the knee, called genu recurvatum, as the body tries to compensate for weak muscles.

These problems can increase the risk of falls, reduce walking confidence, and place extra stress on the hips, back, and other leg.

At The Rehab Street, we provide polio leg treatment in Delhi NCR with custom KAFOs, AFOs, polio calipers, orthopedic footwear, gait assessment, and mobility rehabilitation. Our aim is to help people with polio-related weakness walk more safely and efficiently while protecting their joints from unnecessary stress.

What Causes Knee Buckling After Polio?

Poliomyelitis can damage motor nerve cells that control muscles. When the muscles around the hip, knee, ankle, or foot become permanently weak, the leg may not have enough strength to remain stable during walking.

Weakness of the quadriceps, the muscles at the front of the thigh, is especially important.

During normal walking, the quadriceps help control the knee when body weight moves onto the leg. If these muscles are too weak, the knee may suddenly bend or collapse. This is commonly described as knee buckling or the knee “giving way.”

Some people develop a different compensation. Instead of allowing the knee to bend, they push it too far backwards into hyperextension to create stability. Over time, this may place abnormal stress on the knee.

Knee instability related to neuromuscular weakness can contribute to falls, pain, reduced mobility and difficulty completing everyday activities. KAFOs are commonly considered when an AFO or simpler knee brace cannot adequately control the instability.

Signs That Polio-Related Knee Weakness Needs Assessment

Knee weakness does not always begin with a major fall. It may gradually change the way you walk.

You may need an orthotic assessment if you notice:

Frequent knee buckling while walking
The knee moving too far backwards
Repeated falls or near-falls
Pressing your hand against your thigh or knee while walking
Difficulty standing for long periods
Foot drop or the toes catching the floor
Increasing fatigue during walking
Hip hiking or swinging the leg around to clear the foot
Difficulty using stairs or slopes
New pain in the knee, hip, lower back, shoulder, or opposite leg
Your existing polio caliper becoming uncomfortable or unstable

A change in walking ability after many stable years should not simply be considered a normal part of ageing. It may require a reassessment of muscle strength, gait and your current orthosis.

Custom KAFO for Knee Buckling and Polio Leg Weakness

A KAFO (Knee Ankle Foot Orthosis) is a brace that supports the knee, ankle and foot together.

It is also commonly known as a polio caliper, long-leg brace or polio knee brace.

A KAFO may be recommended when weakness is severe enough that an AFO cannot provide sufficient knee control. The purpose is to create a stable lower limb during standing and walking.

Research involving polio survivors shows that common goals for KAFO use include improving stability while standing and walking, increasing walking ability and reducing walking effort.

At The Rehab Street, KAFOs are custom-made according to the patient's:

Muscle strength
Knee stability
Hip control
Ankle position
Foot alignment
Joint range of motion
Leg shape and size
Daily activity requirements
Current walking pattern

There is no single KAFO design that is suitable for every person with polio.

Types of KAFO Available

Depending on the assessment, options may include:

Polypropylene KAFO:A custom-moulded thermoplastic brace commonly used for everyday support.

Carbon Fibre KAFO:A lightweight option that may be considered when reducing brace weight and walking effort is particularly important.

Metal and Leather Polio Caliper:The traditional style of KAFO. It remains useful for selected patients who prefer this construction or have particular clinical requirements.

Locked-Knee KAFO:Keeps the knee stable during weight-bearing. Because the knee remains locked during walking, some users need compensatory movements to clear the foot during the swing phase.

Stance-Control KAFO:Designed to provide stability during the stance phase while allowing knee movement during the swing phase in appropriately selected users. Suitability depends on factors such as muscle strength, joint range, alignment and the specific device.

The best option is selected after a clinical assessment rather than simply choosing the lightest or most advanced brace.

AFO for Foot Drop After Polio

Not every person with polio needs a KAFO.

If the knee is stable but weakness causes foot drop or ankle instability, an AFO (Ankle Foot Orthosis) may provide enough support.

Different designs include:

Posterior leaf spring AFO
Solid AFO
Carbon or dynamic AFO
Ground-reaction AFO

A ground-reaction AFO can influence forces around the knee and may help selected people with mild knee-control problems. However, when significant knee buckling cannot be controlled with an AFO, a KAFO may be necessary.

The decision should be based on muscle testing and gait assessment.

Hand-on-Knee Walking Is an Important Warning Sign

Some polio survivors place one hand on the thigh or knee every time they take weight through the weak leg.

This is often called a hand-to-knee or hand-knee gait.

The person is effectively using the arm to prevent the knee from collapsing because the quadriceps cannot provide enough stability.

Although this technique may help someone continue walking, repeatedly depending on the upper limb is usually a sign that lower-limb support should be reassessed. It may also increase physical demand on the arm and shoulder over time.

If you regularly press your hand against your knee to stop knee buckling, an orthotic and gait assessment can determine whether a KAFO or another solution could provide safer support.

Post-Polio Syndrome and New Leg Weakness

Some people who recovered from polio develop new problems many years later. This is known as post-polio syndrome (PPS).

Symptoms may include:

New muscle weakness
Increasing fatigue
Muscle or joint pain
Reduced walking distance
More difficulty with stairs
Increasing falls
Reduced tolerance for an old brace

A population-based study found post-polio syndrome in about 28.5% of people in its studied group who had experienced paralytic polio, although reported rates vary between populations and diagnostic methods.

Management is individual. There is no single treatment that reverses PPS. Rehabilitation may include energy conservation, appropriate assistive devices, carefully planned exercise and avoidance of excessive muscle fatigue.

If your walking has changed, your old KAFO or caliper may also need to be reviewed.

What Happens During a Polio Leg Assessment?

At The Rehab Street, polio leg treatment in Delhi NCR starts with understanding exactly which parts of the leg need support.

1. Medical and Mobility History

We discuss your previous polio history, current walking ability, falls, fatigue, pain, existing braces and everyday mobility goals.

2. Muscle Strength Testing

Strength is assessed around the:

Hip
Knee
Ankle
Foot

This is especially important when deciding whether the knee requires direct support from a KAFO.

3. Gait Analysis

We observe how you walk and look for:

Knee buckling
Knee hyperextension
Foot drop
Hip hiking
Circumduction
Trunk leaning
Hand-to-knee support
Unequal step length

4. Joint and Alignment Assessment

Range of motion, joint position, fixed deformities and leg-length differences are checked because these can affect orthotic design.

5. Existing Brace Review

If you already use an AFO, KAFO or traditional polio caliper, bring it with you. We assess its fit, alignment, condition and whether it still meets your current needs.

6. Casting or 3D Measurement

When a custom orthosis is required, accurate limb measurements, casting or digital scanning may be used to create an individually fitted device.

7. Fitting and Walking Trial

The completed orthosis is checked for comfort, alignment, stability and function while you stand and walk.

Gait Training After Receiving a KAFO

A new KAFO is not simply handed to the patient and forgotten.

Learning how to use it correctly is an important part of treatment.

Rehabilitation may include:

Correctly putting on and removing the KAFO
Gradually increasing wearing time
Checking the skin for pressure areas
Practising safe standing and walking
Turning and changing direction
Using stairs and ramps when appropriate
Improving balance
Learning energy-saving walking techniques
Strengthening muscles that remain functional without excessive fatigue

For people with post-polio syndrome, exercise should be carefully prescribed because repeatedly exercising to the point of pain or fatigue may be counterproductive.

Custom Orthopedic Footwear for Polio

A brace performs best when the foot and shoe provide a stable base.

Polio can also cause:

Leg-length difference
Foot deformity
Ankle instability
Difficulty fitting a KAFO into normal shoes

The Rehab Street can provide customised orthopedic footwear when required, including extra-depth footwear and shoe modifications or raises for appropriately assessed leg-length differences.

Get Help for Knee Buckling and Polio Leg Weakness

If your knee is buckling, your leg feels increasingly unstable, you are pressing your hand against your knee to walk, or your old polio caliper is no longer giving you enough support, it may be time for a detailed reassessment.

At The Rehab Street, we provide personalised polio leg treatment in Delhi NCR, including custom KAFOs, AFOs, polio calipers, orthopedic footwear and gait rehabilitation at our Delhi and Gurgaon clinics.

Book a polio leg and gait assessment with The Rehab Street today. Our orthotic team can assess your muscle strength, knee stability and walking pattern and help identify the most appropriate support for safer, more confident mobility.

Frequently Asked Questions

Can a KAFO stop knee buckling?

A correctly prescribed KAFO is designed to stabilise a weak knee during weight-bearing and can help prevent collapse when knee instability results from muscle weakness. The exact design depends on the cause and severity of the instability.

Is a KAFO better than an AFO for polio?

They perform different jobs. An AFO mainly controls the ankle and foot and may indirectly influence the knee. A KAFO directly supports the knee as well. Significant knee instability may require a KAFO when an AFO cannot provide adequate control.

Can I use a normal knee brace for polio weakness?

Sometimes limited knee support is enough, but significant quadriceps weakness often requires control of the ankle, foot and knee together. An orthotist should assess this before a brace is selected.

Why does my polio leg suddenly give way?

Knee buckling can occur when weakened muscles—particularly the quadriceps—cannot adequately control the knee as body weight passes over the leg. New or worsening episodes should be clinically assessed because other conditions can also cause knee instability.

Can an old polio caliper be replaced with a lighter KAFO?

In many cases, modern thermoplastic or composite designs may be considered. However, the replacement should be designed around your current muscle strength, joint position and gait rather than simply copying the old brace.

Do I need physiotherapy with a KAFO?

Gait training and carefully selected exercises can be useful, particularly when adapting to a new orthosis. In post-polio syndrome, rehabilitation should avoid excessive muscular fatigue.

Is surgery always required for a weak polio leg?

No. Many mobility problems can be managed with orthoses, rehabilitation and assistive devices. Fixed deformities or particular joint problems may sometimes require an orthopedic surgical opinion.