ORTHOTICS

ORTHOTICS

What is An Orthotic Device?

An orthosis is a device used to modify the structural and functional characteristics of the neuromuscular and skeletal systems. There are several named orthotics devices depending on the body part which needs support.

What is An Orthotic Device?

An orthosis is a device used to modify the structural and functional characteristics of the neuromuscular and skeletal systems. There are several named orthotics devices depending on the body part which needs support.

Roll over the areas on Dynamic Dude to learn more about different orthotics:

Elbow Orthotics

DYNAMIC ELBOW EXTENSION SPLINT - This brace can be used to improve elbow motion. It gives a slow stretch to the tight biceps muscle and can provide a static or dynamic stretch. Most often used for patients with a flexion contracture of the elbow, however, some therapists have found it also useful to prevent excessive hand to mouth issues.

ELBOW IMMOBOLIZERS - Are also used to keep the elbow straight but do not have joints to allow movement. This can assist with a person who has biceps tightness but no contracture present.

Foot Orthotics

UCB INSERTS - UCB stands for University of California at Berkeley where it was developed. It is also referred to as the UCBL and the L stands for biomechanical Laboratory. This insert assists in decreasing pronation and supporting the arch of the foot with proper biomechanical alignment.

CUSTOM FOOT ORTHOTICS- This would be a semi rigid orthotic that can be used for more support in normal shoewear.

CASCADE INSERTS - Cascade has prefabricated products that we can order for less customized support. The "Hotdog" provides minimal support. The "Pattibob" provides moderate support. The "Pollywog" provides maximum support.

Wrist Orthotics

ADJUSTABLE WRIST SPLINT - To be used for stretching out the wrist flexors, this brace can allow a static stretch at a certain angle. As the wrist flexors are stretched, the angle of the brace can be changed to allow a more optimal wrist position.

COCK UP SPLINT - Provides support for the wrist in a slightly extended position yet does not have an impact on the finger position.

RESTING WRIST HAND SPLINT - Provides support for the wrist and hand/fingers and assists in preventing finger flexion contractures. Is often used as a nighttime brace.

Neck Orthotics

TOT COLLAR - (Tubular Orthosis for Torticollis) helps to stretch a tight muscle in the neck called sternocleidomastoid (SCM). This fits around the neck area.

CUSTOM TORTICOLLIS COLLAR - Is ordered when there is a need for a stronger support to counteract the pull of the tight muscle (SCM). This has a head and neck support.

Hand Orthotics

RESTING WRIST HAND SPLINT - Provides support for the wrist and hand/fingers and assists in preventing finger flexion contractures. Is often used as a nighttime brace.

BENIK THUMB SPLINT- Helps to support the thumb and prevent the thumb from folding inward towards the palm (indwelling).

Ankle - SMO (Supramalleolar Orthosis)

This orthotic is named for the anatomical location on the body, namely, supramalleolar orthosis which in non medical jargon means a brace above the ankle bone. This allows for more control of the ankle and foot. It is more supportive than a UCB but less supportive than an AFO. An SMO gives medial and lateral ankle support but it does not aide in lifting the toes during walking (dorsiflexion) for foot clearance like an AFO does. This means it has free plantar flexion and dorsiflexion movement. So someone using an SMO can actively push off and heel strike on their own. For children who play on the floor and are in-between floor, standing, and walking activities, a SMO is a good choice because it limits the torque placed on the knee as opposed to when the ankle is locked in a position with an ankle-foot orthosis (AFO). You may also be interested in a combination brace where you can have the support of an AFO for walking yet the flexibility of an SMO for floor play. See AFO/SMO combo for more info on this type of brace.

Lower Leg Below Knee - AFO

SOLID ANKLE AFO - This type of AFO is used for someone that needs maximum stability. This optimizes the ankle/knee relationship in order to provide the best position in midstance. It has a well shaped foot plate with full contact padding and pressure on key points of the foot while allowing a flexible fit over the dorsum and the ball of the foot plate area to provide for easy roll over during walking.

AFO/SMO - Has the same benefits as a solid afo plus more. It will provide the patient the ability to use as a AFO during ambulation and also provide the ability to use a smo only during therapy or for short duration of ambulation to strengthen their muscles and eventually allow the possibility of being weaned from an afo. Also this allows for crawling with ease by using the smo only.

ARTICULATING AFO - This is a hinged afo that has all the same principles as a solid afo but allows for free dorsiflexion (ankle movement that lifts the foot up) as well as resisting plantar flexion. So someone that has stronger thigh muscles that can resist and control knee flexion and that can benefit from more ankle motion would be a candidate for this brace.

ARTICULATING AFO/SMO - This yields the benefits of an articulating afo in conjunction with the benefits of an AFO/SMO. (see above descriptions of these braces) While allowing the dynamic hinged joint for ankle motion (free dorsiflexion), it also has the smo insert to be used alone when needed for trial ambulation with less support or with crawling.

GROUND REACTION AFO - This type is the strongest of all AFO's. The plastic wraps around the front of the leg below the knee to provide a lot of support and resist ankle dorsiflexion during the stance phase. The brace helps support the knee and hip to maintain a more neutral position in standing. Knee flexion contractures will hinder the benefits of this type of bracing. To counteract contractures, please see dynamic knee extension splints.

Knee Orthotics

DYNAMIC KNEE EXTENSION SPLINT - This brace is designed to allow joint movement during use but also uses a tension joint to stretch the tight musculature and connective tissue slowly over time. This benefits those with knee flexion contractures.

KNEE IMMOBOLIZERS - do not have joints to allow movement but can also assist in keeping the leg straight either at night while sleeping or during standing. This type of brace is most effective for someone with tight hamstrings but no contractures present.

Upper Leg Above Knee - KAFO

This is a higher level of support for the lower extremity above the knee. In addition to the AFO, this type of brace has more support and control of the knee joint. KAFOs are commonly used to treat symptoms due to cerebral palsy, spina bifida, paraplegia, polio or muscular dystrophy. KAFOs with a knee lock are generally used to keep the knee from bending when there is a loss of or weakness of the muscles (quadriceps) that straighten the knee.

Trunk Spine Orthotics

LSO - The lumbar-sacral orthosis is used to treat spinal listhesis or a fracture in this area of the spine.

TLSO - The thoraco-lumbar-sacral-orthosis refers to the areas of the spine where the brace offers support. Most often used to treat scoliosis, but may also be used post fracture. Some types are worn 23 hours a day while others are used only at nighttime. For a fracture, a Boston Overlap Brace is used. For scoliosis, there are a few different types of named braces. The Boston Brace, the Charleston Bending Brace, the Providence Brace, and a Flex Foam TLSO. Your physician will determine which type is most effective for your diagnosis.

Hip Orthotics

HKAFO - This brace has similar support as provided by a KAFO but also provides extra support to the hip.

S.W.A.S.H. - S.W.A.S.H. means standing, walking and sitting hip orthosis. This brace address two problems; sitting imbalance and scissoring gait. These issues usually are associated with cerebral palsy. The orthosis works by promoting abduction (knees apart) with sitting and narrows when standing or walking.

HIP ABDUCTION (MAPLE LEAF) - Used post operatively to stabilize the hip and allows incremental adjustment in flexion and abduction.

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