Orthotic devices are used to support, correct or replace musculoskeletal functions lost through physical impairment. These devices are prescribed for patients with temporary or permanent disabilities, associated with conditions such as sports injuries, strokes, multiple sclerosis, muscular dystrophy, fractures, scoliosis, diabetes and neurological deficits.
We fit most types of custom fabricated braces, including
Spinal orthoses are devices applied externally to the spinal region of the body to limit the motion of, correct deformity in, reduce axial loading on, or improve the function of a particular segment of the spine.
Orthoses are generally named according to the body regions that they span. For example, a cervical orthosis (CO) is applied to the cervical spine, while a cervicothoracolumbosacral orthosis (CTLSO) spans the entire length of the spine.
Indications for recommending the use of spinal orthoses include the following:
Upper extremity orthoses are devices applied externally to restore or improve functional and structural characteristics of the musculoskeletal and nervous systems. In general, musculoskeletal problems include those resulting from trauma, sports, and work-related injuries. Upper extremity orthoses also are used frequently on patients who have had neurologic problems, such as stroke, traumatic brain injury, multiple sclerosis, cerebral palsy, spinal cord injury, and peripheral nerve injury. They often are used in arthritic conditions as well.
An orthosis is classified as a static or dynamic device.
Functions of upper extremity orthoses include:
A lower limb orthosis is an external device applied or attached to a lower body segment to improve function by controlling motion, providing support through stabilizing gait, reducing pain through transferring load to another area, correcting flexible deformities, and preventing progression of fixed deformities.
Orthosis (or orthotic device) is the medical term for what most people would refer to as a brace or splint.Orthoses generally are named by the body regions that they involve, as demonstrated by the following abbreviations:
An orthosis is classified as a static or dynamic device. A static orthosis is rigid and is used to support the weakened or paralyzed body parts in a particular position. A dynamic orthosis is used to facilitate body motion to allow optimal function. In all orthotic devices, 3 points of pressure are needed for proper control of a joint.
A lower limb orthosis should be used only for specific management of a selected disorder. The orthotic joints should be aligned at the approximate anatomic joints. Most orthoses use a 3-point system to ensure proper positioning of the lower limb inside the orthosis.
The orthosis selected should be simple, lightweight, strong, durable, and cosmetically acceptable. Considerations for orthotic prescription should include the 3-point pressure control system, static or dynamic stabilization, flexible material, and tissue tolerance to compression and shear force. An orthosis can be constructed from metal, plastic, leather, synthetic fabrics, or any combination. Plastic materials, such as thermosetting materials and thermoplastics, are the materials most commonly used in the orthotic industry. Shoes are the important foundation of the lower limb orthosis. Shoes are used to protect and warm the feet, transfer body weight while walking, and reduce pressure or pain through redistributing weight. Shoes should be comfortable and properly fitted. They should be at least 1 cm longer than the longest toe and correspond to the shape of the feet.
An ankle-foot orthosis (AFO) is commonly prescribed for weakness or paralysis of ankle dorsiflexion, plantar flexion, inversion, and eversion. AFOs are used to prevent or correct deformities and reduce weight bearing. The most common material used in fabrication of AFO-s is semi-rigid thermoplastic.
The following is a general outline of what to expect from the orthotic fitting process, from the first evaluation appointment to the final delivery and follow-up care.
Evaluation
At this time, the orthotist will ask you many questions about your health history, lifestyle, your vocation (what you do for a living), your hobbies, your future plans, and your expectations for using your orthosis. Your orthotist will also do a thorough evaluation of your strength and range of motion, or flexibility.
If you have used an orthosis in the past, please bring it to your evaluation appointment. If you are being fit with a KAFO, or long-leg brace, it is helpful if you bring or wear shorts to this appointment. If needed, we can provide you with disposable paper shorts to wear for the evaluation. If you are being fit with any lower-limb orthosis, please also bring the complete pair of shoes that you plan to wear with your device.
Your othotist will contact your physician to report these findings along with a recommendation for the type of orthosis that will serve your goals, expectations, and abilities. Your device recommendation will also be forwarded to your insurance carrier for financial verification at this time. Some insurance carriers can take several weeks to review your case and reach a final decision. Before proceeding with fitting and delivery of your device, you will have the opportunity to meet with our financial coordinator to review and approve the device that has been recommended for you.
Measurement and Impression-taking
For many types of orthotic devices, your orthotist will take measurements or an impression at the same time as the evaluation appointment. An impression is normally taken with fiberglass or plaster bandage. Your orthotist will wrap the plaster or fiberglass around the area where the orthosis will be worn, then he or she will use a special cast cutter to remove the cast. Once the cast is finished and all measurements have been taken, the orthotist will use this information to fabricate, or build, your orthotic device.
Depending on the type of device, it will normally take 1-2 weeks before you return for the final fitting and delivery appointment. If your device requires more time for fabrication, or requires a different fitting process, your orthotist will explain the process at this time.
Fitting and Delivery
At this time your orthotist will fit the device on to your body to do the final trimming and shaping. If you are able, he or she will then have you walk or use the device and observe its function. Small changes may be made to the device to optimize function during this appointment.
When the fitting is complete, you will normally get to take the finished device home with you that same day. Your orthotist will make sure that you understand the use of your device, and that you are aware of the care and maintenance required for your device. He or she will also set guidelines for an initial wearing schedule to give your body some time to get used to wearing the orthosis. It is very important that you follow the wearing schedule and safety guidelines set by your orthotist and physical therapist. If you notice any lasting redness or discomfort, stop wearing the orthosis and contact your orthotist for an appointment to re-evaluate the fit and function of your device.
Follow-up
Once your orthosis is finished, you will return occasionally for adjustments and minor repairs. Contact your orthotist if you notice that your device is fitting differently or that any parts of the orthosis appear worn or are not working properly. Your orthotist will let you know if any parts of your orthosis require special maintenance.
