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Physiotherapy


Orthotics (Supports and Braces)

Introduction

An orthotics is a mechanical appliance fitted to the body part to enable better use of that particular part anatomically and functionally.

Classification

Depending on function: Supportive orthotics, Functional orthotics, Corrective orthotics, Protective orthotics, Orthotics that help in strengthening certain muscles, Pain relieving orthotics, Preventing weight-bearing orthotics.

Depending on region-fitted:

1.Cervical orthotics
2.Head cervical orthotics (HCO)
3.Head cervical thoracic orthotics (HCTO)
4.Sacral orthotics (SO)
5.Lumbar-sacral orthotics (LSO)
6.Thoracic lumbar-sacral orthotics (TLSO)
7.Upper extremities orthotics
       a.Shoulder arm orthotics
       b.Elbow orthotics
       c.Wrist orthotics
       d.Hand orthotics
8.Lower extremities orthotics/ Calipers
       a.Hip-knee-ankle-foot orthotics (HKAFO)
       b.Knee-ankle-foot orthotics (KAFO)
       c.Ankle-foot orthotics (AFO)
       d.Foot orthotics (FO)
9.Splints

Advantages

It provides support, stability and pain relief to the part fitted.
It assists and resists movements.
It supports the weakened paralyzed muscles and unstable joints too.
It controls, corrects and prevents deformity and contractures.
It reduces weight bearing and replaces the paralyzed muscles.
It also reduces and increases range of movements.

Disadvantages

• Loss of skin integrity due to compressive forces.
• Weakening of axial muscles.
• Increased movements at ends of immobilized segments.
• Physical and psychological dependence.
• Osteopenia (condition of thinning of bones) and lack of cosmoses.

Contraindications

• Skin infections
• When muscle power is getting affected by weight of orthotic.
• If the orthotic is limiting the movement of normal joints.
• Lack of motivation/psychological problems.
• Very young and old patients.

Some of the orthotics

Note:  There are many kinds of orthotics present in the market. While using a splint take advice of your doctor depending on the condition.

• Swedish knee cage: It controls minor/moderate genu-recurvatum (hyperextension of knee).
  
• Pediatric orthotic: Standing frame for toddler with spina bifida/T12 neurosegmental lesion/Child with cerebral palsy.
  
• Para podium (swivel orthotic): It is used for leg length discrepancy to support and assist in upright posture.
 
• Cervical orthotic: Used in neck strains, sprains, injuries etc. (e.g. Collars).

• Head cervical orthotics: e.g. Minerva jacket, Four post cervical orthotic.
 
• Head cervical thoracic orthotic: e.g. SOMI (Sterno-Occipito-Mandibular Immobilization) brace, HALO orthotic.
 
• Thoracic lumbar sacral orthotic: e.g. Jewett brace, Milwaukee brace
 
• Lumbar sacral orthotic: e.g. Knight brace, Boston brace.

Lumbar orthotic:

• Sacral orthotic: Sacroiliac corset.
 
• Splints: These are two types 1) Static  2) Dynamic

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