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Orthoses for Positioning, Range of Motion, and Healing

Due to immobility, spasticity, and/or abnormal postures, many children are at risk for joint contractures, muscu­loskeletal deformity, and skin breakdown. Traditionally, caregivers have used pillows and towel rolls to main­tain more appropriate postures.

Bony areas such as the occiput, scapular spine, coccyx, femoral head, fibular head, and calcaneus are at greatest risk for skin break­down from prolonged bedrest or maintenance of one position. Gel pads may be used to distribute weight over a larger area. The child may benefit from position­ing pieces to maintain neutral positions and decrease pressure on parts of the body. Foam wedges in various lengths and sizes are commonly used for back support to position a child in side-lying. An abduction pillow may be used to decrease scissoring and increase hip abduction. Foam arm and leg elevators help to reduce edema, and foot splints/boots are available to maintain the foot in a dorsiflexed position with relief for the cal­caneus to prevent pressure sores.

The Versa Form pillow is a semipermanent posi­tioning support. These styrene bead bags are avail­able in a variety of sizes and allow for molding to a child in any position. A vacuum pump is required to remove air from the pillow to make it firm. The bead bags need to be reformed after several weeks of use. This new technology gives the practitioner flexibility to change a child's positioning frequently.

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Source: Alexander M.A., Matthews D.J.. Pediatric Rehabilitation: Principles and Practice. 4 th. åd. — New York: Demos Medical Publishing,2010. — 540 ð.. 2010
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