When choosing an orthosis, there are a few key principles to keep in mind.
The orthosis should enhance normal movement while decreasing the presence of abnormal postures and tone. It should be simple, lightweight, durable, and strong. It should be easy for the child to use and maintain.
Lastly, it should augment functional independence. An orthotic device is not successful unless it assists in improving a child's quality of life. A relatively new medical device in the rehabilitation field is manufactured by the Bioness Corporation. Their devices are neuromodulation products that are designed to service populations with multiple sclerosis, traumatic brain injury, cerebral vascular accident, spinal cord injury and cerebral palsy, and aid in their recovery. Their product can assist both the upper and lower extremity using stimulation to aid in regaining mobility and functional skills so that they can achieve optimal self-care independence, play, and/or work productivity. The upper limb orthosis addresses neurological impairments, while the lower extremity orthosis focuses on regaining the associated foot drop commonly seen in those clients with central nervous system disorders. Both upper and lower extremity orthoses use mild functional electrical stimulation (FES) to improve loss of function from injury associated with a central nervous system disability. The orthoses can be used in the clinic setting or at home. The overall goal of its use with the involved extremity is to reduce the spasticity, minimize the pain and discomfort during use, increase local blood circulation, prevent muscle atrophy, improve or maintain range of motion in the limb, and reeducate muscle use to enhance functional movement. (See the following Web site for additional information: http://www.bioness.com/ Bioness_for_Hand_Rehab.php.)Tables 6.1, 6.2, and 6.3 list some of the more common upper and lower extremity orthoses. Special considerations and limitations are also listed.
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