ORTHOTICS

An orthosis is a custom designed and custom fabricated device to help restore function & mobility, prevent deformity and provide support and protection for an affected limb. 

Once a prescription for a custom orthosis has been made, the process of obtaining an orthosis may begin. At the initial appointment, the patient is assessed both physically and cognitively to determine their needs, goals, and desires.  From this, the orthotist will determine how the brace should be designed to best suit the patient.  On certain occasions, video gait analysis would be performed to assist in forming the orthotic prescription and to help show the positive effects the device is having on the patient’s gait pattern.  

FIG. 1 - Assessment                                                FIG. 2 - Observational Gait Analysis

Orthotic devices prescribed vary in severity and complexity and include the following:  

FIG. 3 - Preparing to take a plaster mould    FIG. 4 - Negative casts for FO's 

When fitting a custom brace, the orthotist is required to take measurements and a cast of the affected body segment.  Once the assessment, measurements, and casting are completed, a positive mould is generated out of plaster.  

Fig. 5 - Taking negative mould for a pediatric AFO. 

The mould is then modified by the orthotist to provide sufficient support and relief areas in the brace.  Once the mould is modified, the brace is fabricated and a static and dynamic analysis and fitting is scheduled for the patient. 

Fig. 6 - Static analysis of orthosis. 

At this appointment: the brace is evaluated, the patient is advised of proper wearing schedules, maintenance, as well as washing instructions.  During this appointment, the orthotist will also educate the patient on how to apply and take off the device, as well as provide gait training (lower extremity cases), and give suggestions regarding essential day-to-day activities (upper extremity cases).

Fig. 7 - KAFO with UltraFlex Joints for Spasticity Management

Fig. 8 - Plagiocephaly helmet

Fig. 10 Leather gauntlet to support the wrist. This is often prescribed for arthritic clients, however may help other clients with wrist problems.

A follow up appointment is scheduled for two weeks later to address any possible fit issues, answer questions, as well as provide a check up on patient progress.   If the brace is performing as intended, then no further appointments are booked at this time.  

Fig. 8 Hinged AFO

When fitting an ‘off-the shelf-device’ (OTSD), the orthotist is required to take measurements of the affected limb/area.  Once the assessment and measurements are taken, the orthotist will use discretion to provide a specific brace that will best suit the patient’s needs, problems and concerns.  The brace will either be from stock, or ordered from a supplier.   Even though they are an off the shelf device, they can be customized by the orthotist and follow-up care will be provided.

Sudbury Prosthetic & Orthotic Design Ltd. is a facility that sees a diverse patient base.  Possible patients include those with pathologies such as: