Orthosis Designs
Keith Smith
keithorth@sbcglobal.net

The most important goal for patients with PLS and HSP is to maintain and/or improve joint range of motion. Secondary goals include improving balance and coordination, maintaining strength and decreasing muscle tone.

A hinged orthotic is the best choice due to the absolute necessity of maintaining and improving range of motion. A hinged brace can also allow for static progressive positioning, which will in turn increase that ever important range of motion. Clients need to ask, “Why?” if the orthotic professional wants to deny or minimize this crucial muscular task.

Two of the most recent innovations in the field are the WalkAide system and Carbon Fiber. Many of us are already familiar with the WalkAide system. This device uses electrical stimulation to help with gait and drop foot problems. The system also reduces spasticity. The major roadblock in using the WalkAide is the same as last year, and the year before that: Health Insurance Programs do not cover the cost of this orthotic device.
 
Carbon Fiber is a newer material that is being used for braces. The advantage of this type of orthotic is that it is lightweight, extremely flexible and comes in a noodle design. A noodle design is one that does not wrap around or cover the leg completely. The brace is therefore much cooler than the stereotypical design. Carbon fiber, though a newer development in the field of orthotics has been used in the airline industry for over twenty years.

The most important idea to remember from Keith Smith’s presentation is this: HSP and PLS clients need to maintain joint RANGE OF MOTION for as long as possible. Use hinged orthotics to help accomplish this goal.

More information on the WalkAide

WalkAide is a medical device that was developed after years of research. It is now FDA approved. WalkAide addresses the ‘foot drop’ problem that many of us develop with diseases that damage upper motor neurons and the pathways to the spinal cord. This device is a small, self-contained unit that consists of a battery-operated electrical stimulator, attachment cuff, two electrodes, and electrode leads. It is applied directly to the leg below the knee and can be worn discreetly. A cuff holds the system in place. The stimulation from the electrodes activates the muscles that cause foot drop to flex the foot at the appropriate time during the gate cycle. For some patients, this produces a more natural pattern of walking and can help minimize falls. For more information, please visit the web site at: www.walkaide.com. 

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