Horizon Prosthetics offers a full line of custom orthoses and bracing solutions. Below is helpful information and answers to some frequently asked questions about orthosis.
WHAT IS AN ORTHOSIS?
An orthosis is a brace that supports any part of the body. Brace and Orthosis are synonymous. The brace may help to keep a body part from pain or further injury by immobilizing that area of the body, it may be used to support a non-functional part of the body, or it may help control the motion of a functional part of the body.
WHO NEEDS AN ORTHOSIS?
Nearly everyone will need some type of orthosis at some point in his or her life.
Sometimes babies are born with hip, cranial, foot, limb and spine anomalies that can be helped by some type of brace. The orthosis can help stabilize areas of risk and guide proper development of those areas as the infant matures.
Children and Youth
- Children with injuries may need orthoses to help support and immobilize that area until it is healed. Orthoses can often act as casts, with the benefit of removal for cleaning.
- Sometimes children may have a medical condition or developmental condition that may require orthoses to eliminate too much motion, or to help promote an increase in motion in those areas.
- Other orthoses are designed to help promote correct development as the child grows.
- Children and Youth with the following conditions often require bracing (not a conclusive list):
- Lower Extremity Orthoses: Toe Walking, Flat Feet/Pes Planus, Spina Bifida, Cerebral Palsy, ALS-Lou Gehrig’s Disease, Charcot Marie Tooth Syndrome, Club Foot, Injury
- Upper Extremity Orthoses: Cerebral Palsy, Spina Bifida, Injury
- Spinal Orthoses: Spina Bifida, Cerebral Palsy, Scoliosis, Kyphosis, Spondylolisthesis, Spondylolisis, Injury
- Cranial: Trauma, Cerebral Palsy.
Adults often need orthoses for injuries sustained in their youth. Degenerative diseases can often be managed with orthoses through immobilization or limitation of motion. Trauma may cause a need for an orthosis in order to stabilize the area while it heals. Osteoarthritis, Rheumatoid Arthritis, Joint Pain, Foot Pathologies, Trauma, Spondylolysis, Spondylolisthesis, Post-Polio, Multiple Sclerosis, CVA are all examples of why an adult may require an orthosis.
Athletes often have to wear ankle, knee, and other braces to prevent injuries from worsening while playing. Many athletes have to sit out of their sport after sustaining an injury and wear an orthosis until they are fully healed and ready to return to their sport. Some schools and athletes prefer to brace prophylacticly – or before injury in hopes to prevent injury. This use of orthosis has not yet been proven definitively in the professional literature, and thus in many cases, insurance will not help in providing such orthoses.
TYPES OF ORTHOSIS
Prefabricated vs. Custom Made to Measurement vs Casting/Scanning Lower Extremity Upper Extremity Spinal/Cranial Brand Names
Prefabricated vs. Custom
- Orthoses come in many types, shapes, and sizes. A brace that is pre-fabricated is considered to be a brace that is available “off-the-shelf” for anyone that has the same measurements as the fabricated model.
- However, people also come in many types, shapes, and sizes. And often do not fit within the pre-fabricated model parameters. Or, the prefabricated model may not address all issues that the patient needs addressed. In both cases, a brace would need to be made specifically for the patient. This brace would be considered a custom-fabricated orthosis.
- At Horizon Prosthetics, we make nearly all of our custom bracing in-house in our prosthetics/orthotics lab. This is to meet our goal of providing the best quality in fit and function that we can possibly provide.
Made to Measurement vs. Casting or Scanning
- If a patient needs a custom orthosis, the practitioner will need to get a model of that patient’s affected area.
- Depending on the type of brace being made, the practitioner may only need to measure the patient in order to make a custom “made-to-measurement” orthosis.
- More often than not, the practitioner will need an exact model of the patient’s affected area. In order to get this, the practitioner will either cast the patient’s affected area and immediately remove the cast. Or, in many cases, the practitioner may use a scanning device to collect all the data of the affected area, which will later be downloaded to a computer and a direct model of the patient’s affected area will be made.
- With both casting and scanning, the practitioner ends up with a replica of the patient’s affected area to use for orthosis fabrication in the lab.
- Orthoses are named according to the joints that they cross. For instance, a knee brace is considered a “KO” or a “Knee Orthosis.” Braces can be made for any part of the lower extremity.
- Some orthoses are named according to their function. Example: RGO = Reciprocating Gate Orthosis.
- FO – Foot Orthosis
- AFO – Ankle Foot Orthosis
- KO – Knee Orthosis
- KAFO – Knee Ankle Foot Orthosis
- HKAFO – Hip Knee Ankle Foot Orthosis
- RGO – Reciprocating Gate Orthosis
- Like the other types of orthoses, upper extremity orthoses are most-frequently named after the joints they cross or the portion of the limb that they brace.
- FO – Finger Orthosis
- HO – Hand Orthosis
- WHO – Wrist, Hand Orthosis
- WHFO – Wrist Hand Finger Orthosis
- EO – Elbow Orthosis
- SO – Shoulder Orthosis
- SEO – Shoulder Elbow Orthosis
Spinal and Torso
- SO – Sacral Orthosis
- LSO – Lumbo Sacral Orthosis
- TLSO – Thoraco Lumbo Sacral Orthosis
- CTLSO – Cervico Thoraco Lumbo Sacral Orthosis
- CO – Cervical Orthosis/Collar
- Rib Belt
- Cranial Helmet
Often, braces will come to be known by a certain manufacturer, by the designer of the brace, or by the name of a certain style of that brace. In other words, Kleenex is to Tissue; as Minerva is to CTLSO. The Minerva is still a CTLSO, but not every CTLSO is a Minerva style. Boston Jacket is a type of TLSO, but not every TLSO is a Boston Jacket.
- There is an adjustment period with nearly every type of brace. The body is not used to wearing a brace, and needs to adjust to it gradually. Typically, the orthotist will give you a wearing schedule to give your body adequate time to adjust to the orthosis. It is important to adhere to the wearing schedule. Over-wearing the brace at first can result in soreness and fatigue.
- Wearing schedule – A typical wearing schedule is starting with 2 hours of wear per day, and gradually increasing by 2 hour increments each successive day. If it begins to feel sore, you can remove it early for that day. But do not over-wear the orthosis.
Need For Adjustment
Pay close attention to your skin when you remove the orthosis. If you are wearing the orthosis correctly, and it is a good fit, you should have an overall pink or dark hue of the skin when the brace is removed. However, the skin tone should quickly return to normal once removed. If a red or dark spot stays for longer than 15 minutes after the brace is removed, you are in danger of developing a hot-spot or blister. Please discontinue wear and schedule a follow up appointment with your orthotist. The orthotist can make an adjustment that will relieve this spot and restore proper fit and function to the brace.
Shoes can often be a problem when worn with orthoses. Sometimes orthoses can be made to fit into the current size of shoe. But more often than not, the patient may need to get a slightly larger shoe size to accommodate the orthosis. An ideal shoe for a brace has the following properties:
- Sturdy base (no high heels, or wedge shoes)
- Wide Shoe
- Extra Depth
- Lace or Velcro Closure
- Athletic Sneaker
- Other shoes can sometimes be used and made to work but an athletic sneaker with those qualities is the best bet for comfort and stability while wearing the orthosis.
Cleaning, Care and Maintenance
- Plastic braces can be cleaned with soap and water and thoroughly washed. Another option is to mix a half and half solution of alcohol and water and rub down the orthosis. Wipe dry.
- Braces with cloth should be hand washed with soap and water, and well rinsed. Lay flat or hang to dry.