orthotic treatment of polio myelitis
DESCRIPTION
poliomyelitisTRANSCRIPT
Orthotic treatment of polio myelitis
Rabia MustafaKing Edward Medical University
Poliomyelitis
Poliomyelitis, literally meaning “gray spinal cord inflammation.”
It is a viral infection. It is contagious usually spread
from person to person.Only harmful to humans
Background:Orthotic treatment in the context
of rehabilitation medicine is a frequently applied intervention to promote mobility.
Orthoses should be used until no further recovery is anticipated.
orthoses are given in stage of greatest paralysis.
Appropriate orthotic appliances are prescribed to prevent deformities due to muscle imbalance.
Static joint stability usually can be controlled by orthoses
Dynamic joint instability eventually results in a fixed deformity that can not controlled with orthoses
Treatment
No specific treatment. Pt. either will or will not recover the
muscle power depend upon the severity of neurological damage.
Duties of orthopedic team are to prevent deformities, to assist returning muscle power by gradual exercises, and to reduce residual disability in final stage by the provision of appropriate appliances or by operations on joints or muscles.
Appliances
The upper limbs the following are commonly prescribed Spinal brace: To support a weakend spine Abdominal support: To check abdominal protrusion when the abdominal
muscles are weak Knee calliper: To hold the knee extended in case of severe quadriceps
paralysis Below knee brace: To stabilize a flail ankle or foot Ankle foot orthoses: To hold the foot up when the Dorsiflexion muscles are
paralysed
Hip knee ankle foot orthosis
If the hip abduction power is poor (i.e., < 2), the appliance will include a pelvic band with a hip joint (hip-knee-ankle-foot orthoses) to prevent the lurching gluteus medius gait.
Knee ankle foot orthosis
A knee-ankle-foot orthosis (KAFO) is an orthosis that covers the knee, ankle and foot.
When the quadriceps power is 2 or below, the knee has to be stabilized and hence a knee-ankle-foot orthoses (full or above-knee calliper) is prescribed.
Motion at all three of these lower limb areas is affected by a KAFO.
can include, stopping motion limiting motion assisting motion in any or all of the 3 planes of
motion saggital, coronal, and axial.
Knee orthosis
A knee orthosis (KO) or knee brace is a brace that extends above and below the knee joint and is generally worn to support or align the knee.
KO prevent flexion or extension instability of the knee
Ankle foot orthosis
An ankle-foot orthosis (AFO) is an orthosis or brace (usually plastic) that supports the ankle and foot
When the power of muscles controlling the hip and knee are normal and the weakness is only in the dorsiflexors or plantar flexors of the ankle or invertors or evertors of the foot, the patient is prescribed an ankle-foot orthoses (below-knee orthoses or calliper).
AFOs are externally applied and intended to control
positionmotion of the anklecompensate for weakness or correct deformities. It is used to support weak limbs,
or to position a limb with contracted muscles into a more normal position.
Spinal orthosis
The Milwaukee brace, also known as a cervico-thoraco-lumbo-sacral orthosis or CTLSO.
Milwaukee brace are use in 3 ways to treat the scoliosis
As a corrective apparatus Hold the spine in position A substitute for surgery
Role of orthotist
Is that of biomechanical back up to the clinical team. From the point of view of the person with polio, the Orthotist provides orthoses (splints).
These include insoles to persons’ shoes, foot Orthoses, ankle-foot orthoses (AFO), knee ankle foot orthoses (KAFO) (Short or long callipers), and spinal jackets.
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In some cases, orthopaedic the majority of AFOs and KAFOs (callipers) are now made to a cast, Footwear is also prescribed
Old style orthoses of sidebars and T-straps are not so common anymore and use lightweight plastics.
These orthoses are normally lighter and fit directly inside footwear. This often means footwear does not have to be Adapted and walking is made easier.
The Orthotist, when making orthoses, considers skeletal alignment, joint integrity and ease of walking
