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Overview of Orthoses and Alternatives to Improve Gait in Children

presented by Lisa Selby-Silverstein, PT, PhD, NCS

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Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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This course discusses types of orthoses, their componentry, and modifications that can be used to improve a child's gait. Alternatives to custom orthoses will also be discussed. Methods of adapting insoles and using Aquaplast(TM) and plaster casting to enable use of orthosis laboratories will be demonstrated. The therapist will be challenged to identify the problems to be addressed, the immediacy of need for remediation, the time period for orthosis use, and the environments where the orthosis is needed before deciding what type of orthosis and footwear to recommend. The need to do an orthotic checkout and modify the orthosis or footwear to optimize goal attainment will be highlighted. The fact that children will not wear the same orthosis all day in all settings and the concept of optimizing various footwear options for patients will be discussed.

This course is part of a four course series:.

  1. Scientific Basis for Orthosis Prescription to Improve Gait in Children
  2. Overview of Orthoses and Alternatives to Improve Gait in Children
  3. Pediatric Case Studies Part 1: Orthotic Decision-Making
  4. Pediatric Case Studies Part 2: Orthotic Interventions

Meet Your Instructor

Lisa Selby-Silverstein, PT, PhD, NCS

Dr. Selby-Silverstein is a Professor at Neumann University teaching in the Physical Therapy Program. She previously was on faculty at Thomas Jefferson University, where she also was Director of the Human Performance Laboratory. She has been a PT in rehabilitation settings, gait laboratories, developmental centers, early intervention, school-based, home care, and outpatient physical therapy settings.…

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Chapters & Learning Objectives

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1. Factors that Influence Effectiveness of an Ankle Foot Orthoses

Lever arms, materials types and thicknesses, cut lines and configurations that enable 3 point pressure systems will be discussed. Footwear and “tuning” for shank angle, matching orthosis joint angles with anatomical joints, and pros and cons of active, passive and immobile ankle joints will be discussed.

2. Ankle Foot Orthoses Options and Alternatives

Different types of ankle foot orthoses, and orthotic components will be discussed. Knee braces will be discussed in comparison to controlling the knee using an AFO. Aquaplast™ and functional electrical stimulation alternatives will also be discussed.

3. Foot Orthoses and SMOs: Options and Considerations

This chapter focuses on foot orthoses (FOs), supramalleolar orthoses (SMOs), taping, and footwear options. Custom casting is compared to over-the-counter options. When and how much to correct poor alignment, materials, and where/how to procure devices will be discussed.

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