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Pediatric Case Studies Part 2: Orthotic Interventions

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 presents intervention for and management of three children who used various orthoses: a child with Sever's Injury, a child with Spastic Diplegic Cerebral Palsy, and a child with Down Syndrome. Treatment options for a child with Sever's, including rigid taping, insole adaptations using Spenco, and Aquaplast alternatives (ranging from foot support to immobilization), will be presented. The implications of considering orthotic options but also assistive device options for children with cerebral palsy will be emphasized. Providing a plan of care that optimizes the principal of "least restrictive environment" and optimizing fitness will be emphasized by presenting PT management of a child with CP and a child with Down Syndrome.

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. Intervention Alternatives for a Child with Sever’s Injury that Optimize Participation

While some children with Sever’s Injury require immobilization to heal, some may be managed with footwear that allows them to continue to participate in sports and other activities. For those that require immobilization Aquaplast bivalved AFOs may be worn in sneakers and permit better overall mobility and foot/ankle immobilization, than a CAM walker. Progression toward and away from immobilization and return to play will be discussed. Fabrication of an Aquaplast™ shoe insert and of a foam insert will be demonstrated.

2. Orthosis and Assistive Device Alternatives for a Child with Spastic Diplegic Cerebral Palsy (CP)

This case demonstrates various orthotic and assistive device alternatives with an emphasis on empowering the child to maximize his participation. The clinician is encouraged to consider providing different assistive device/footwear setups for use by the same child in different settings and contexts.

3. Orthoses to Optimize Alignment, Mobility and Development in a Child with Down Syndrome (DS)

This case discusses footwear alternatives for minimization and prevention of foot deformity, discomfort or pain, while optimizing the patient’s gross motor development, strength, "functional mobility" and fitness. Plaster slipper casting with be demonstrated.

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