Orthotics (Greek: ????? , ortho , "to align" or "align") is a specialization in the medical field concerned with the design, manufacture and application of orthoses. An orthosis (plural: orthoses ) is "an externally applied device used to modify structural and functional characteristics of a neuromuscular and skeletal system". An orthotist is the main medical doctor responsible for the prescription, manufacture and management of orthoses. An orthosis can be used to:
- Controlling, guiding, restricting, and/or paralyzing the extremities, joints or body segments for some reason
- Limit movement in a certain direction
- Assist movements in general
- Reduce the load bearing style for a specific purpose
- Rehabilitate relief from fracture after casts removal
- If not improve shape and/or body function, to provide easier movement ability or reduce pain
Orthotics combines knowledge of anatomy and physiology, pathophysiology, biomechanics and techniques. Patients who benefit from orthosis may have conditions such as spina bifida or cerebral palsy, or have had a spinal injury or stroke. Equally, orthoses are sometimes used prophylactically or to optimize performance in sports.
Video Orthotics
Producing and materials
Orthoses are traditionally made by following a limb trace with measurements to help create the right device. Furthermore, the emergence of plastics as the material of choice for construction necessitated the idea of ​​creating Paris mold plaster from the corresponding body part. This method is still widely used throughout the industry. Currently, CAD/CAM, CNC machines and 3D printing are involved in orthotic manufacture.
Orthoses are made of various types of materials including thermoplastics, carbon fibers, metals, elastics, EVA, fabrics or similar material combinations. Some designs can be purchased at local retailers; others are more specific and require a prescription from the doctor, which will correspond to the orthoses according to the patient's needs. The free-sell binder is basic and available in various sizes. They are generally slid or tied with Velcro, and held tightly in place. One of the goals of this braces is the protection of injury.
Maps Orthotics
Classification
Under the terminology of International Standards, orthoses are classified by acronyms depicting the anatomical joints they contain. For example, ankle foot orthosis ('AFO') is applied to the feet and ankles, thoracolumbosacral orthosis ('TLSO') affects the thoracic, lumbar and sacral areas of the spine. It is also useful for describing the function of orthosis. The use of International Standards is promoted to reduce wide variations in orthoses' descriptions, which are often a barrier to the interpretation of research studies.
Upper-extremity extremities
The upper-extremity extremity (or upper extremity) is a mechanical or electromechanical device applied externally to the arm or segment to restore or repair the function, or the structural characteristics of the arm segments encumbered by the device. In general, musculoskeletal problems that can be alleviated by the use of upper extremity orthosis include those resulting from trauma or disease (eg arthritis). They can also be useful in helping individuals who have suffered from neurological disorders such as stroke, spinal cord injury, or peripheral neuropathy.
Type of upper-limb orthosis
- Upper extremity Orthosis
- Clavicle and orthoses shoulder
- Arm orthoses
- Orthose functional arm
- Elbow orthoses
- Lower arm muscle orthosis
- The bottom arm-wrist-thumb orthoses
- Arms under the hands of orthoses
- Hand orthoses
- Brain over limb (with special function)
Lower limb extremity
Lower-extremity orthos is an external device applied to the lower segment of the body to improve function by controlling movement, providing support through stabilization gait, reducing pain through transfer of load to other areas, correcting flexible defects, and preventing the development of permanent deformity. The term caliper or kaliper remains widely used for lower extremity orthosis in the UK.
Foot orthoses
The orthoses foot (called "orthotics") is a device inserted into the shoe to provide support for the leg by redistributing the soil reaction force acting on the foot joint while standing, walking or running. They may be either pre-printed (also called pre-fabricated) or custom made according to a cast or ankle impression. A large amount of information exists in the orthotic literature that describes their medical use for people with foot problems as well as the impact of "orthotics" can have foot, knee, hip, and spine deformities. They are used by everyone from athletes to the elderly to accommodate biomechanical defects and soft tissue conditions. Custom-made foot orthoses are effective for relieving pain for people with high arched legs (pes-cavus), and may be effective for people with rheumatoid arthritis, plantar fasciitis or hallux valgus ("bunions"). For children with juvenile idiopathic arthritis (JIA) specially crafted and pre-fabricated foot orthosis may also reduce leg pain. Foot orthopedics may also be used in conjunction with properly placed orthopedic footwear in the prevention of foot ulcers in risky diabetic feet.
Orthotic anthitis
Ankle orthosis (AFO) is an orthosis or anchoring that clogs the ankles and legs. AFO is applied externally and is intended to control the position and movement of the ankle, compensate for weakness, or improve deformity. AFO can be used to support weak limbs, or to position limbs with muscles contracting to a more normal position. They are also used to paralyze the ankles and lower legs in the presence of arthritis or fractures, and to improve foot fall; AFO is also known as a foot brace. Ankle orthosis is the most commonly used orthosis, which makes up about 26% of all orthoses provided in the United States. According to Medicare's review of Medicare payment data from 2001 to 2006, AFO's base cost is about $ 500 to $ 700. AFO is generally made of light polypropylene-based plastic in the form of "L", with an upright part behind the calf and bottom running under feet. They are attached to the calves with a rope, and are made to fit in an accommodative shoe. The unbroken "L" shape of some designs gives rigidity, while other designs (with jointed ankles) provide different types of controls.
Getting a good match with AFO involves one of two approaches:
- AFO off-the-shelf or prefabricated custom-size AFO provisions with end users
- custom creation of individual AFOs from positive models, obtained from negative cast or use of computer-assisted imaging, design, and milling. Plastics used to make durable AFO must be heated to 400 Â ° F (200 Â ° C), making direct printing of material to the end user impossible.
The International Red Cross recognizes four main types of AFO:
The International Committee of the Red Cross issued a manufacturing guide for ankle orthoses in 2006. The goal is to provide standardized procedures for the manufacture of high-quality, modern and durable devices for people with disabilities worldwide.
Ulan healing orthosis (UHO)
An ankle/foot ankle made specifically for the treatment of a patient with a plant ulcer is disclosed, comprising a rigid L-shaped member of support and a rigid anterior support shell articulated to a L-shaped member. The plantar portion of the L-shaped member further comprises from at least one hollow spatally-located hollow protector for fitting in the inferior joints to the plantar user ulcer, thereby enabling users to transfer the user's weight away from plantar ulcers and facilitate plantar treatment ulcers. Anterior support shell is designed for lateral hinged attachment to the L-shaped member to take advantage of the medial medial tibial structure to improve the load-bearing properties of the expressed orthosis. The flexible hinge polyethylene hinge member attaches the anterior support shell to the L-shaped member and secures the rope securely attaching the anterior support shaft to the fixed proximal load relation, the anterior portion of the user's lower leg.
Knee-Ankle Orthosis (KAFO)
A knee-ankle-foot orthosis (KAFO) is an orthosis that weighs on the knees, ankles and feet. The motion in these three lower extremity areas is affected by KAFO and may include stopping motion, restricting movement, or assisting movement in any or all of the three areas of motion in the human joint: saggital, coronal, and axial. Mechanical hinges, as well as electrically controlled hinges, have been used. Various ingredients for the manufacture of KAFO include but are not limited to metals, plastics, fabrics, and leather. Conditions that may benefit from the use of KAFO include paralysis, joint weakness or arthritis, fractures, and others. Although not widely used as knee orthosis, KAFO can make a real difference in the lives of people who are paralyzed, help them walk therapeutically or, in the case of polio patients, at the community level. This device is expensive and requires maintenance. Several studies are underway to improve the design; even NASA helped pioneer the development of knee joints specifically for KAFO.
Knee orthosis (KO)
A knee orthosis (KO) or knee brace is a clamp extending above and below the knee joint and is generally used to support or align the knee. In the case of a disease that causes a nervous breakdown or muscle muscle around the knee, KO may prevent flexion or extension knee instability. In the case of conditions affecting the ligaments or cartilage of the knee, KO can provide stabilization to the knee by replacing the function of the injured or damaged parts. For example, a knee buffer can be used to reduce the pressure of knee joints affected by diseases such as arthritis or osteoarthritis by realigning the knee joints to valgus or varus. In this way, a KO can help reduce osteoarthritis pain. However, knee support is not intended to treat injury or disease alone, but is used as a joint treatment component with medication, physical therapy and possibly surgery. When used properly, knee support can help a person to remain active by improving knee position or motion or reducing pain.
Prophylactic, functional and rehabilitation broth
Prophylactic braces are used primarily by athletes who participate in contact sports. Evidence of prophylactic knee bracelets, which use football liners often stiff with a knee hinge, indicates they are ineffective in reducing anterior cruciate ligaments, but may be helpful in withstanding a collateral medial and lateral ligament tear.
Functional braces are designed for use by people who have suffered knee injuries and need support to recover from it. They are also indicated to help people with arthritis-related pain. They are intended to reduce knee rotation and support stability. They reduce the possibility of hyperextension, and improve the agility and strength of the knee. Most are made of elastic. They are the most expensive of all braces and are easy to find in any size.
Rehabilitation braces are used to limit knee movement in both medial and lateral directions - these braces often have adjustable range of motion potential to limit flexion and extension after ACL reconstruction. They are mainly used after injury or surgery to paralyze the legs. The size is bigger than any other braces, because of its function.
Spinal orthoses
Scoliosis, a condition that describes abnormal spinal curvature, may be in some cases treated with spinal orthoses, such as the Milwaukee brace, Boston brace, and brace bending from Charleston. Because this condition develops most frequently in adolescent women who are experiencing accelerated growth of their puberty, adherence by wearing is this orthosis is hampered by the concerns of these people about the changes in appearance and restriction caused by using this orthosis. Spinal orthoses may also be used in the treatment of vertebral fractures. A Jewett brace, for example, can be used to facilitate the healing of anterior wedge fractures involving T10 to L3 vertebrae. Body jackets can be used to stabilize the involved spinal fractures. The halo brace is a cervical piston orthosis used to paralyze the cervical spine, usually after a fracture. The halo brace allows minimal cervical movement of all cervical orthosis currently in use; first developed by Vernon L. Nickel at Rancho Los Amigos National Rehabilitation Center in 1955.
Orthotists
Orthotists are health care professionals specializing in providing orthoses. In the United States, orthotists work with prescriptions from licensed health care providers. Physical therapists are not legally permitted to prescribe orthoses in the US. In the UK, orthotists will often receive open referrals for orthotic assessments without specific prescriptions from doctors or other health care professionals.
Canada
In Canada, Certified Orthotist CO (c) provides clinical assessment, development of care plans, patient management, technical design, and custom orthoses fabrication to maximize patient outcomes. To obtain CBCPO certification through Orthotics Prosthetics Canada (OPC), applicants must successfully meet the following requirements: - fluent in French or English; - be a Canadian citizen or legitimate immigrant; - graduated from the OPC approved post-secondary post-secondary prosthetic and Orthotic program; - completing a minimum of 3450 hours of Residency in Orthotics under the direct supervision of a certified orthotist Canada; - successfully challenged national certification exam written, spoken and practical.
Upon successful completion of the national certification exam, the candidate is awarded the appointment of Canadian Certified Orthotist CO (c).
United Kingdom
In the UK orthotists assess the patient, and where the appropriate design and fit orthoses for each part of the body. Registration is done with the Board of Health and Nursing Professions and BAPO - the British Prosthetic Association and Orthotists. This training is B.Sc. (Hons) in Prosthetics and Orthotics at the University of Salford or Strathclyde University. New graduates are thus eligible to work as an orthotist and/or prosthetist.
Podiatrists are other professions involved with the provisions of orthotic feet. They are also enrolled in the Board of Health and Nursing Professionals. Podiatrists assess the gait to provide orthotics to improve leg function and alignment or perhaps use orthoses to redistribute pressure on pressure areas for those with diabetes or rheumatoid arthritis.
United States
A licensed orthotist is an orthotist recognized by a particular country in which they are licensed to have met the basic standards of proficiency, as determined by the examination and experience to adequately and safely contribute to the health of the country's population. American Board Board of orthopedic board has met certain standards; this includes degrees in orthotics, completion of one year of residency on approved clinical sites, and passing a rigorous three-part exam. A certified orthotist (CO) is an orthotist who has passed the certification certification of American Board of Certification in Orthotics, Prosthetics and Pedorthics. Other credential bodies involved in orthotics include the Orthotic Certification Council, the pharmaceutical industry, the Pedorthic Footcare Association, and various professional associations working with athletic trainers, physical and occupational therapists, and orthopedic technicians/cast technicians.
Iran
Four universities including the Iranian Medical University, Isfahan Medical University, the University of Social Welfare and Rehabilitation Sciences and the University of the Red Crescent of Iran confer the bachelor of science in the field of Prosthetics and Orthotics. Three universities including Isfahan Medical University, Iran's Medical Science University and the University of Social Welfare and Rehabilitation Science also provide M.Sc. and Ph.D. New graduate scholars are eligible to work as orthotist and prosthetist after enrollment in the Medical Council of Iran.
See also
- Cognitive Orthotics
- Neuromechanical orthosis
- Dental braces
- Orthotic horse shoes
- Comparison of orthotics
References
External links
- The Prosthetics Society and International Orthotists
- The American Academy of Orthotists and Prosthetics
- The British Prosthetic Association and Orthotists
- The Orthotics & amp; Virtual Prosthetic Library
- PFA Footcare Association (Canadian Chapter)
- Australian Merchant Merchants Association
Source of the article : Wikipedia
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