Custom orthoses includes the design and fabrication of devices used for:
Orthotics is a specialty within the medical field concerned with the design, manufacture and application of orthoses. Orthoses) is "an externally applied device used to modify the structural and functional characteristics of the neuromuscular and skeletal system". An orthosis may be used to:
Patients benefiting from an orthosis may have a condition such as Spina bifida or cerebral palsy, or have experienced a spinal cord injury or stroke. Equally, orthoses are sometimes used prophylactically or to optimize performance in sports.
Upper-limb orthoses are mechanical or electromechanical devices applied externally to the arm or segments thereof in order to restore or improve function, or structural characteristics of the arm segments encumbered by the device. In general, musculoskeletal problems that may be alleviated by the use of upper limb orthoses include those resulting from trauma or disease (arthritis for example). They may also be beneficial in aiding individuals who have suffered a neurological impairment such as stroke, spinal cord injury, or peripheral neuropathy.
A lower-limb orthosis is an external device applied to a lower-body segment to improve function by controlling motion, providing support through stabilizing gait, reducing pain through transferring load to another area, correcting flexible deformities, and preventing progression of fixed deformities
Foot orthoses comprise a specially fitted insert or foot bed to a shoe. Also commonly referred to as "Orthotics" these orthoses provide support for the foot by distributing pressure or realigning foot joints while standing, walking or running.
They are often used by athletes to relieve symptoms of a variety of soft tissue inflammatory conditions like plantar fasciitis. They may also be used in conjunction with properly fitted orthopedic footwear in the prevention of foot ulcers in the at-risk diabetic foot.
An ankle-foot orthosis is an orthosis or brace that surrounds the ankle and at least part of the foot. AFOs are externally applied and intended to control position and motion of the ankle, compensate for weakness, or correct deformities. This type of orthosis is believed to cause chronic joint weakness if over or improperly worn. They control the ankle directly, and can be designed to control the knee joint indirectly as well.
AFOs are commonly used in the treatment of disorders affecting muscle function such as stroke, spinal cord injury, muscular dystrophy, cerebral palsy, polio, multiple sclerosis and peripheral neuropathy.
AFOs can be used to support wasted limbs, or to position a limb with contracted muscles into a more normal position. They are also used to immobilize the ankle and lower leg in the presence of arthritis or fracture, and to correct foot drop; an AFO is also known as a foot-drop brace.
A knee-ankle-foot orthosis (KAFO) is an orthosis that encumbers the knee, ankle and foot. Motion at all three of these lower limb areas is affected by a KAFO and can include stopping motion, limiting motion, or assisting motion in any or all of the 3 planes of motion in a human joint: sagittal, coronal, and axial.
Mechanical hinges, as well as electrically controlled hinges have been used. Various materials for fabrication of a KAFO include but are not limited to metals, plastics, fabrics, and leather.
Conditions that might benefit from the use of a KAFO include paralysis, joint laxity or arthritis, fracture, and others. Although not as widely used as knee orthoses, KAFOs can make a real difference in the life of a paralyzed person, helping them to walk therapeutically or, in the case of polio patients on a community level.
These devices are expensive and require maintenance. Some research is being done to enhance the design, even NASA helped spearhead the development of a special knee joint for KAFOs
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. In the case of diseases causing neurological or muscular impairment of muscles surrounding the knee, a KO can prevent flexion or extension instability of the knee.
In the case of conditions affecting the ligaments or cartilage of the knee, a KO can provide stabilization to the knee by replacing the function of these injured or damaged parts.
For instance, knee braces can be used to relieve pressure from the part of the knee joint affected by diseases such as arthritis or osteoarthritis by realigning the knee joint into valgus or varus. In this way a KO may help reduce osteoarthritis pain.
However, a knee brace is not meant to treat an injury or disease on its own, but is used as a component of treatment along with drugs, physical therapy and possibly surgery. When used properly, a knee brace may help an individual to stay active by enhancing the position and movement of the knee or reducing pain.
Scoliosis or Spinal Orthoses, a condition describing an abnormal curvature of the spine, may in certain cases be treated with spinal orthoses, such as the Milwaukee brace, the Boston brace, and Charleston bending brace.
As this condition develops most commonly in adolescent females who are undergoing their pubertal growth spurt, compliance with wearing is these orthoses is hampered by the concern these individuals have about changes in appearance and restriction caused by wearing these orthoses.
There are a number of spinal orthotic designs common to assist individuals with pathologies of the neck and back.
A thoracolumbar spinal orthosis (TLSO) is a plastic body jacket to immobilize the thoracolumbar spine, although that term describes any type of orthosis that encumbers the trunk, ranging from soft corsets to metal braces to strap and pad designs that affect pathologies ranging from back pain to scoliosis to fracture.