Atlas of Orthoses and Assistive Devices

Description

Front Matter Atlas of Orthoses and Assistive Devices Copyright Copyright Page Contributors Contributors Foreword Foreword Preface Preface 1. Orthotic Prescription 1 Orthotic Prescription Key Points Terminology Ankle Joint Controls and Their Function Evaluation of the Patient Orthotic Prescription Case Scenario and Orthotic Prescription Recommendation Case Scenario Assessment Rationale for Orthotic Prescription and Treatment Plan Options Conclusion References 2. Materials Science 2 Materials Science Abstract Keywords Key Points Understanding Material Science to Maximize Patient Safety Imperial and Metric Conversions Strength and Stress Tensile, Compressive, Shear, and Flexural Stresses Tensile Stresses Compressive Stresses Shear Stresses Flexural Stress Yield Stress Ultimate Stress Strain Stress–Strain Curve Plastic Range Yield Point Tensile Strength Toughness and Ductility Thermal Stress Centroids and Center of Gravity Moment of Inertia Parallel Axis Theorem Stresses in Beams Section Modulus Beam Torque Beam Stress Beam Deflection Metals Crystallinity Grain Structure Slip Planes Mechanical Properties Plasticity Steel and Aluminum Alloys Commercial Name for Metals Carbon Steel Alloy Steel Characteristics of Specific Alloys Stainless Steels SAE Number and Other Steel Number Grading Systems Comparison of Steel and Aluminum (Aluminium) Stress–Strain Diagram Size, Weight, and Strength Comparisons: Strength-to-Weight Ratio Strengthening Aluminum and Steel Heat Treatment Purposes Techniques Example. Heat-Treat Cycle Heat Treatment Influencing Fabrication Practices Aluminum Heat Treatment Examples Stress–Strain Diagram Titanium Preventing Failure and Maximizing Patient Safety Fatigue Steel and Aluminum Fatigue Compared Stress Concentration Example. Minimizing Stress Concentration Minimizing Stress Concentration as a Result of Bending Shaping Parts of an Orthosis Distribution of Materials in Beams Designs in Orthoses Other Designing Problems Fastening Components Riveting Aluminum Rivet Materials Rivet Size Rivet Spacing Edge Distance Rivet Holes Rivet Sets and Bucking Tools Using the Bucking-Up Set Rivet Length Aluminum Rivet Material Riveting Stainless Steels Recommended Procedures Plastics and Composites Building Polymers Thermoplastics Thermosets Thermoplastic Composites Thermoset Composites Mechanical Properties Short-Term Tensile Tests Isochronous Stress–Strain Curve Stiffness and Moduli Strain Recovery Effects of Temperature Impact Loading Hardness Thermosetting Plastics Condensation Reactions Polymerization Controlling the Rate of Polymerization of Thermosetting Plastics Laminated Plastics Cellular Structures Sandwich Constructions Miscellaneous Structures Polyesters Laminating Plastic Parts Thermoforming Plastics Amorphous Crystalline Commonly Used Materials Polypropylene Copolymer Polyethylene Surlyn (Ionomer) Copolyester (Durr-Plex) Polycarbonate Kydex Thermoforming Processing Temperature Cast and Set Lower Processing Limit Normal Forming Upper Limit Sheet Selection Sheet Heating Considerations Heating Thermoplastics Convection Conduction Radiation Popular Heating Elements Contained in Heating Equipment (Ovens) Small-Diameter Coiled Nichrome Wire Tubular Rods and Metal Panels Ceramic Panels and Quartz Panels Gas Fired, Infrared-Type Additive Manufacture, Rapid 3D Printing Conclusion 3. Principles of Fabrication 3 Principles of Fabrication Abstract Keywords Key Points Data Collection: Measurements, Impressions, and Scans Thermoplastic Materials Thermoset Lamination Techniques Computer-Aided Design Computer-Aided Manufacturing: Model Carving and Additive Manufacturing Conclusion References 4. Principles of Normal and Pathologic Gait 4 Principles of Normal and Pathologic Gait Abstract Keywords Key Points Normal Human Gait Gait Cycle Stance Phase Swing Phase Functional Considerations Rockers: Pivot Points During Stance Determinants of Gait: Economy of Walking Lower Extremity Movement Patterns Temporal Spatial Measures Kinematics Ankle. Knee. Hip. Pelvis. Kinetics Ankle. Knee. Hip. Muscle Activity Pathologic Gait Observational Gait Analysis Instrumented Gait Analysis Principles of Assessment Pathologic Gait Classification Structural Deformity Muscle Weakness Sensory Impairment Pain Impaired Motor Control Pathologic Gait Patterns Ankle Dorsiflexion Weakness or Excessive Ankle Plantarflexion Ankle Plantarflexion Weakness or Excessive Ankle Dorsiflexion Knee Weakness and Instability Hemiparetic Gait Spastic Diplegia Painful (Antalgic) Gait References 5. Biomechanics of the Spine 5 Biomechanics of the Spine Key Points Spinal Orthoses Spinal Stability Under Stress Loading Forces Strain Shear Forces Spinal Instability Microinstability Macroinstability Biomechanics of Surgical Decompression and Stabilization Decompression References Spinal Stability Under Stress Spinal Instability Surgical Decompression and Stabilization 6. Principles and Components of Spinal Orthoses 6 Principles and Components of Spinal Orthoses Abstract Keywords Key Points Semirigid Spinal Orthoses (Corsets) Corset Examples Rigid Spinal Orthoses Components of Conventional (Metal) Spinal Orthoses Examples of Rigid Orthoses: Conventional Spinal Orthoses and Contemporary Equivalents Lumbosacral Orthosis: Sagittal Control Lumbosacral Orthosis: Sagittal–Coronal Control Lumbosacral Orthosis: Extension–Coronal Control (Williams Flexion) Thoracolumbosacral Orthosis: Flexion Control (Hyperextension Orthosis) Thoracolumbosacral Orthosis: Sagittal Control Thoracolumbosacral Orthosis: Sagittal–Coronal Control Thoracolumbosacral Orthosis: Triplanar Control Thoracolumbosacral Orthosis: Triplanar Control, Custom-Fabricated Body Jacket Thoracolumbosacral Orthosis: Triplanar Control, Soft Body Jacket Cervical Orthoses Examples of Cervical Orthoses Cervical Orthosis: Cervical Cervicothoracic Orthosis: Cervicothoracic Orthoses for Spinal Deformity Principles and Components of Orthoses for Spinal Deformity Cervicothoracolumbosacral Orthoses Pad placement. Pad loading. Thoracic and lumbar pad force. Triangulation of forces. High thoracic curves. Thoracolumbosacral Orthoses Pad placement. Pad loading. Examples of Thoracolumbosacral Orthoses Low-Profile Thoracolumbosacral Orthoses Boston. Rosenberger. Miami. Lyonnaise. Wilmington jacket. Computer-Aided Design and Computer-Aided Manufacturing Thoracolumbosacral Orthoses Charleston Bending Brace Providence Nocturnal Scoliosis System Conclusion References 7. Orthoses for Spinal Pain 7 Orthoses for Spinal Pain Key Points Orthoses in Low Back Pain Epidemiology Treatments of Low Back Pain Range-of-Motion Restrictions Spinal Column Unloading Change in Proprioception Pain Reduction Side Effects Outcomes Summary Cervical Orthoses Immobilization Pain Conclusion References 8. Orthoses for Spinal Deformities 8 Orthoses for Spinal Deformities Abstract Keywords Key Points Scoliosis Idiopathic Scoliosis Pathophysiology and Natural History Historical Perspective Treatment Recommendations Orthotic Management and Best Practices Current Research Scheuermann Kyphosis Historical Perspective Pathophysiology Treatment Recommendations Orthotic Management Best Practice References 9. Orthoses for Spinal Trauma and Postoperative Care 9 Orthoses for Spinal Trauma and Postoperative Care Abstract Keywords Key Points Historical Perspective Introduction Cervical Spinal Trauma C1 or Jefferson Fracture Recommended Orthotic Operative Treatment With a Postoperative Orthotic Considerations Hangman Fracture Levine Classification Type I Type IA Recommended orthotic. Type II Type IIA Recommended orthotic. Type III Operative treatment with a postoperative orthotic. Odontoid or Dens Fracture Type I Recommended orthotic. Type II Recommended orthotic. Operative treatment with a postoperative orthotic. Type III Recommended orthotic. Operative treatment with a postoperative orthotic. Considerations. Facet Joint Dislocations Unilateral Facet Dislocation Recommended orthotic. Operative treatment with a postoperative orthotic. Bilateral Facet Dislocations Operative treatment with a postoperative orthotic. Thoracolumbar Spinal Trauma Compression Fracture Recommended Orthotic Considerations Burst Fracture Recommended Orthotic Considerations Operative Treatment With a Postoperative Orthotic Considerations Chance Fracture Recommended Orthotic Considerations Operative Treatment With a Postoperative Orthotic Postoperative Care Current Issues and Research References 10. Orthoses for Osteoporosis 10 Orthoses for Osteoporosis Abstract Keywords Key Points Pathophysiology of Osteoporosis Overview of Vertebral Compression Fractures Prevention of Vertebral Compression Fractures Treatment of Vertebral Compression Fractures Pharmacologic Treatments Nonpharmacologic Treatments Surgical Treatments Orthoses for Treatment of Vertebral Compression Fractures Posture-Training Support Lumbosacral and Dorsolumbosacral Corsets Three-Point Hyperextension Orthoses Spinomed (Thoracolumbosacral Orthosis–Sagittal Plane Control) Posterior-Shell Thoracolumbosacral Orthosis Conclusion Orthotic Management of Osteoporosis Overview Acute Pain Management Chronic Pain Management Clinical Assessment and Orthotic Recommendation Measurements for Patient Assessment and Sizing the Orthosis Plaster Impression Technique for the Posterior-Shell Thoracolumbosacral Orthosis Fitting the Orthosis and Follow-Up Conclusion Best Practices Supporting Evidence General Information Nonpharmacologic Treatment Efficacy of Specific Orthotic Devices Vertebroplasty and Kyphoplasty Multidisciplinary Team Approach to Treatment References 11. Biomechanics of the Upper Limb 11 Biomechanics of the Upper Limb Abstract Keywords Key Points Motion Description of Motion Normal Range of Motion Arcs Versus Functional Motion Requirements Compensatory Motion in the Upper Limb Synergistic Motion of the Wrist and Hand Stability Shoulder Elbow Forearm Joint Wrist Strength Muscle Mechanics Orthotic Considerations After Hand Injury Functional Hand Essentials Biomechanical Impact of Digital Loss Thumb Digital Loss Biomechanical Impact of Fusion Wrist Fusion Conclusion References 12. Principles and Components of Upper Limb Orthoses 12 Principles and Components of Upper Limb Orthoses Abstract Keywords Key Points Clinical Principles of Upper Limb Orthotic Management Patient Goals and Outcomes Underlying Pathology Paralysis Spinal cord injury scale and muscle function. Stroke types. Pain Position Neurosensory Conditions Functional Deficits and Opportunities Upper Limb Biomechanics Contralateral Function and Dominance Expected Prognosis and Rehabilitative Trajectory Design Principles for Upper Limb Orthoses Nomenclature and Terminology Components and Applications of Upper Limb Orthoses Finger Orthoses Static. Dynamic. Hand Orthoses Static. Dynamic. Wrist–Hand Orthoses Static Static positional wrist–hand orthoses. Resting wrist–hand orthosis or resting splint. Static wrist–hand orthosis and hand orthosis attachments. Dynamic wrist–hand orthoses. Wrist-Driven Wrist–Hand Orthoses Ratchet-Style Wrist–Hand Orthosis Wrist-Action or Wrist-Range Orthoses External Power and Functional Electrical Stimulation for the Wrist and Hand Elbow Orthoses Static Elbow Orthoses Static Progressive Elbow Orthoses Dynamic Elbow Orthoses Dynamic Joint Mobility Orthoses Fracture Management (Long Bone Segments) Shoulder, Shoulder–Elbow, and Shoulder–Elbow–Wrist–Hand Orthoses Static Shoulder Orthoses Static Shoulder–Elbow Orthoses Shoulder–Elbow–Wrist or Shoulder–Elbow–Wrist–Hand Orthoses Dynamic Shoulder–Elbow, Shoulder–Elbow–Wrist–Hand, and Elbow Orthoses Mobile arm support. Low-Temperature Thermoplastic Orthoses Team-Based Approach to Orthotic Management Clinical Use and Training Education Training Exploration and Experimentation Prefunctional Training Functional Activities Donning and Doffing Advanced Functional Training Follow-Up Summary References 13. Upper Limb Orthoses for the Stroke- and Brain-Injured Patient 13 Upper Limb Orthoses for the Stroke- and Brain-Injured Patient Abstract Keywords Key Points General Principles Treatment Options for Temporary Control of Spasticity Anesthetic Nerve Blocks Phenol Nerve Blocks Chemodenervation Causes of Limited Joint Motion General Classification of Orthoses Uses of Orthotic Devices Contracture Prevention Orthoses as Reinforcements After Chemodenervation Contracture Correction Maintaining Limb Position Functional Aids Shoulder Orthoses Lap Board Arm Supports Sling Humeral Cuffs Abduction Pillow Electrical Stimulation Robotic Shoulder Rehabilitation Orthoses Elbow Orthoses Long Arm Cast Dropout Cast Bivalved Long Arm Cast Dynamic Elbow Orthoses Wrist and Hand Orthoses Short Arm Cast Bivalved Short Arm Cast Volar Wrist Splint Resting Wrist–Hand Orthoses Dynamic Wrist Orthoses Finger and Thumb Orthoses Static Hand Splints Dynamic Hand Splints Split Ring Orthoses Thumb Spica Cast Thumb Abduction Splint Lycra Pressure Garments References 14. Upper Limb Orthoses for Persons With Spinal Cord Injuries and Brachial Plexus Injuries 14 Upper Limb Orthoses for Persons With Spinal Cord Injuries and Brachial Plexus Injuries Abstract Keywords Key Points Spinal Cord Injury Epidemiology Pathophysiology Classification of Spinal Cord Injuries Historical Perspective Orthotic Intervention Surgical Intervention Evaluation of the Upper Limb Upper Limb Orthotic Management Acute Tetraplegia High Tetraplegia (C1–4) Midcervical (C5) C6–7 C8–T1 Neuroprosthesis Serial Casting for the Upper Limb in Tetraplegia Surgical Options Brachial Plexus Injuries Pathophysiology and Epidemiology Evaluation Treatment Role of Orthotics and Prosthetics Shoulder Support Shoulder and Elbow Support Flail Arm Hand and Wrist Support Surgical Treatment Amputation With Prosthetic Fitting Conclusion References 15. Orthoses for the Burned Hand 15 Orthoses for the Burned Hand Abstract Keywords Key Points Pathophysiology Initial Assessment Treatment and Recommendations Structural Considerations Inflammation and Edema Range of Motion Programs Wound Healing Orthotic Management Best Practices in the Treatment of Specific Complications of Burned Hands Boutonnière Deformity Burn Clawhand Deformity Web Space Contractures Functional Outcomes Conclusion References 16. Orthotic Treatment Considerations for Arthritis and Overuse Syndromes in the Upper Limb 16 Orthotic Treatment Considerations for Arthritis and Overuse Syndromes in the Upper Limb Abstract Keywords Key Points Section I. Orthotic Treatment Considerations for Arthritis in the Upper Limb Introduction Overarching Principles of Orthosis Design and Function Force Systems Moment Arm Material Stiffness Properties Pressure Shear and Friction Intimacy of Fit Between Orthosis and Limb Formulating the Orthotic Treatment Plan Describe the Functional Impairments and Detail the Functional Deficits Establish Treatment Objectives Determine Orthotic Recommendation Assessment and Orthotic Treatment of RA and OA at the Elbow Joint Background and Functional Impairments Orthotic Treatment Orthotic Treatment of Advanced Elbow Arthritis (Maximal Control of Elbow Motion) Orthotic Treatment of Moderate Elbow Arthritis (Minimal Control of Elbow Motion) Assessment and Orthotic Treatment of RA and OA at the Wrist Joint Background and Functional Impairments Orthotic Treatment of the Wrist Orthotic Treatment of Advanced Wrist Arthritis (Maximal Control of Wrist Motion) Orthotic Treatment of Moderate Wrist Arthritis (Moderate Control of Wrist Motion) Orthotic Treatment of Early Wrist Arthritis (Minimal Control of Wrist Motion) Assessment and Orthotic Treatment of RA and OA at the Thumb Background and Functional Impairments Orthotic Treatment of the Thumb Assessment and Orthotic Treatment of RA and OA at the Fingers Background and Functional Impairments Orthotic Treatment of the Fingers Conclusion Section II. Orthotic Treatment Considerations for Overuse Syndromes in the Upper Limb Introduction Lateral Epicondylitis Background, Anatomy, and Functional Impairments Orthotic Treatment of Lateral Epicondylitis Cubital Tunnel Syndrome Background, Anatomy, and Functional Impairments Orthotic Treatment of Cubital Tunnel Syndrome Carpal Tunnel Syndrome Background, Anatomy, and Functional Impairments Orthotic Treatment of Carpal Tunnel Syndrome De Quervain Tenosynovitis Background, Anatomy, and Functional Impairments Orthotic Treatment of de Quervain Tenosynovitis Trigger Finger (Stenosing Tenosynovitis) Background, Anatomy, and Functional Impairments Orthotic Treatment of Trigger Finger Conclusion Suggested Readings References 17. Functional Bracing of Selected Upper Limb Fractures 17 Functional Bracing of Selected Upper Limb Fractures Key Points Functional Bracing of Diaphyseal Humeral Fractures Rationale Indications and Contraindications Management Brace Application Instructions to the Patient Discontinuing Use of the Brace and Follow-Up Expected Outcome Complications Nerve Palsy Malalignment Delayed and Nonunion Skin Problems Refracture Muscle Weakness and Limited Range of Motion Functional Bracing of Diaphyseal Ulnar Fractures Rationale Indications and Contraindications Acute Management Closed Fractures Initial Immobilization Brace Application and Function Patient Instructions Brace Removal and Follow-Up Expected Outcome Managing Complications Synostosis Malalignment Delayed and Nonunion Skin Problems Refracture Poor Grip and Range of Motion Functional Casting and Bracing of Distal Radius Fractures Rationale Indications Management Outcome Conclusion References 18. Biomechanics of the Hip, Knee, and Ankle 18 Biomechanics of the Hip, Knee, and Ankle Key Points Basic Biomechanical Principles Statics Action–Reaction Pressure Moments and Levers Equilibrium Shared Overlapping Force Systems Dynamics Kinematics and Kinetics Ground Reaction Force and Moments Application of Biomechanical Principles to Normal and Pathologic Gait Observations of Joint Kinematics Normal Gait Pathologic Gait Observations of Segment Kinematics Normal Gait Pathologic Gait Observations of Ground Reaction Force Kinetics Normal Gait Pathologic Gait Observation of Interactions Between Kinematics and Kinetics Normal Gait Pathologic Gait Application of Biomechanical Principles to Orthoses Direct Biomechanical Effect of Orthoses Indirect Biomechanical Effect of Orthoses Combined Direct and Indirect Biomechanical Effects of Orthoses Relevance of Biomechanical Principles to Total Patient Management References 19. Foot Biomechanics 19 Foot Biomechanics Key Points Anatomy Skeletal Joints Ligaments Muscles Arches Motion Ankle Subtalar Midfoot, Calcaneocuboid, and Talonavicular Tarsometatarsals Metatarsophalangeal Proximal Interphalangeal and Distal Interphalangeal Open and Closed Chain Motion Foot Stability Static The First Ray Dynamic: Medial Longitudinal Arch Dynamic: Lateral Longitudinal Arch Transverse Arch Gastroc–Soleus Complex Plantar Aponeurosis Gait Phases of Gait: First, Second, and Third Rocker Surgical Considerations in the Correction of Foot Deformities Musculotendinous Considerations Bony Procedures Pantalar Arthrodesis Ankle Arthrodesis Subtalar Joint Arthrodesis Talonavicular Arthrodesis Triple Arthrodesis Tarsometatarsal Arthrodesis Metatarsophalangeal Arthrodesis References 20. Shoes and Shoe Modifications 20 Shoes and Shoe Modifications Abstract Keywords Key Points Essence of Footwear Anatomy of the Foot Anatomy of the Shoe Purpose of Footwear Importance of Proper Fit Choosing the Right Footwear Various Shoe Types and Going Shoeless Running Shoes Dress Shoes Ballet Shoes (Ballet Slippers) Barefoot Running Shoe Construction Functional Orthotics and Accommodative Orthotics Orthotics and Technology Technology Ideas and Advances Conclusion References 21. Foot Orthoses 21 Foot Orthoses Key Points Evaluation Impression-Taking Techniques Design Materials Components of the Foot Orthosis Conclusion References 22. Lower Limb Orthoses 22 Lower Limb Orthoses Key Points Foot Orthoses Ankle–Foot Orthoses Knee Orthoses Indications for Knee Orthoses Commonly Prescribed Knee Orthoses Knee–Ankle–Foot Orthoses Commonly Prescribed Knee–Ankle–Foot Orthoses Hip Orthoses Indications for a Hip Orthosis Hip–Knee–Ankle–Foot Orthoses Indications for Hip–Knee–Ankle–Foot Orthoses Pediatric Orthoses Specialty Lower Extremity Orthoses References 23. Lower Limb Orthoses for Persons With Spinal Cord Injury 23 Lower Limb Orthoses for Persons With Spinal Cord Injury Key Points Introduction Evaluation Clinical Examination The Neurologic Status and Level of Injury Use of Orthoses Walking Recovery Orthoses and the Compensation-Based Approach Types of Orthoses Indications and Management Ankle–Foot Orthoses Commonly Prescribed Ankle–Foot Orthoses Knee–Ankle–Foot Orthosis Hip–Knee–Ankle–Foot Orthosis Energy Expenditure and Usage Hydraulic, Pneumatic, and Electrically Powered Orthoses Functional Electrical Stimulation Bioness Systems L300 Foot Drop System L300 Plus Walk Aide Parastep I Best Practices References 24. Orthoses in Total Joint Arthroplasty 24 Orthoses in Total Joint Arthroplasty Abstract Key Points Orthoses After Total Hip Arthroplasty Management of Dislocations Neurologic Injury Additional Functional Problems Orthoses After Total Knee Arthroplasty Extensor Mechanism Deficiency Medial Collateral Ligament Injury Flexion–Extension Contracture Summary References 25. Knee Orthoses for Sports-Related Issues 25 Knee Orthoses for Sports-Related Issues Abstract Keywords Key Points Knee Joint Biomechanics Orthosis Design Prefabricated Braces Custom Braces Geometry and Mechanism of Attachment Fabrication Materials Hinge Design Brace Design Limitations Clinical Relevance Historical Perspective Ligamentous Injuries Current Research in Orthosis Design Epidemiologic Studies: Knee Bracing in Sports Clinical Performance During Knee Brace Use Current Research: Anterior Cruciate Ligament Current Research: Medial Collateral Ligament Current Research: Posterior Cruciate Ligament Current Research: Multiligament Injury Osteoarthritis Patellofemoral Pain References 26. Orthotic Management of Neuropathic and Dysvascular Feet 26 Orthotic Management of Neuropathic and Dysvascular Feet Abstract Keywords Key Points Peripheral Neuropathy Overview Charcot Arthropathy Complications of the Neuropathic Foot Toe Deformities Examination Inspection and Range of Motion Motor Examination Sensation Temperature Documentation Prevention and Patient Education Orthotic Treatment Interventions Total Contact Cast Orthotic Dynamic Splint Nonremovable Walker Neuropathic Walker and Charcot Restraint Orthotic Walker Total Contact Ankle–Foot Orthosis Patellar-Tendon–Bearing Orthosis Orthopedic Walkers Shoes Accommodative Inserts Peripheral Vascular Disease Venous Stasis Ulcers Unna Boot Pressure-Graduated Stockings Arterial Ulcers References 27. Orthotic Management of Polio and Postpolio Syndrome 27 Orthotic Management of Polio and Postpolio Syndrome Abstract Keywords Key Points Introduction Pathophysiology Historical Perspective Current Issues Current Research Treatment Recommendations Orthotic Management Patient Assessment Orthotic Management Algorithm Design Ankle–Foot Orthoses Posterior leaf spring. Solid ankle. Articulated ankle. Ground reaction. Articulated rear entry ground reaction. Metal double upright. Knee–Ankle–Foot Orthoses Knee Joints Posterior offset. Drop, or ring, lock. Bail, or lever, locks. Stance control knee joints. Proximal Thigh Section Standard thigh. Quadrilateral and ischial containment. Miscellaneous Components Molded inner boots. Metal and leather AFOs and KAFOs. Additional materials. Best Practices References 28. Lower Limb Orthoses for Persons Who Have Had a Stroke 28 Lower Limb Orthoses for Persons Who Have Had a Stroke Abstract Keywords Key Points Pathophysiology Epidemiology Clinical Features Key Issues Orthotic Treatment Recommendations Functional Deficit/Biomechanical Deficit Principles of Assessment Setting Objectives Orthotic Management Prefabricated Orthoses Control of the Foot and Ankle Equinus Associated With Low Tone Equinus Associated With High Tone Hypertonic Equinus Control Using AFO Dorsiflexion Control Supination (Varus) Control Pronation (Valgus) Control Control of the Knee Knee Hyperextension Control Indirect Control of Knee Hyperextension Knee Flexion Control Indirect Control of Knee Flexion Knee Genu Varum and Genu Valgum Control Control of the Hip Hip Flexion/Retraction Current Research Conclusion References 29. Assessment and Orthotic Management of Gait Dysfunction in Individuals With Traumatic Brain Injury 29 Assessment and Orthotic Management of Gait Dysfunction in Individuals With Traumatic Brain Injury Key Points Normal Locomotion Temporal and Spatial Descriptive Measures Kinematics Kinetics Lower Limb Orthoses Pathologic Gait After Traumatic Brain Injury Abnormal Base of Support Limb Instability Limb Clearance Abnormal Hip Adduction Incomplete Knee Extension Pelvic Retraction Summary References 30. Congenital and Acquired Disorders 30 Congenital and Acquired Disorders Key Points Physiologic Development and Alignment (Genu Varum and Valgum) Footwear Congenital Foot Deformities Juvenile Bunion (Hallux Valgus) Metatarsus Adductus Skewfoot Flatfoot Flatfoot Posture Flexible Flatfoot Rigid Flatfoot Freiberg Infraction Tarsal Coalition Accessory Navicular Kohler Disorder Clubfoot Congenital Vertical Talus Calcaneovalgus Foot Cavus (and Cavovarus) Deformity Tibia Vara (Blount Disease) Tibial Bowing Lateral Tibial Bowing Anterior Bowing Posteromedial Bowing Anterolateral Bowing Idiopathic Toe Walking References 31. Pediatric Hip Orthoses 31 Pediatric Hip Orthoses Key Points Developmental Dysplasia of the Hip Frejka Pillow Pavlik Harness Tübingen Hip Orthosis von Rosen Orthosis Ilfeld Orthosis Semirigid Plastazote Hip Abduction Orthoses Camp Dynamic Hip Abduction Orthosis Legg-CalvÉ-Perthes Disease Toronto Orthosis Newington Orthosis Trilateral Socket/Tachdjian Orthosis Atlanta Scottish Rite Orthosis A-Frame Orthosis Cerebral Palsy Resting Abduction Orthoses SWASH Orthosis Lycra Garments Lower-Extremity Weakness or Paralysis Passive Standing Orthoses Vertical Standers A-Frame Standers Parapodiums and Swivel Walkers Body-Weight Support Devices Mobile Standers Hip-to-Ankle Braces Twister Cables and Straps (Torsional Deformities) Hip–Knee–Ankle–Foot Orthoses Hip-Guidance Orthoses Reciprocating Gait Orthosis Parawalker Walkabout or Multiaxial Subperineal Hip Joints Postoperative Hip Orthoses Acknowledgments References 32. Orthoses for the Muscle Disease Patient 32 Orthoses for the Muscle Disease Patient Abstract Keywords Key Points Introduction Orthotic Treatment Interventions Lower Extremity Orthoses Ankle–Foot Orthoses Knee–Ankle–Foot Orthoses Spinal Orthoses Upper Extremity Orthoses Mobility Aides References 33. Orthoses for Cerebral Palsy 33 Orthoses for Cerebral Palsy Key Points Pathophysiology Historical Perspective Current Research Treatment Recommendations Orthotic Management Ankle–Foot Orthosis–Footwear Combination Tuning Functional Electrical Stimulation Computer-Aided Design, Computer-Aided Manufacturing, and 3D-Printing Applications for Orthotics and Prosthetics Best Practice References 34. Orthoses for Myelomeningocele 34 Orthoses for Myelomeningocele Abstract Keywords Key Points Thoracic/High Lumbar Levels Standing Frames Parapodiums Gait Trainers Hip–Knee–Ankle–Foot Orthoses Reciprocating Gait Orthoses Spinal Orthoses Midlumbar to Low Lumbar Level Knee–Ankle–Foot Orthoses Ankle–Foot Orthoses Ankle–Foot Orthoses: Floor-Reaction Type High Sacral Level Low Sacral Level Supramalleolar Orthoses and Foot Orthoses Conclusion References 35. Cranial Remolding Orthoses 35 Cranial Remolding Orthoses Key Points Pathophysiology Historical Perspective Current Issues Current Research Treatment Recommendations Orthotic Management Craniosynostosis: Orthotic Management Treatment Outcomes Best Practices Conclusion References 36. Canes, Crutches, and Walkers 36 Canes, Crutches, and Walkers Abstract Keywords Key Points Canes Crutches Walkers Measuring Assistive Devices Canes Axillary Crutches Forearm Crutches Triceps Crutches Platform Crutches Walkers Gait Patterns Alternating (Reciprocal) Gaits Four-Point Gait Two-Point Gait Three-Point Gait Cane Gait Walker Gait Swinging (Simultaneous) Gaits Drag-To Gait Swing-To Gait Swing-Through Gait Biomechanics of Assistive Devices Kinematic Factors Kinetic Factors Energy Expenditure Benefits of Assistive Devices Complications of Assistive Devices Conclusion References 37. Wheeled Mobility - Evaluation for Orthotic Seating and Positioning 37 Wheeled Mobility Key Points Seating Evaluation Sitting Supine Postural Evaluation: Fixed or Flexible? Accommodation Versus Correction of Deformity Types of Seating Systems Cushion Selection Pressure Mapping References 38. Wheeled Mobility - Device Prescription and Care 38 Wheeled Mobility Key Points Background Wheeled Mobility Clinic Team Manual Wheeled Mobility Powered Wheeled Mobility Transportation Wheelchair Skills Training References 39. Wheelchair and Assistive Device Considerations for Remote Settings 39 Wheelchair and Assistive Device Considerations for Remote Settings Abstract Keywords Key Points Benefits of Wheelchairs and Assistive Devices Provision Demand and Needs Barriers Government and Leadership Barriers Affordability and Cost Barriers Delivery of Services Barriers Manpower Barriers Production Barriers Physical Barriers Cultural and Social Barriers Removing Barriers and Increasing Access Needs Assessment Legislative Strategies Increasing Affordability and Reducing Cost Increasing Production Appropriate Services Development Educational Opportunities Partnerships and Consultations Conclusion References 40. Communication Devices and Electronic Aids to Activities of Daily Living 40 Communication Devices and Electronic Aids to Activities of Daily Living Abstract Keywords Key Points Evaluation Interdisciplinary Team Funding Access Scanning Augmentative and Alternative Communication Evaluation Nonspeaking Systems, Low Technology, and High Technology Nonspeaking Systems Low Technology Communication boards. Eye gaze boards. Letter boards. Modified ETRAN boards. High-Technology Devices Additional Considerations Electronic Aids to Daily Living Evaluation Access Telephones Safety, Alert, and Monitoring Systems Integration of Equipment Training Reevaluation Future of Technology Acknowledgments References 41. Sports Adaptations and Assistive Devices for Recreation 41 Sports Adaptations and Assistive Devices for Recreation Key Points Historical Perspective General Exercise Considerations Cardiorespiratory Exercise Resistance Exercise Flexibility Exercise Neuromotor Exercise Activity and Sport Specific Considerations All-Terrain Vehicles Archery Basketball and Rugby Billiards Bowling Cycling Equestrian Sports Fencing Fishing Golf Hunting and Shooting Sled Hockey Paddling Sports Power Soccer Sailing Scuba Diving Snow Skiing Softball Swimming Table Tennis Tai Chi Tennis Track and Field Conclusion References 42. Driving and Related Assistive Devices 42 Driving and Related Assistive Devices Abstract Keywords Key Points Driver Evaluation Clinical Evaluation Medical History and Driving History Vision Cognition and Perception Physical and Functional Ability On-the-Road Evaluation Driver Training Fitting and Orientation Assistive Devices Ambulation Scooters Manual Wheelchairs Power Wheelchairs Vehicle Selection Sedans Minivans Pickup Trucks and Sport Utility Vehicles Full-Size Vans Predrive Upper Torso Support Driving Controls Hand Controls Pedal Extensions Left Foot Accelerator Two-Foot Driving Crossover Technique Pedal Guards Steering Devices Reduced-Effort Steering Servo Steering Foot Steering Secondary Controls Special Precautions Conclusion Resources References 43. Neuromuscular Electrical Stimulation Applications 43 Neuromuscular Electrical Stimulation Applications Abstract Keywords Key Points Upper Limb Applications Stroke Spinal Cord Injury Lower Limb Applications Stroke Neuromuscular Electrical Stimulation for Footdrop Multijoint Neuromuscular Electrical Stimulation for Hemiparetic Gait Spinal Cord Injury Neuromuscular Electrical Stimulation for Standing Neuromuscular Electrical Stimulation for Walking Conclusion References 44. Exoskeletal Assisted Rehabilitation After Spinal Cord Injury 44 Exoskeletal Assisted Rehabilitation After Spinal Cord Injury Abstract Keywords Key Points Classification of Spinal Cord Injury Effects of Lack of Weight-Bearing on a Person With Spinal Cord Injury History and Background Locomotion and Spinal Cord Injury Powered Exoskeletons Exoskeleton Training Protocols Potential Health Benefits of Exoskeletal-Assisted Walking After Spinal Cord Injury Improvements in Gait Function Improvements in Body Composition Improvements in Cardiometabolic Parameters Improvements in Spasticity Improvements in Bowel Function Improvements in Quality of Life Other Health Benefits Recommendations and Future Directions Conclusion References 45. Future Trends and Research in Orthoses 45 Future Trends and Research in Orthoses Key Points Stance Control Devices Powered Devices Functional Electrical Stimulation Systems Emerging Technologies References