Atlas of Orthoses and Assistive Devices PDF
Preview Atlas of Orthoses and Assistive Devices
ATLAS of ORTHOSES and ASSISTIVE DEVICES Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. Fifth Edition ATLAS of ORTHOSES and ASSISTIVE DEVICES Joseph B. Webster, MD Associate Professor Department of Physical Medicine and Rehabilitation School of Medicine at Virginia Commonwealth University Staff Physician, Physical Medicine and Rehabilitation Hunter Holmes McGuire VA Medical Center Richmond, Virginia Douglas P. Murphy, MD Associate Professor Department of Physical Medicine and Rehabilitation School of Medicine at Virginia Commonwealth University Staff Physician, Physical Medicine and Rehabilitation Hunter Holmes McGuire VA Medical Center Richmond, Virginia Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 Atlas of Orthoses and Assistive Devices, Fifth Edition ISBN: 978-0-323-48323-0 Copyright © 2019 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2008, 1997, 1985, and 1975 by Mosby Inc., an imprint of Elsevier, Inc. ISBN: 978-0-323-48323-0 Library of Congress Cataloging-in-Publication Data Names: Webster, Joseph B. (Joseph Bradley), 1965- editor. | Murphy, Douglas (Douglas P.), editor. Title: Atlas of orthoses and assistive devices / [edited by] Joseph Webster, Jr., Douglas Murphy. Description: Fifth edition. | Philadelphia, PA : Elsevier, [2019] | Preceded by AAOS atlas of orthoses and assistive devices / [edited by] John D. Hsu, John W. Michael, John R. Fisk. 4th ed. c2008. | Includes bibliographical references and index. Identifiers: LCCN 2017025277 | ISBN 9780323483230 (hardcover : alk. paper) Subjects: | MESH: Orthotic Devices | Biomechanical Phenomena | Orthopedic Fixation Devices | Self-Help Devices Classification: LCC RD755 | NLM WE 26 | DDC 617/.9–dc23 LC record available at https://lccn.loc.gov/2017025277 Senior Content Strategist: Kristine Jones Senior Content Development Specialist: Jennifer Ehlers Publishing Services Manager: Patricia Tannian Project Manager: Stephanie Turza Design Direction: Patrick Ferguson Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. C O N T R I B U TO R S Mark F. Abel, MD Josephine R. Bundoc, MD David Drake, MD Charles Frankel Professor Professor Director, Interventional and Integrative Pain Division Head, Pediatric Orthopaedics College of Allied Rehabilitation Medicine Department of Orthopaedic Surgery Sciences University of the East Department of Physical Medicine and University of Virginia Ramon Magsaysay Memorial Medical Rehabilitation Charlottesville, Virginia Center, Inc. Hunter Holmes McGuire VA Medical Center Quezon City, Philippines Richmond, Virginia Daniel Acker, OTR/L CHT Clinical Coordinator William E. Carter III, MD, MPH Christopher C. Duncan, MD Occupational Therapy Assistant Professor Assistant Professor (Clinical) Georgia Hand Shoulder and Elbow Department of Physical Medicine and Department of Physical Medicine and Atlanta, Georgia Rehabilitation Rehabilitation Virginia Commonwealth University University of Utah School of Medicine Tamara A. Alexander, PT, DPT Richmond, Virginia Salt Lake City, Utah SCI Clinical Specialist Department of Veteran Affairs John Chae, MD John S. Early, MD Tibor Rubin Medical Center Professor and Chair Clinical Professor Long Beach, California Department of Physical Medicine and Department of Orthopedic Surgery Rehabilitation University of Texas Southwestern Medical Alan P. Alfano, MD Professor Center Professor Department of Biomedical Engineering Dallas, Texas Department of Physical Medicine and Case Western Reserve University Rehabilitation Medical Director Joan Edelstein, MA, PT, FISPO University of Virginia Neuromusculoskeletal Service Line Special Lecturer Charlottesville, Virginia MetroHealth System Program in Physical Therapy Cleveland, Ohio Columbia University Omkar Baxi, MD New York, New York Orthopaedic Surgery Resident Lynette Codamon, PT New Jersey Medical School Section Chief Steven R. Edgley, MD Newark, New Jersey Inpatient Physical Therapy Associate Professor (Clinical) Hunter Holmes McGuire VA Medical Center Department of Physical Medicine and Tanya Berenz, MS, OTR/L Richmond, Virginia Rehabilitation Occupational Therapy Division University of Utah School of Medicine Department of Physical Medicine and Bill Contoyannis, MEngSc Salt Lake City, Utah Rehabilitation Rehabilitation Engineer Michigan Medicine REHAB TECH Jason Edinger, MD University of Michigan Melbourne, Australia Assistant Professor Ann Arbor, Michigan Department of Physical Medicine and Benjamin J. Darter, PT, PhD Rehabilitation Roy Bowers, HDip Prosthetics and Assistant Professor University of Pittsburgh School of Medicine Orthotics Department of Physical Therapy Pittsburgh, Pennsylvania Principal Teaching Fellow School of Allied Health Professions at Department of Biomedical Engineering Virginia Commonwealth University Alberto Esquenazi, MD National Centre for Prosthetics and Physical Therapist Director, Gait & Motion Analysis Orthotics Department of Physical Medicine and Laboratory University of Strathclyde Rehabilitation MossRehab Glasgow, United Kingdom Hunter Holmes McGuire VA Medical Center Elkins Park, Pennsylvania Richmond, Virginia Jonathan N. Brantley, DPM Deanna Fish, MS, CPO Chief of Podiatric Medicine and Surgery Katherine L. Dec, MD Clinical Outreach Manager Department of Surgery Professor Orthomerica Products Inc. Hunter Holmes McGuire VA Medical Center Department of Physical Medicine and Orlando, Florida Richmond, Virginia Rehabilitation Virginia Commonwealth University School Mark Fisher, MD of Medicine University of Pittsburgh Medical Center Richmond, Virginia Pittsburgh, Pennsylvania v Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. vi Contributors Benjamin D. Fortson, MS, CO Christopher Hovorka, PhD, CPO, LPO, Jayme S. Knutson, MD Certified Orthotist, Resident Prosthetist FAAOP Assistant Professor Prosthetics and Sensory Aids Service Prosthetics and Orthotics Program Department of Physical Medicine and Hunter Holmes McGuire VA Medical Center School of Applied Physiology Rehabilitation Richmond, Virginia Georgia Institute of Technology Case Western Reserve University Atlanta, Georgia Senior Staff Scientist John R. Fox, CPO Department of Physical Medicine and Chief, Orthotic and Prosthetic Laboratory Jared Howell, MS, CPO/L, FAAOP Rehabilitation Prosthetic Treatment Center Director, Orthotics and Prosthetics Program MetroHealth Rehabilitation Institute U.S. Department of Veterans Affairs School of Allied Health Sciences Biomedical Engineer Richmond, Virginia Baylor College of Medicine Louis Stokes Cleveland Veterans Affairs Houston, Texas Medical Center David R. Gater Jr., MS, MD, PhD Cleveland, Ohio Professor, Chair and Residency Program Timothy Hudson, MD Director Faculty Physician Gary J. Kroll, CO, CTO Department of Physical Medicine and Physical Medicine and Rehabilitation Assistive Technology Department Rehabilitation Hunter Holmes McGuire VA Medical Center Gillette Children’s Specialty Healthcare Penn State College of Medicine Richmond, Virginia St. Paul, Minnesota Hershey, Pennsylvania Marjorie Johnson Hilliard, PT, MS, EdD Michael Kwasniewski, MD Lance L. Goetz, MD Associate Professor Department of Physical Medicine and Staff Physician, SCI&D Service Associate Chair of Professional Education Rehabilitation Hunter Holmes McGuire VA Medical Center Department of Physical Therapy and Virginia Commonwealth University Associate Professor Human Movement Sciences Richmond, Virginia Department of Physical Medicine and Northwestern Feinberg School of Medicine Rehabilitation Chicago, Illinois Loren L. Latta, PE, PhD Virginia Commonwealth University Professor Emeritus Richmond, Virginia Brian M. Kelly, DO Director of Biomechanics Research Professor, Physical Medicine and Department of Orthopaedics Gregory Jason Golladay, MD Rehabilitation Miller School of Medicine Associate Professor University of Michigan Medical School University of Miami, Orthopaedic Surgery Medical Director, Division of Orthotics and Miami, Florida; VCU Health Prosthetics Director of the Max Biedermann Institute Richmond, Virginia Department of Physical Medicine and for Biomechanics Rehabilitation Mount Sinai Medical Center Ashraf S. Gorgey, PhD Michigan Medicine Miami Beach, Florida Director of Spinal Cord Injury Research University of Michigan Department of Veterans Affairs Ann Arbor, Michigan Timothy D. Lavis, MD Spinal Cord Injuries and Disorders Chief Hunter Holmes McGuire VA Medical Center Shannon M. Kelly, MD Spinal Cord Injuries and Disorders Richmond, Virginia Assistant Professor Hunter Holmes McGuire VA Medical Center Department of Orthopaedic Surgery and Assistant Professor Erik Hansen, MD Sports Medicine Department of Physical Medicine and Department of Orthopaedics Children’s National Medical Center Rehabilitation Virginia Commonwealth University Health Washington, DC Virginia Commonwealth University System Richmond, Virginia Richmond, Virginia Kevin L. Kilgore, PhD Professor Rondy Michael Lazaro, MD Anne Hegberg, MS, OTR/L, CDRS Department of Orthopaedics Resident Physician Senior Clinician MetroHealth Medical Center Department of Physical Medicine and Driver Rehabilitation Case Western Reserve University Rehabilitation Marianjoy Rehabilitation Hospital Biomedical Engineer Virginia Commonwealth University Wheaton, Illinois Louis Stokes Cleveland Veterans Affairs Richmond, Virginia Medical Center Joan Hou, MD Cleveland, Ohio Dulcey Lima, CO, OTR/L TBI/Polytrauma Fellow President Department of Physical Medicine and Kevin M. King, CPO Orthotic Interventions Rehabiliation Department of Prosthetics and Orthotics Lombard, Illinois Hunter Holmes McGuire VA Medical Center University of Virginia Virginia Commonwealth University Charlottesville, Virginia Richmond, Virginia Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. Contributors vii Anthony Lin, BA Miguel N. Mojica, CO Ajit B. Pai, MD Research Fellow Assistant Professor Medical Director New Jersey Medical School Certified Prosthetist Orthotist Polytrauma Rehabilitation Center Newark, New Jersey University of Texas Southwestern Medical Hunter Holmes McGuire VA Medical Center Center Physical Medicine and Rehabilitation Sheldon Lin, MD Dallas, Texas Service Orthopaedic Surgeon Assistant Professor New Jersey Medical School Jeffrey Bulaong Montes, MD Department of Physical Medicine and Newark, New Jersey Part Time Assistant Professor Rehabilitation La Consolacion University Philippines Virginia Commonwealth University William Lovegreen, MS, CPO College of Allied Medical Sciences Richmond, Virginia Prosthetist-Orthotist Regional Clinical Director Director JBM Physical Medicine and Rehabilitation Preeti Panchang, MD Department of Physical Medicine and Centre Fellow in Musculoskeletal and Amputee Rehabilitation Bulacan Medicine Veterans Administration Malolos City, Philippines Hunter Holmes McGuire VA Medical Center Richmond, Virginia Physical Medicine and Rehabilitation Maximilian Munoz, MD Virginia Commonwealth University Christopher D. Lunsford, MD Research Fellow Richmond, Virginia Pediatric Rehabilitation New Jersey Medical School Department of Physical Medicine and Newark, New Jersey Dawne Pound, OTR/L, ATP Rehabilitation Occupational Therapist University of Virginia Douglas P. Murphy, MD Assistive Technology Professional Charlottesville, Virginia Associate Professor Spinal Cord Injury and Disorders Department of Physical Medicine and Hunter Holmes McGuire VA Medical Center Thomas R. Lunsford, MSE, CO Rehabilitation Richmond, Virginia Certified Orthotist School of Medicine at Virginia Lone Star Orthotics Commonwealth University Sara N. Raiser, MD The Institute for Rehabilitation and Staff Physician Resident Physician Research Department of Physical Medicine and Department of Physical Medicine and Houston, Texas Rehabilitation Rehabilitation Hunter Holmes McGuire VA Medical Center University of Virginia Nathaniel Makowski, PhD Richmond, Virginia Charlottesville, Virginia Instructor Department of Physical Medicine and Leif M. Nelson, DPT, ATP, CSCS Aaron Rasmussen, CO, MBA Rehabilitation Assistant Chief, Clinical Care Certified Orthotist Case Western Reserve University Extremity Trauma and Amputation Center Assistive Technology MetroHealth Medical Center of Excellence Gillette Children’s Specialty Healthcare Cleveland, Ohio U.S. Department of Veterans Affairs St. Paul, Minnesota New York, New York Earnest P.S. Mawusi, DPM, ABFAS Doug Reber, CO, LO Co-Founder Tom F. Novacheck, MD Director Ambulatory Foot & Ankle Center Director Education and National Residency Program P.C. Limb Salvage Center Gillette Children’s Specialty Healthcare, Hanger Clinic Attending Physician St Paul, Minnesota; Austin, Texas Department of Podiatric Surgery Center for Gait and Motion Analysis Hunter Holmes McGuire VA Medical Center Adjunct Associate Professor Reynaldo R. Rey-Matias, PT, MD, Richmond, Virginia Department of Orthopedics MSHMS University of Minnesota Chair Barry Meadows, PhD, CEng, MIMechE, Minneapolis, Minnesota Department of Physical Medicine and Csci, MIPEM, FISPO Rehabilitation Visiting Professor Melissa Oliver, MS, OTR/L St. Luke’s Medical Center National Centre for Prosthetics and Assistive Technology Program Coordinator Associate Professor Orthotics Physical Medicine and Rehabilitation St Luke’s College of Medicine University of Strathclyde Service Quezon City, Philippines Former Head of Neurobiomechanics Hunter Holmes McGuire VA Medical Center Westmarc Richmond, Virginia Southern General Hospital Glasgow, United Kingdom Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. viii Contributors Christopher A. Robinson, MS, MBA, Amy Strouse, DO Jeffrey T. Tubbs, MD CPO, ATC, FAAOP(D) Resident Physician Inpatient Section Chief Assistant Professor Physical Medicine and Rehabilitation Spinal Cord Injury and Disorders Department of Physical Medicine and Penn State Hershey Medical Center Hunter Holmes McGuire VA Medical Center Rehabilitation Hershey, Pennsylvania Assistant Professor Northwestern Feinberg School of Medicine Department of Physical Medicine and Chicago, Illinois Seth K. Stubblefield, MD Rehabilitation Clinical Research Assistant Virginia Commonwealth University Olivier Y. Rolin, MD, PhD Department of Orthopaedic Surgery and Richmond, Virginia Resident Physician Sports Medicine Physical Medicine and Rehabilitation Children’s National Health System Joseph B. Webster, MD Virginia Commonwealth University Health Washington, DC Associate Professor Systems Department of Physical Medicine and Richmond, Virginia Ryan Sumrell, BS Rehabilitation Research Health Science Specialist School of Medicine at Virginia Natasha Romanoski, DO SCI Research Commonwealth University Assistant Professor Hunter Holmes McGuire VA Medical Center Staff Physician, Physical Medicine and Department of Physical Medicine and Richmond, Virginia Rehabilitation Rehabilitation Hunter Holmes McGuire VA Medical Center Penn State College of Medicine Terry J. Supan, CPO, LPO, FAAOP, Richmond, Virginia Hershey, Pennsylvania FISPO President and CEO Justin L. Weppner, DO Augusto Sarmiento, MD Supan Prosthetic Orthotic Consultations Department of Physical Medicine and Professor Emeritus Rochester, Illinois Rehabilitation Department of Orthopaedics University of Virginia Miller School of Medicine Mukul Talaty, PhD Charlottesville, Virginia University of Miami Research Engineer Miami, Florida Gait & Motion Analysis Laboratory Tiffany Williams, MS, OTR/L MossRehab Occupational Therapy Division Shannon Schultz, MD Elkins Park, Pennsylvania; Department of Physical Medicine and Resident Physician Division of Science and Engineering Rehabilitation Department of Physical Medicine and Pennsylvania State University Michigan Medicine Rehabilitation Abington, Pennsylvania University of Michigan Penn State College of Medicine Ann Arbor, Michigan Hershey, Pennsylvania Laura L. Tosi, MD Director, Bone Health Program Ann Yamane, MEd, CO/LO Weibin Shi, MD, PhD Division of Orthopaedics and Sports Senior Lecturer Assistant Professor Medicine Department of Rehabilitation Medicine Department of Physical Medicine and Children’s National Health System University of Washington Rehabilitation Associate Professor Seattle, Washington Penn State Hershey Medical Center Department of Orthopaedics Penn State College of Medicine George Washington University Michael Yeranosian, MD Hershey, Pennsylvania Washington, DC Orthopaedic Surgery Resident New Jersey Medical School Amit Sinha, MD Daniel Tsukanov, DO Newark, New Jersey Assistant Professor Pain and Sports Medicine Department of Physical Medicine and Department of Physical Medicine and Kristin D. Zhao, PhD Rehabilitation Rehabilitation Director Children’s Hospital of Pittsburgh of UPMC Hunter Holmes McGuire VA Assistive and Restorative Technology Pittsburgh, Pennsylvania Medical Center Laboratory Richmond, Virginia Rehabilitation Medicine Research Center Marcus J. Smith, MD Department of Physical Medicine and Assistant Professor Rehabilitation Department of Physical Medicine and Mayo Clinic Rehabilitation Rochester, Minnesota Virginia Commonwealth University Richmond, Virginia Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. F O R E WO R D Advances in technology, materials, and miniaturization, a greater is a must-have for every medical library. The collection of real-world appreciation of the functional biomechanics of human movement, and clinicians who have contributed to this comprehensive tome have put a recognition that the specific wants and needs of the individual end together a single-source, authoritative reference that provides both the user have pushed the field of prosthetics and orthotics to the next level. latest in technological and biomechanical breakthroughs and the core Keeping current and on the leading edge of these advancements, knowledge of the integrative approach to care that is the foundation appreciations, and recognitions has become increasingly challenging of PM&R care. It is with great enthusiasm and appreciation that I for both the super-specialists and the day-to-day clinicians who prescribe, introduce and celebrate the 5th edition of this important atlas. fit, train in, and monitor the use of these assistive and adaptive devices. David X. Cifu, MD This new Atlas of Orthoses and Assistive Devices, edited by my esteemed Associate Dean of Innovation and System Integration colleagues Joseph Webster and Douglas Murphy, represents the cutting- Herman J. Flax, MD Professor and Chairman, Department of Physical edge solution for all providers who work with these devices and the Medicine and Rehabilitation individuals who use them. Organized by two of the world’s leading Virginia Commonwealth University School of Medicine academic physiatrists, who help to champion the prosthetic and orthotic Richmond, Virginia needs of America’s service members and veterans, this impressive work ix Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. P R E FAC E This newest edition of the Atlas of Orthoses and Assistive Devices has In 1997, the third edition of the AAOS Atlas of Orthoses and Assistive been driven by the need for an updated publication that captures the Devices built upon this heritage by assembling a diverse group of experts significant advances that have occurred in the fields of orthotics, assistive from multiple disciplines and by implementing standards to cite available technology, rehabilitation medicine, and orthopedics over the past 10 controlled studies and provide scientifically valid justification for the years. Since its inception, the scope and aim of this publication have opinions expressed. evolved greatly over the course of the past 65 years. This new edition The fourth edition of this atlas was published in 2008 and provided reflects the shift in practice that has occurred from the use of traditional an up-to-date overview of the clinical application of contemporary bracing materials and fabrication techniques to the development of orthoses with an emphasis on the more sophisticated technology and highly sophisticated and technically advanced orthoses and assistive the application of this technology to achieve measurable results. This devices. Technological advances have occurred in materials science, in edition also reflected the evolution in the role of the orthotist from fabrication techniques with computerized modeling, and through the simply performing brace fabrication and fitting to serving as an active incorporation of more advanced electrical and computerized systems consultant in the development and implementation of the most effective into the structure and function of orthoses. All of these advances are treatment plan for each individual. proceeding at a rapid pace. The Atlas of Orthoses and Assistive Devices, 5th edition, builds on The fifth edition of the Atlas of Orthoses and Assistive Devices is built the tradition of the prior editions with the overall aim of providing a upon a strong foundation that began in 1952 with the publication of text that has practical application for clinicians by facilitating effective, the Orthopaedic Appliances Atlas. This original publication, which was informed decisions regarding today’s advanced orthotic devices. This supported by the Surgeon General, the Veterans Administration, and new edition encompasses both the more traditional fabrication and the National Research Council, aimed to standardize bracing nomen- fitting principles along with information on advances in the material clature and classify the use and production of disease-specific devices. sciences, 3D printing technology, functional electrical stimulation, The first edition of the Atlas of Orthotics was not forthcoming until microprocessor technologies, and robotics. These advances have made 1975 when this text was published by C. V. Mosby under the auspices clinical decision making around the prescription and application of of the American Academy of Orthopedic Surgeons (AAOS) Committee these devices more complex than ever before. The Atlas of Orthoses and on Prosthetics and Orthotics. The primary focus of this initial edition Assistive Devices, 5th edition, brings medical and rehabilitation profes- was to provide a rational basis for the prescription of an orthosis best sionals completely up to date with these advances and creates the suited for a particular patient’s needs. This edition introduced a new opportunity to achieve optimal results in every patient. nomenclature using terminology to describe orthoses "by the joints While the 5th edition has maintained the overall organizational they encompass and … their effect on the control of anatomic joint structure of the prior edition, many new authors and several new chapters motions," which was subsequently adopted by the International Standards have been added. Despite the greater technological sophistication in Organization (ISO). orthoses and assistive devices, the new edition has maintained a high The second edition of the Atlas of Orthoses was published within level of readability and practical application. Comprehension of the the next decade by the American Academy of Orthopaedic Surgeons content is enhanced by the large number of figures and tables, as well in order to capture the advances in material science and the application as by the addition of color photographs. The Key Points boxes at the of orthoses for a variety of conditions. The intent of this publication beginning of each chapter highlight the authors’ primary learning was to "bridge the gap between a rote therapeutic approach and the objectives. While the field of orthotics and assistive devices could benefit frontiers of science." This edition established the conceptual organization from a more rigorous scientific foundation, this edition has incorporated of topics and content that continues to this day in the fifth edition. the most recent research literature and promotes the utilization of an This text also broke new ground by emphasizing the consideration of evidence-based practice approach. the orthosis as one of many treatment options, including pharmacologic, Joseph B. Webster, MD medical, and surgical interventions. Douglas P. Murphy, MD xi Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved. 1 Orthotic Prescription Ann Yamane KEY POINTS • A prescription for an orthosis communicates the type of device • Optimally, the prescription for an orthosis is determined with recommended to meet the biomechanical needs of the patient to input from members of the health care team and patient, improve function and promote participation in life activities. incorporating meaningful shared rehabilitation goals that use • An appropriate orthotic prescription and treatment plan is patient-centered and interdisciplinary team approaches. generated based on knowledge of the patient’s disease process • An effective prescription for an orthosis summarizes the medical along with information from a comprehensive history, physical and functional issues related to the patient, details the examination, and integration of patient-related and biomechanical functions desired, and specifies key technical environmental factors. attributes of the desired orthosis. The prescription for an orthosis is an essential part of the larger process rather than a custom-fitted orthosis, (2) need for long-term use of the of rehabilitation to improve patient function and promote participation orthosis, and (3) planes of static and dynamic control necessary at each in life activities. Each member of the interdisciplinary team offers expertise joint (sagittal, coronal, transverse).3 that allows the team to work collaboratively with the patient to identify In addition, the physician considers additional referrals necessary goals for orthotic intervention and shared rehabilitation goals. to support the comprehensive orthotic treatment plan. This may include An effective interdisciplinary approach fosters communication by supporting therapies, medications, surgeries, or injections to improve involving all team members throughout the treatment process. A col- the underlying condition before provision of an orthosis or to improve laborative clinical environment allows team members the opportunity the outcomes of the intervention. For example, an individual with a to clarify their clinical recommendations and educate other team knee flexion contracture and quadriceps weakness may be referred to members on their areas of expertise. Because of current health care physical therapy in an attempt to reduce the contracture before orthotic policy and financial demands, this interdisciplinary approach may be intervention. Reducing the knee flexion contracture will improve the possible in the acute setting but is typically challenging to achieve in effective use of a ground-reaction ankle-foot orthosis (AFO) by increasing outpatient settings. This lack of face-to-face communication requires the external knee extension moment created by the AFO from midstance the use of detailed documentation notes by the physician and others to terminal stance. to convey the assessment findings and clinical reasoning. The interdisciplinary team is most effective when team members Formulation of the orthotic prescription begins with the physician’s work cooperatively, sharing perspectives and expertise and effecting a medical evaluation of the patient, identification of the pathology and blend of the physician’s medical knowledge; the orthotist’s understanding associated functional impairments, and prognosis. The assessment of of biomechanics, design, and material options; and the occupational the individual consists of a history that includes problems noted by the and physical therapists’ evaluation of functional abilities, education, patient, prior interventions, and patient expectations and goals. The and therapy to improve function. identification of patient-related and environmental factors as outlined Follow-up is crucial to assess the functional outcome and success by the World Health Organization’s conceptual framework, the Inter- of the orthotic treatment plan in meeting the patient’s goals and the national Classification of Functioning, Disability, and Health (also known patient-centered rehabilitation team goals. Functional outcomes may as the ICF) provides insight into how an individual functions in daily be patient reported or performance based to assess improved quality life. This context is key to informing the orthotic treatment plan.6 of life, mobility, self-care, or other constructs of value specific to each Determining the appropriate orthotic prescription is grounded in individual. The Activities-Specific Balance Confidence (ABC) Scale4 is the biomechanical needs of the patient as identified through a physical an example of a self-report measure used to assess an individual’s level evaluation that includes manual muscle testing (MMT), range-of-motion of confidence while involved in specific activities such as walking up (ROM) testing, and sensory testing. Through the integration of the or down stairs, in crowds, or on icy sidewalks. The Timed Up and Go biomechanical needs and the personal and environmental factors of (TUG)5 is a commonly used performance measure assessing balance, the individual, the optimal orthosis design is identified. Although the functional mobility, gait, and potential risk for falls. The routine integra- actual prescription for an orthosis communicates the type of device tion of outcome measures into the orthotic treatment plan has the recommended to meet the biomechanical and functional needs of the potential to provide increased knowledge regarding the success of the patient, the physician’s clinic documentation note contains the necessary orthotic prescription in achieving the desired improvement in patient information justifying the (1) need for a custom-fabricated orthosis function and increased participation in life activities. 2 Downloaded for Anonymous User (n/a) at Egyptian Knowledge Bank from ClinicalKey.com by Elsevier on November 26, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved.
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