useful facts about O from A to Z.
By definition an orthosis is a medical or orthopedic device for stabilizing, relieving, immobilizing, guiding, or correcting limbs or the trunk.
We distinguish between thigh and lower leg orthoses, hand orthoses, ankle, knee, wrist and finger orthoses, back and torso orthoses or hip braces or corsets, splints and insoles.
The use of misalignment or posture corrective orthoses is based on the application of the "three-force principle" - two major points and an opposing pressure point.
Depending on the pathological gait pattern of our patients, the requirements of the doctor and physiotherapists, our orthopedic technicians build the orthosis to achieve the desired leverage effect.
There are simple joints, spring joints, joints with backspring effects or flexible toe area. For high spring forces there are system ankle joints (NEURO SWING).
By using the center of rotation and certain adjustment options you get as much mobility as you need.
Orthopedic insoles with a sensorimotor footbed are a simple and helpful treatment for CP (Cerebral Palsy) patients. These can be added into SMOs (supramalleolar ortheses) – overarching ankle ortheses that (partly) correct the position of the foot and even activate muscles.
Orthopedic splints are used for stabilization and immobilization, e.g. bracers, wrist forearm splints, elbow splints or knee splints.
AFO (Ankle Foot Orthosis):
Lower leg orthoses are often made without ankle joints. They are subdivided into dynamic (DAFO) and static (SAFO) lower leg orthoses. For example a dynamic lower leg orthosis allows a movement in the anatomical ankle joint, whereas a static lower leg orthosis completely prevents a movement of the ankle.
In case of CP the brain may transmit wrong impulses to the affected muscles - that's why they work too hard, too weak or at the wrong moment. Depending on the type of injury, paralysis may occur, which is may be accompanied by spasticity in many patients.
Depending on the clinical picture, medical care of CP patients can be supported using a variety of orthopaedic aids. Interdisciplinary teamwork between doctors, physiotherapists and our orthopedic technicians is important to us and essential for optimum care.
Contracture (Lat. contrahere: contract):
Contracted tissue - e.g. muscles or tendons, involuntarily shrink and contract continuously. Thereby adjacent joints become limited in mobility or forcibly misaligned. This can be counteracted with a appropriate indication.
the crouch gait is characterized by steadily bent hip and knee joints.
DAFO (Dynamic Ankle Foot Orthosis):
For example a DAFO allows a movement of the anatomical ankle joint.
Diplegia (Gr. dis: double; plege: paralysis):
A bilateral paralysis , where 2 body parts are affected (e.g. both arms or both legs).
Dorsal (Lat. dorsum: dorsal):
If something is located to the back, or to the rear. For example, a dorsal lower leg orthosis is located at the calf.
means lifting the foot. The contrary motion is dropping the foot (plantar flexion).
Extension (Lat. extensio: extension):
An active or passive stretching movement of a joint. The extension is the contrary motion to flexion and characteristically leads to an increase of the joint ankle. On ankle joint and wrist, the human extension (lifting of the tip of the toe or fingertip) is generally defined as a dorsal flexion (dorsiflexion). On the spine, the general term is reclination. If a body part is overstretched, it is called a hyperextension (e.g. in the knee joint as genu recurvatum).
Extensor (Lat. extendere: stretch, extend):
is a skeletal muscle that leads to a joint extension. In some names of anatomical muscle, especially at forearm and lower leg muscles, the term Extensor is explicitly used as the second part of the name, e.g. “musculus extensor carpi ulnaris“, elbow-sided extensor of the carpus.
Eccentric muscle activity (Lat. ex centro: outsite the centre):
The perfomance of a muscle, when it is actively extending and controls a joint movement with a braking contraction – for example the power from the pedals, while riding a bike, or the footwork when absorbing a jump from a low height or on a trampoline.
Flexion (Lat. flectere: bend, flex):
The active or passive bending movement of a joint. The flexion is the contrary motion to the extension and characteristically leads to a decrease of the joint angle.
FRAFO (Floot Reaction AFO):
A rigid orthosis with an anterior, forward facing orthotic mould, which ensure a moment of knee or waist extension.
Hemiplegia (Gr. hemi: half; plege: paralysis): hemiplegia patients have a paralysis of one half of the body.
KAFO (Knee Ankle Foot Orthosis): Thigh orthosis or full leg orthosis with adjustable, varying degrees of movement (NEURO SWING).
Muscle (Lat. Musculus: muscle): Muscles contract on command and then relax again. each muscle or group of muscles has two or more points of attachment to the moving bones, "welded" through the tendons. Whenever the muscle contracts, these points of approach move towards each other: the joint between is bent. At the same time, the oppositely working extensor is relaxed.
Nancy Hylton Ortheses
Nancy Hylton, an American physiotherapist turned the world of orthotics on its head in the 1990s.
We mainly use these in the treatment of patients with cerebral movement disorders (ICP).
NEURO SWING (system ankle joints): The dynamic system ankle joint - with adjustable freedom of movement and variable spring force, is optimally and individually adapted to the needs of the patient and to a pathological gait pattern.
Plantarflexion (Lat. Planta: sole of the foot):
Means lowering the foot.
Plantarflexion causes the lowering of the foot.
The countermovement is the dorsiflexion, lifting the foot.
A joint lock in the knee joint of an orthosis. The Swiss lock enables the lock for the knee extension. By releasing the lock, the block can be reversed. In addition, the blocking bracket can be pulled out and the lower leg can be bent in or - by locking the bracket into the joint, it’s possible to prevent a collapse in the knee joint of a patient with paralysis or atrophy.
Refers to the interaction of sensory and motor parts of the nervous system.
For example sensory inputs affect the function of certain muscles through the soles. Sensomotoric elements can be constructed as inlays or as integrated footbeds in supramalleolar Ortheses (SMOs).
SMO (supramalleolar ortheses):
With such ankle overlapping ortheses made of polypropylene, we can correct the position of the foot and activate the muscles. The plantar flexion can be reduced and controlled by the height of the design, in order to guarantee good plantar flexion during the complete release of the achilles tendon.
Spasticity (Gr. spamos: spasm):
tone increase of the skeletal culture that forces the extremities in typical, non-functional patterns of posture. It is always caused by damage to the brain or spinal cord.
Ventral (Lat. Venter: body, waist): towards the abdomen. To lead and stabilise the joint, a ventral orthosis actively limits the flexion.