Glad You Asked...about Orthotics
“What lower-limb orthosis do you think is the most effective, and why?”
“I guess I would say a posterior-entry
floor-reaction orthosis. This kind of orthosis helps stabilize the knee
while preventing the need for a long-leg brace or a KFO.
“It is also a lot easier for the patients to wear and is usually
custom-made.”
Marty Mandelbaum, CPO
President/owner
M.H. Mandelbaum Orthotic &
Prosthetic Services Inc.
Port Jefferson, N.Y.
“For the majority of cerebral vascular accidents—such as a stroke—I would say the most effective type of orthosis would be some kind of a custom-molded AFO, with optional trim lines and designs.
“I think that most people with CVA would require a definitive type orthosis so that it would be comfortable.”
R. Scott Mosher, CO, BOCO
Co-owner
Active Brace and Limb
Traverse City, Mich.
“That’s a pretty open question. It’s hard for me to answer it because I’m much more of a patient-specific kind of guy. But, I would have to say a solid ankle AFO is probably the most effective, because you can treat the majority of conditions that you see in patients.
“A lot of the patients that I see are geriatric—some of them have charcot ankles, some of them have drop foot or cerebral vascular
accidents and things like that. With a solid ankle AFO, you can treat the instability.”
Joseph Perry, CP, COF
Part-owner
Land of Lakes Orthotics & Prosthetics Inc.
Plymouth, Minn.
“I consider the AFO/SMO combination to be one of the most effective lower-extremity orthoses. Patients who present with high tone or those with dorsiflexion and plantarflexion weakness [who also need] medial/
lateral control benefit greatly from this type of orthosis.
“The SMO provides sub-talar and mid-foot control, while the AFO gives total leg weight-bearing alignment. I have experienced cases where I have tried to control ankle inversion instabilities with an AFO, independent of the SMO. The result was lateral malleolus pressure or a compromised alignment due to having to provide relief for the lateral malleolus.
“The SMO addition gives intimate total contact control, and coupled with the AFO, together they provide a synergistic ‘one-two’ punch for managing the more severe instabilities.
“Additionally, the SMO can be used independent of the AFO section in pediatric cases where crawling is needed.”
Maurice Johnson, CO, BOCO, C.Ped.
Assistant manager
Floyd Brace Co. Inc.
North Charleston, S.C.
Correction
William Penney Jr., CPO, is the owner of Philadelphia Orthotics & Prosthetics Inc., in Vorhees, N.J. In the O&P Almanac’s February 2006 issue, Blake Christoph, CPO, was incorrectly listed as owner.
The Almanac regrets any confusion this mistake may have caused.
“It is also a lot easier for the patients to wear and is usually
custom-made.”
Marty Mandelbaum, CPO
President/owner
M.H. Mandelbaum Orthotic &
Prosthetic Services Inc.
Port Jefferson, N.Y.
“For the majority of cerebral vascular accidents—such as a stroke—I would say the most effective type of orthosis would be some kind of a custom-molded AFO, with optional trim lines and designs.
“I think that most people with CVA would require a definitive type orthosis so that it would be comfortable.”
R. Scott Mosher, CO, BOCO
Co-owner
Active Brace and Limb
Traverse City, Mich.
“That’s a pretty open question. It’s hard for me to answer it because I’m much more of a patient-specific kind of guy. But, I would have to say a solid ankle AFO is probably the most effective, because you can treat the majority of conditions that you see in patients.
“A lot of the patients that I see are geriatric—some of them have charcot ankles, some of them have drop foot or cerebral vascular
accidents and things like that. With a solid ankle AFO, you can treat the instability.”
Joseph Perry, CP, COF
Part-owner
Land of Lakes Orthotics & Prosthetics Inc.
Plymouth, Minn.
“I consider the AFO/SMO combination to be one of the most effective lower-extremity orthoses. Patients who present with high tone or those with dorsiflexion and plantarflexion weakness [who also need] medial/
lateral control benefit greatly from this type of orthosis.
“The SMO provides sub-talar and mid-foot control, while the AFO gives total leg weight-bearing alignment. I have experienced cases where I have tried to control ankle inversion instabilities with an AFO, independent of the SMO. The result was lateral malleolus pressure or a compromised alignment due to having to provide relief for the lateral malleolus.
“The SMO addition gives intimate total contact control, and coupled with the AFO, together they provide a synergistic ‘one-two’ punch for managing the more severe instabilities.
“Additionally, the SMO can be used independent of the AFO section in pediatric cases where crawling is needed.”
Maurice Johnson, CO, BOCO, C.Ped.
Assistant manager
Floyd Brace Co. Inc.
North Charleston, S.C.
Correction
William Penney Jr., CPO, is the owner of Philadelphia Orthotics & Prosthetics Inc., in Vorhees, N.J. In the O&P Almanac’s February 2006 issue, Blake Christoph, CPO, was incorrectly listed as owner.
The Almanac regrets any confusion this mistake may have caused.
Have a question or want to answer one?
Do you have a question you’d like to ask your colleagues? Or, would you like to answer a question for this column? Here’s your chance. Contact Becky Kesner at bkesner@AOPAnet.org or (571) 431-0876, ext. 215.
