Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T17:39:31.443Z Has data issue: false hasContentIssue false

6 - Orthoses, splints and casts

Published online by Cambridge University Press:  22 August 2009

By
Paul T. Charlton  and
Duncan W. N. Ferguson
Edited by
Michael P. Barnes  and
Garth R. Johnson
Paul T. Charlton
Affiliation:
Senior Orthotist J. C. Peacock & Son, Newcastle upon Tyne, UK
Duncan W. N. Ferguson
Affiliation:
Senior Orthotist J. C. Peacock & Son, Newcastle upon Tyne, UK
Michael P. Barnes
Affiliation:
University of Newcastle upon Tyne
Garth R. Johnson
Affiliation:
University of Newcastle upon Tyne
Get access

Summary

Introduction

As defined by the International Standards Organization, ‘An orthosis is an external device used to modify the structural or functional characteristics of the neuromuscular system’. This definition encompasses all other devices referred to as splints, braces and casts. Although not so well defined, it is common practice for clinicians to refer to orthoses as those external devices provided by an orthotist, while splints are commonly recognized as orthoses made of low-temperature plastics or fabric by therapists other than orthotists. Nonremovable orthoses made of plaster or casting tape are referred to as casts.

The use of orthoses (in all their forms) for adults presenting with spasticity has been controversial (ACPIN, 1988), and use varies from centre to centre depending on the treatment regime used by the therapist. However, in pediatrics, their use is more widely accepted, partially due to the work of Meadows (1984) in the early 1980s and those therapists using the Conductive Education techniques promoted by the Peto Institute.

In adult neurology, treatment is often based on the Bobath concept of normal movement (Bobath, 1980), which for many years frowned on the use of splinting because of the obvious impingement on the ability to perform normal movement.

Normal movement is the ultimate goal in neuro-rehabilitation. However, to expect all patients with a neurological deficit to make a full recovery is not realistic.

Keywords

ankle-foot orthosisbiomechanicscastingknee-ankle-foot orthosissplintingspasticity
Type
Chapter
Information
Upper Motor Neurone Syndrome and Spasticity
Clinical Management and Neurophysiology
 , pp. 113 - 130
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Association of Chartered Physiotherapists with an Interest in Neurology (ACPIN). (1998). Clinical Practice Guidelines on Splinting Adults with Neurological Dysfunction. London: ACPIN.
Baker, K. & Charlton, P. (2005). The effect of physiotherapy and orthotic intervention 40 years after stroke. Physiol Res Int, 10: 3.Google Scholar
Bobath, K. (1980). A Neurological Basis for Treatment of Cerebral Palsy, 2nd edn. London: Spastics International Medical Publications.
Butler, P. B. (1998). A preliminary report on the effectiveness of trunk targeting in achieving independent sitting balance in children with cerebral palsy. Clin Rehab, 12: 281–93.Google Scholar
Butler, P. B., Farmer, S. E. & Major, R. E. (1997). Improvement in gait parameters following late intervention in traumatic brain injury; a long term follow up of a single case. Clin Rehab, 11: 220–6.Google Scholar
Butler, P. B. & Major, R. E. (1987). The Parawalker: a rational approach to the provision of reciprocal ambulation for paraplegic patients. Physiotherapy, 73: 393–7.Google Scholar
Butler, P. B. & Major, R. E. (1992). The learning of motor control: biomechanical considerations. Physiotherapy, 78: 1–6.Google Scholar
Butler, P. B., Thompson, N. & Major, R. E. (1992). Improvement in walking performance of children with cerebral palsy: preliminary results. Dev Med Child Neurol, 34: 567–76.Google Scholar
Carus, D. A., Lamb, J. & Johnson, G. R. (1993). Upper limb orthoses. In: Bowker, P., Brader, D. L., Pratt, D. J.et al. (eds.), Biomechanical Basis of Orthotic Management. Oxford, UK: Butterworth Heinemann, p. 206.
Condie, E. (2004). A Report on a Consensus Conference on the Orthotic Management of Stroke Patients. ISPO ISBN 87-89-809-14-9.
Cool, J. (1989). Biomechanics of orthoses for the subluxed shoulder. Prosthet Orthot Int, 13: 90–6.Google Scholar
Douglas, R. & Solomonow, M. (1987). The LSU reciprocating gait orthosis. J Rehabil Res Dev, 25: 57–8.Google Scholar
Edwards, S. (1998). Physiotherapy management of established spasticity. In: Sheean, G., (ed.), Spasticity Rehabilitation. London: Churchill Communications Europe Plc.
Edwards, S. & Charlton, P. T. (1996). Splinting and use of orthoses in the management of patients with neurological dysfunction. In: Edwards, S. (ed.), Neurological Physiotherapy: A Problem Solving Approach. London: Churchill Livingstone.
Farmer, S. E., Butler, P. B. & Major, R. E. (1999). Targeted training for crouch posture in cerebral palsy. Physiotherapy, 85: 242–7.Google Scholar
Gage, J. R. (1983). Gait analysis for decision-making in cerebral palsy. Bull Hosp Joint Dis Orthop Inst, 43: 147–63.Google Scholar
Harris, E. E. (1973). A new orthotic terminology: a guide to its use for prescription and fee schedule. Orthop Prosthet, 27: 6–19.Google Scholar
Hylton, N. & Allen, C. (1997). The development and use of SPIO Lycra compression bracing in children with neuromotor deficits. Pediatr Rehabil, 1: 109–16.Google Scholar
Hylton, N. M. (1989). Postural and functional impact of dynamic AFO's and FO's in paediatric population. J Prosthet Orthop, 2: 40–53.Google Scholar
Meadows, C. B. (1984). The Influence of Polypropylene Ankle Foot Orthoses on the Gait of Cerebral Palsy Children. PhD thesis. Glasgow: University of Strathclyde.
Meadows, C. B. (2004). Proceedings of the North East Regional Orthotic Conference. January.
Owens, E. (2004). ‘Shank Angle to Floor’ Measures and Tuning of ‘Ankle-Foot Orthosis Footwear Combinations’ for Children with Cerebral Palsy, Spina Bifida and Other Conditions. MSc thesis. Glasgow: University of Strathclyde.
Price, C. I. M., Franklin, P., Rodgers, H., Curless, R. H. & Johnson, G. R. (1999). A non-invasive method to evaluate shoulder problems post stroke. Lancet, 353: 298.
Shumway-Cook, A. & Woollacott, M. H. (2001). Motor Control. Theory and Practical Applications. Philadelphia: Lippincott Williams & Wilkins.
Small, G. J. (1995). The orthotic management of the foot in cerebral palsy. In: Condie, D. N. (ed.), Report of a Consensus Conference on the Lower Limb Management of Cerebral Palsy. Copenhagen: International Society for Prosthetics and Orthotics, pp. 123–6.
Stallard, J. (1987). Assessment of mechanical function of orthoses by force vector visualisation. Physiotherapy, 73: 398–402.Google Scholar
Taylor, P. N. & Burridge, J. H. (1999). Clinical use of the Odstock Dropped Foot Stimulator. Its effect on speed and effort of walking. Arch Phys Med Rehabil, 80: 1577–83.Google Scholar
Whittle, M. W. (1996). Gait Analysis: An Introduction. Oxford, UK: Butterworth Heinemann.
Yates, G. (1968). A method for provision of lightweight aesthetic orthopaedic appliances. Orthopaedics, 1: 153–62.Google Scholar
Zander, C. L. & Healy, N. L. (1992). Elbow flexion contractures treated with serial casts and conservative therapy. J Hand Surg, 17: 694–7.Google Scholar
Bowker, P.,, Condie, D. N., Bader, D. L. & Pratt, D. J. (1993). Biomechanical Basis of Orthotic Management. London: Butterworth Heinemann.
Duncan, W. & Mott, D. (1983). Foot reflexes and the use of the inhibitive cast. Foot Ankle 4(3): 145–8.Google Scholar
Rose, G. (1986). Orthotics: Principles and Practice. London: Heinemann.

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×