Orthosis use for children in expectation of treatment

Abstract

The experiences of rehabilitation by using orthosis for children with neuromuscular disorders are discussed in this article. For appropriate orthosis prescription, estimating the details of gait abnormalities using the PDCA (Plan-Do-Check-Act) cycle was helpful for untrained therapists. The most important tips were stabilization of the subtalar joint, normalization of the tibiotalar joint, and normalization of the forefoot alignment. Although when to start the treatment with orthosis is controversial, we suggest early intervention in the post-neonatal infantile term before the patient starts walking, to get the effective work of polyarticular muscles around the ankle stabilizing the bony alignment of the foot, in order to prevent dilation to bony deformation or increment of gait disturbance induced by congenital muscle tone abnormality, so that the patient will have a better gait than without orthosis.