We had the opportunity to work with a young boy with cerebral palsy.

He had previously used orthotics but had outgrown them, necessitating new orthotic intervention. This case presented unique challenges due to his age and the dynamic nature of his condition.

Reason for Referral to Orthotics Plus

The patient and his family were referred to our clinic after he outgrew his previous orthotics.

They were seeking a closer location for treatment and discovered our clinic through our website. This referral allowed us to provide our expertise to a family in need.

Prescription Decision

Upon assessment, we decided to adjust his prescription. Our plan included:

  • Choosing a less restrictive approach due to his age and the relatively mild nature of his physical presentation.
  • Providing Supramalleolar Orthosis (SMOs) and foot orthotics.
  • Focusing on addressing the right side of his body, which was more severely affected, while also considering some upper limb involvement, particularly in his right hand.

Choosing SMOs over AFOs

A significant part of our decision-making process revolved around choosing SMOs over Ankle Foot Orthotics (AFOs). SMOs are less restrictive than an AFO and offer excellent foot support and control whilst allowing for ankle plantarflexion and dorsiflexion.

They are made of firm plastic rather than softer EVA, which provides greater control and correction.

Additionally, SMOs can be customised to address specific issues, such as pronation, by exerting pressure above the ankle. This level of control is crucial for patients like the young boy we were assisting.

Gait Assessment

To determine the most suitable orthotic solution for our young patient, we conducted a thorough gait assessment. Our process involved:

  • Conducting a gait analysis and thorough assessment with both AFOs and SMOs to evaluate their impact on his mobility and muscle control.
  • Discovering that he walked more effectively with the SMOs, which allowed for better muscle control whilst maintaining an anatomically correct position.

Increasing Acceptance

Orthotic wear can sometimes carry a stigma, children tend to be more accepting of orthotic devices but this can decrease as they enter early teen years and adulthood.

Personalisation and customisation played a significant role in increasing acceptance in this case. By allowing the patient to choose patterns and designs for his SMOs, we made the orthotics a source of pride rather than a cause for concern.

Additionally, supportive environments where other children may have similar conditions helps normalise the use of orthotics.

Enhancing Daily Life

The primary goal for the patient and his family was to improve his daily life.

By maintaining an anatomically correct position in his ankle we corrected his biomechanics- reducing pain, increasing gait efficiency and reducing pathological movements in his lower limb which can result in deformity and issues later in life. By providing him with a better range of motion, we have also enabled and improved his participation in various activities. This approach ensured that he could experience a more fulfilling and active childhood and improved his physical and social development in the longer term.

The Joy of Personalisation

In the end, our efforts paid off not only in terms of improved functionality but also in the young patient’s emotional well-being. He took great delight in the personalised patterns on his SMOs and proudly showed them off to everyone.

This personalisation not only enhanced his acceptance of the orthotic treatment but also added an element of fun to his journey towards improved mobility and comfort.