Taking the Obscurity out of Orthoses: Using Algorithms to Assist in Decision Making

Lower extremity bracing is a common practice used by physical therapists with goals such as improving gait, maintaining range of motion, or improving function. Yet, minimal information is provided to physical therapy students and very few continuing education courses are offered to practicing physical therapists on this topic. Thus, many physical therapists feel ill prepared to manage orthoses in clinical practice and deviations in practice occur due to a lack of a clear direction. This course will review current concepts in lower extremity orthoses management in children with developmental disabilities. Common terminology, components of an orthoses evaluation, rationale for use, bracing styles, functional impact, and practical solutions to bracing challenges will be reviewed. Evidence will be sited to support orthoses use for children with various diagnoses including cerebral palsy, Down syndrome, and spina bifida. There was a call to action in 2019 for the creation of an algorithm to guide orthoses decision-making. This course will present evidence-based algorithms that allow therapist to problem solve the ideal bracing set-up and style for each individual child. Using the algorithms provided participants will be able to apply this information immediately upon return to patient care. Videos case examples will be used to emphasize importance components of each algorithm concept.