Even those who are not O&P professionals likely know someone who uses foot orthotics or a lower-limb orthosis to overcome foot pain, correct a gait issue, or address a foot or ankle pathology—estimates are that millions of people in the US use them. As such, these devices are essential to patients’ mobility and well-being. In this issue, we look at lower-limb orthotic devices and treatments: the importance of creating standardization in AFO stiffness, how casting techniques should be adapted for new designs, and the role orthotists and pedorthists can play in fall prevention.
With a rise in the aging population and in conditions that can cause loss of sensation and foot pain, such as diabetes, awareness of fall risk becomes even more important. “O&P’s Role in Fall Prevention” shares how clinicians can identify patients’ risk and help them manage that danger, including proper footwear and foot orthotics.
Another feature addresses a challenge in AFO interventions. The outcomes depend on whether the stiffness dosage is appropriate for the individual, which is not yet available in a standardized measurement. Put another way, if your physician prescribes a medication, one crucial element for effectiveness is how much of the active ingredient is in the prescription—the dosage, 10mg, for example. Lacking this precision, the current system for AFO stiffness dosage equivalent might be medium, which if it were a drug prescription could range from 8-11mg, depending on the manufacturer. “Prescribed Precision: Dosing AFO Stiffness for Maximum Outcomes” explains why this matters and suggests strategies to improve this system.
While orthotic devices have not experienced the kind of lightspeed evolution of prostheses, there have been notable advances, including the introduction of dynamic AFO ankle joints. However, like the devices themselves, the progress of casting techniques has lagged behind. “Relevance of Gait-Related Posture Casting in Lower-Limb Orthotics” discusses how this dynamic and responsive approach to AFOs differs and why a different casting method is needed.
Happy reading.
Andrea Spridgen
