While my keyboard is warm, I will throw this topic out there.
I was reading my monthly O&P Business News and was disturbed by the
article entitled “Dynamic Ankle Foot Orthoses: Do They Work?”
First, I realize that this is not a research based journal. Although it
does not state specifically, can I assume that these are the so-called
“custom” AFO’s made by Cascade? Here are my concerns…..
1) Why would an Orthotist ever use these when you can make them
yourself? (Aside from the money issues, if you can’t make a hybrid AFO
that has an intimate fit and controls motion in the appropriate planes,
can you call yourself an Orthtotist?) This may sound frivolous and
simplified, but, is this not what we are trained to do? Assess, Cast,
Modify and Fabricate?? Do “Orthotists” actually take a cast (or worse
yet, just measurements) of a spastic CP child and mail it away to be
made? Am I just a naive Canadian, that has been trained entirely in
Southern Ontario, living in a vacuum? I am pretty sure that no one in
Ontario would ever do this (aside from the fact that the government
would never pay for it of course), and Lord help me if it ever comes to
that….I mean, making these braces in the shop is the reason I love
what I do! I will concede that there are some adult patients that could
be sufficiently fit with a central-fab device, but spastic CP
kids!!!!!! Come on!!!!
2) I guess I don’t have a second point, but are there other Orthotists
out there that agree with me, or is everyone using these central-fab
DAFO’s and I am the odd one out?
Dazed and Confused in Ontario
Derek Kozar, M.Sc., C.O.(c)
