Orthotics

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Functional Foot Orthoses (FFOs)

Functional foot orthoses are relatively cost effective devices which will fit in many high street shoes available and are used to improve the alignment of the foot and ankle which can have a global effect upon the ankle, knee and hip of an individual, and may well have a positive effect upon the back also. These devices need to be carefully prescribed to get the best functional benefit from their use. Newer techniques now use computer mechanical controlled machinery to produce orthoses as they are more repeatable and have more longevity giving better value for money for the patient. Newer techniques using synthetic casting materials and scanning can also improve data capture to improve the prescription process also. However, the cornerstone of a good prescription is a† good assessment, for an understanding of the patientís needs and goals. The majority of Stephenís caseload deal with functional foot orthoses and he has experience in dealing with patients ranging from patients with disability to occupational health issues right up to elite athletes who need tuning to gain their maximum potential. In Fig ____ I included a typical assessment sheet of the parameters that are required to be assessed for a prescription orthoses to be achieved.

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Foot orthoses can also be used to try to alleviate higher pressure areas or to treat conditions like Mortonís neuroma. Plantar pressure measurement has an important role to play in diagnosing where pressure is within the foot and to then also judge if this pressure has been accurately reduced. This allows fine tuning of the orthoses if required to improve function and fit to a higher level than would normally be expected to achieve.

Knee Ankle Foot Orthoses (KAFOs)

Knee ankle foot orthoses are a very specialized type of orthoses that pass over both the knee and the ankle and can have quite a dramatic effect on an individualís ability to be able to walk. They are often used for patients who have large disabling problems within the knee and for whatever reason are not able to have an operation to treat the knee. They are also valuable in treating patients who have little quadriceps power in their thigh which makes them unstable and tend to fall on a regular basis. A typical patient might also be someone who has suffered from Polio and has both little knee control and often little ability to be able to lift their toes.

Over the last few years there have been a number of developments in this area with the advent now of electronic knees and mechanical knees which allow the knee to flex in swing phase producing a much more natural gait pattern. These types of devices need careful assessment and provision to get the maximum benefit for the patient.

 Functional Foot Orthoses

 Knee Ankle Foot Orthoses

 Knee Orthotics

Knee Orthotics

The provision of a knee orthoses can help an individual who has a number of different problems:

 Loss of anterior or posterior cruciate ligaments

 Collateral ligament damage

 Patella femoral problems

 Osteoarthritis problems in the medial or lateral compartment of the knee

 Hyperextension of the knee

A knee orthosis if designed and applied correctly can have quite a large impact on an individualís gait pattern and comfort. There are many studies that have been published in recent years showing the benefits of using osteoarthritic knee bracing in reduction of discomfort in the knee. Some patients would prefer to use this route rather than an operative route permanently or possibly to defer a knee replacement.

There are many different types of knee orthoses and need to be probably married to the individualís conditions and aims. There are a few different types of knee brace and many more exist and the correct device could be produced after a proper assessment of the individual's needs.


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