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The Align Clinic Blog
​ Your Home For Orthotic and Prosthetic Knowledge

A Step by Step Guide to Getting Above the Knee Prosthetics

6/15/2022

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“Transfemoral amputation” is the medical term for removing the leg from any point higher than the knee joint. Also known as ‘Above-the-knee amputation’. There can be many different reasons for a person to undergo surgery, such as frost-bite, vehicle accident, or Neuroma.

Whatever the cause, your surgical site and amputated limb are unlike any other patient's. If you’ve undergone this surgery recently, you might be wondering what the process of getting fitted for prosthetics might look like.

That’s why the prosthetics you require will depend on several factors such as
​
  • Personal preference
  • The shape of your residual limb
  • Level of activity you wish to maintain
  • Physiotherapy your doctor has cleared you for
  • How your residual limb heals and responds to treatment

The road to mobility after limb loss can be long and at times, painful. Whether you lost your limb suddenly in an accident or had weeks to prepare before the surgery mentally. 

The great news is that more above-the-knee prosthetic options are available to you now than ever before. 

Most prosthetics manufactured these days are lighter, more durable, and better fitting than their predecessors. With proper after-surgery and at-home care, you will be up and about sooner than seems possible right now.

Starting Your Journey

The procedure to get fitted for above-the-knee prosthetics will start shortly after you regain consciousness after amputation surgery. Right after surgery, it’s common to experience the following symptoms
​
  • Swelling
  • Phantom pain
  • Tightness in the residual limb
  • Pain and discomfort in the residual limb

Your doctor will help you manage all these symptoms and give care instructions for bathing, sitting, and cleaning your incision site. It’s crucial to follow all instructions to the T to prepare your limb for prosthetics.

Proper after-care is vital to minimise the chances of infection and ensure the availability of more prosthetic options for yourself.

First Orthotist Appointment

This step will happen once your doctor gives you the all-clear after examining the incision site. Your first meeting with your Orthotics is your first step toward reclaiming your mobility. 

Once your doctor is happy with your recovery, a meeting with an orthotist will be scheduled during your hospital stay.

Your orthotist will ask questions about your pain levels, lifestyle, and activity level. Before designing and fitting you for your custom-made above-the-knee prosthetic.

Compression Sock

A shrinker or compression sock will be the first piece of equipment you will be fitted for. A shrinker sock acts as a compression garment for your residual limb and helps you by
​
  • Decreasing swelling
  • Protecting your incision site
  • Lowering chances of developing edema
  • Bettering your chances of using above-the-knee prosthetics with success
  • Enabling your limb to become compatible with more prosthetic options
  • Gently coax your incision into a more optimal shape for the use of prosthetics
  • Desensitizing and numbing your incision to help manage pain once you start wearing prosthetics

Getting Fitted for the Liner

Once your residual limb adapts to wearing the compression sock, it’s time to start the process of getting fitted for your first prosthetic. To accommodate your limb’s unique shape, a liner made of soft material is worn on the limb. This liner is meant to

  • Act as a shock absorber.
  • Enable the prolonged use of prosthetics.
  • Reduce friction between limb and prosthetic equipment.
  • Reduce strain on your limb that’s healing from surgery.

Depending on your limb shape and physical needs, the liner can be off-the-shelf that's slightly modified to fit you. Or your doctor might make a cast of your limb for a custom-shaped liner.

Temporary Prosthetic

The next step is a temporary or diagnostic prosthetic for your leg. That is usually a transparent and moldable prosthetic meant for use just at the prosthetist's clinic. Think of it as training wheels for your above-the-knee prosthetic. 

The prosthetist will guide you about its use and how to wear it correctly. A diagnostic prosthetic and physiotherapy will help your prosthetist assess your needs and progress. It will also help them decide the type of socket, suspension, liner, and material most suited for your final prosthetic.

Often, the temporary prosthetic is also modified to fit your limb to facilitate you during physiotherapy and support you better as your take the initial steps using your prosthetic.

Final Above-The-Knee Prosthetic

Once your prosthetist is satisfied with your healing and gait training, it’s time to get your long-term prosthetics. Carbon fiber is commonly the material of choice for above-the-knee prosthetics because of its durability, versatility, and ease of use.

The process of getting fitted for this prosthetic will be done over multiple appointments. Your prosthetist will measure, fit and adjust your prosthetic and calibrate it with your height and body. After finalizing alignment, it’s time for more gait training and physiotherapy.

Physiotherapy and Long-Term Care

Physiotherapy is a crucial part of the healing process. The time you spend practicing with your prosthetist and physiotherapist will empower you to confidently put on, take off and walk in your prosthetic.

Getting your prosthetic leg is an ongoing process as your limb changes and adjusts to new realities. Make sure to schedule regular follow-up appointments for physiotherapy and with your orthotist and prosthetist.

Taking the First Step Towards Reclaiming Your Mobility

Limb loss can be a devastating reality to adjust to. Our specialised teams at Align clinic are trained to help you deal with these changes. Reach out today and let our representative guide you more about the physiotherapy and prosthesis options available to you.​
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Schroth Therapy for Children With Scoliosis

6/8/2022

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Scoliosis is the unnatural curvature or abnormal spine rotation. The severity of the disease can vary significantly from mild to completely crippling. Scoliosis often becomes the cause of many other health conditions as well. It can also hinder the proper functioning of vital organs such as the heart.

Scoliosis can be a difficult diagnosis for you and your child. Learning about the different treatment options available to your child can better equip you to make informed decisions regarding your child’s care.

In addition to surgical options, there are now many physiotherapies and bracing options. Early diagnosis and treatment can mean a world of difference when it comes to scoliosis.

What Is the Schroth Therapy?

Schroth therapy is a non-invasive, non-surgical treatment option for scoliosis. It is more than 100 years old and consists of custom-tailored exercises to reverse and manage the condition. The therapy aims to help lengthen and alleviate the spine in a three-dimensional approach. 

Here are the main goals of Schroth therapy:
​
  • Improving muscular proportions and bettering the child’s posture
  • Teaching modified breathing techniques
  • Increasing awareness of the child’s posture, and re-training their body to carry itself better

Schroth therapy works by rhythmically aligning breathing, sensory skills, and limb coordination. It does so by increasing awareness of one’s movement and posture. All to supplement supporting the spine in ways that alleviate its unusual curvature and rotating.

The technique works particularly well for patients still in the growing age suffering from mild to moderate scoliosis. Slowing down the further regression of the deformity can go a long way toward reducing more severe complications later in life. It can also ensure a relatively pain-free and everyday life for them.

Schroth Therapy for Children

Adolescence, the time when most cases of pediatric scoliosis are diagnosed, is also a phase full of growth spurts and changes for your child. Schroth therapy aims to reduce the abnormal spinal curve during this time.

The pediatric version of Schroth therapy often incorporates bracing and breathing and physiotherapy exercises. Each child is different, and so is the treatment route best suited to their needs. Schroth therapy offers customised treatment plans for each child.

After examination, a specially trained orthodontist will determine the need for bracing with orthosis explicitly designed to help children with the condition.

The age of your child, bone maturity and progression of the spinal rotation will all play a part in deciding treatment options. Schroth therapy in children aims to simultaneously slow the speed of abnormal spinal curvature while working to reverse and elongate it.

How Effective Is Adolescent Schroth Therapy

Many surgical and non-surgical methods of treating scoliosis in children have been developed and perfected in recent years as awareness of the malformation grew. This study finds Schroth therapy particularly effective in these areas when it comes to adolescent treatment:

1. Cobb angle

The standard used for measuring the extent of scoliosis’s effects on the spinal curvature. The study finds that Schroth therapy made improvements in decreasing the Cobb angle without surgical intervention

2. Quality of Life

Schroth Therapy helps improve the overall quality of life for younger scoliosis patients. Reduction of the Cobb angle results in a better self-image and less consciousness concerning scoliosis. The benefits of the therapy aren’t limited to phycological betterment alone. 

The therapy also helps manage pain through non-invasive treatment. Enabling your child to participate in regular childhood activities such as sports and play. Schroth therapy also effectively settles other health issues caused by scolioses, such as breathing issues and chronic fatigue.

3. Reducing the Need for Surgery

All surgery carry significant risks. More so when it’s the delicate matter of pediatric spinal surgery. Schroth therapy helps children diagnosed with scoliosis by reducing the need for surgical correction. This form of therapy helps your child make behavioural modifications and  correct habits that could worsen the spinal deformity, in addition to exercise and bracing.

Tips to Increase Schroth Therapy’s Effectiveness for Your Child

Schroth therapy sessions can seem lengthy and physically demanding. It can be hard to convince an active pre-teen to regularly attend sessions when so many other interests take up their time and attention. 

Your child may not always be eager to head to therapy, especially in the initial days when soreness and discomfort are normal. Here are some tips to help enlist your child’s compliance during therapy and at-home exercises.

1. Incentivise Them

Offering incentives to help motivate your child is always a good idea. But it doesn't always have to come in the form of their favourite treat or game show. Help your child understand all the fun activities they will be able to do once their scoliosis improves.

Plan outings and games. Read success stories together of other children who overcame scoliosis and went on to lead active, healthy lives.

2. Schedule a Routine

When you pre-schedule therapy sessions and exercise time at home, it becomes second nature. Take the time to set your child’s calendar and encourage them to adhere to it. Regular practice of breathing techniques and exercise can make Schroth therapy more effective.

3. Lend Support and Encouragement

It’s normal to feel sore and achy during and after therapy sessions as the body adjusts to changes and new habits. Make sure you and your child’s physiotherapy specialist take things at a pace your child is comfortable with. Offer constant encouragement and help them understand how therapy can improve and manage their condition.

4. Record Their Journey

Another great way to encourage your child is to document and show them just how far they have come. Record them performing their exercises and breathing. Show them the improvements in their appearance and be their biggest cheerleader. These recordings can even come in handy to practise the exercises at home.

Final Thoughts

Your child can lead a very active and fulfilling life even with a scoliosis diagnosis. Help your child overcome scoliosis and avoid its complications in later life. The earlier your child is diagnosed, the sooner treatment can begin. 

To learn about more treatment options, Book an appointment today and help your child manage their condition.
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Exploring Vacuum Bell Therapy. Can It Treat Your Child’s Pectus Excavatum?

6/1/2022

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The medical term for the condition commonly known as “Funnel chest” or ‘Sunken chest” is pectus excavatum. It’s the most common of all chest deformities. It’s a treatable condition that can range from a serve deformity to a somewhat concave chest wall appearance.

Pectus excavatum is caused by atypical growth of chest cartilage and connecting tissues. Excessive growth of the cartilage connecting the ribs to the sternum results in a deeper dip in the chest. This depression can be equal or asymmetrical on either side of the chest. 

The congenital condition is often diagnosed as the child grows and enters toddlerhood. The chest hollow becomes more pronounced, although the malformation is present from birth.

Treatment Options for Pectus Excavatum

Conventionally, the treatment for pectus excavatum was only performed surgically. Given the delicate nature of pediatric cases and the risks attached to adolescent surgery, procedures treating pectus excavatum were usually recommended in only the most extreme cases.

Many methods of correcting the defect have emerged and have been perfected over the years. The most routinely used methods are the Ravitch Procedure and the Nuss Procedure, which is less invasive than the former.

Risks Associated With Surgical Treatment of Pectus Excavatum

While surgical treatment approaches for pectus excavatum have come a long way, they carry certain risks parents need to be aware of. Both of these options carry risks, as do all surgical procedures.

An added drawback is that the patient cannot undergo MRI because of the steel bar placed in their chest. In case of emergencies, doing CPR on a patient who has undergone either of these surgeries might not be a feasible option. These added risks place patients, often in their adolescence, in greater danger than their peers. 

Moreover, bar displacement, pleural effusion, and infection are after-surgery complications associated with these procedures.

Vacuum Bell Therapy

Pectus excavatum is often diagnosed in young children and approximately affects 1 out of 300 children. The good news is that the elasticity of a young child’s breast bone lends itself well to early correction. This method works on reshaping the ribcage, breastbone, and muscles to reduce their inclination to pull the ribcage in a concave shape.

Vacuum bell therapy is a minimally invasive, non-surgical treatment option for pectus excavatum. The technique is comparatively recent, developed in 2005 by Eckart Klob in Germany. This therapy works on the simple principle of suction.

How It Works

A small instrument made of flexible material is placed on the patient’s chest. Suction is created to coax the chest depression into a better formation. A hand pump is attached to the instrument and used to create and control suction.

Over time, the vacuum bell re-trains the sternum and ribs to stay in the correct position. The whole process usually takes a year, though improvement can be noticed after 3-4 months.

The success rate of rectifying the condition is high, given that the diagnosis is made early enough. Other factors that play into the success of vacuum bell therapy are compliance with the doctor’s directions and wearing the device for the prescribed period daily.

Who Is a Candidate for Vacuum Bell Therapy

Children with pectus excavatum are often diagnosed with other musculoskeletal issues. Proper screening and testing are required to see if the child can be helped by vacuum bell therapy.

Vacuum bell therapy is a great treatment option for young children with pectus excavatum. Early diagnosis is vital because children under the age of 12 are most suitable to receive treatment. Their chest walls are malleable enough to be corrected by applying suction.

Another factor is the bend of your child’s chest. If the dip is less than 1 inch, the child is considered a good candidate. Else a more invasive procedure would be the only corrective option.

After the doctor deems a patient a suitable candidate for vacuum bell therapy, a custom-tailored device is fitted for the child’s specific chest shape.

Care and Duration of Wear

Once your child is fitted for the device, your doctor will provide you with wear duration and at-home care details. For most children, the duration of wear and suction is slowly build-up to eliminate any discomfort. The therapy is painless, although pressure is felt that can make some children resistant to wearing the device.

Typically, The device is worn for about an hour for the first week, increased to 2 hours by the second week.

By the second month, this duration is increased up to 3 hours of wear time. After the third or fourth month, the initial re-shaping occurs, and the patient enters the maintenance phase. Four hours of wear time is typical at this stage for best results.

Your child can participate in most activities while wearing the device. Vigorous and water sports, however, are discouraged. Some children might be more conscious of wearing the device at school, although it is discreet and can’t be noticed under clothing.

Children can wear the device at home or even during sleep to fulfil the daily wear time requirements.

Help Your Child Avoid Surgery for Correcting Pectus Excavatum

Pectus excavatum can have physical and psychological implications for your child. We at Align Clinic understand that getting a pectus excavatum can seem quite daunting as a parent. 

Time is of the essence as an early diagnosis can start your child on their journey towards better health. Surgery is no longer the only treatment option for your child.
 

Start the healing process today if you suspect your child is suffering from pectus excavatum. Book an appointment today for your child to be checked out by our qualified teams.
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San Mateo, California
700 S Claremont St
Suite #105
San Mateo, CA 94402 
Hours: 8:30-5:30 M-F
​Phone: (650) 375-2231
Fax: (650) 627-4632
Green Bay, Wisconsin
445 Cardinal Lane
Suite #110
Green Bay, WI 54313
Hours: 8:30-5:30 M-F
Phone: (920) 940-5277
Fax: (844) 308-8462


Houston, Texas
1001 Medical Plaza Drive,
​Suite #130
The Woodlands, TX  77380
Hours: 8:30-5:30 M-F
​Phone: (346) 770-2970
Fax: (281) 419-1615
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attention only by appointment
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  • Home
  • The WCR Brace
    • Case Presentations >
      • Infantile Idiopathic Scoliosis
      • Juvenile Idiopathic Scoliosis
      • Adolescent Idiopathic Scoliosis
      • Switching to a WCR Brace
      • Adult Scoliosis Bracing
      • Neuromuscular Scoliosis
      • Treating Upper Thoracic Curves
    • Brace Articles
    • Patient Testimonials >
      • Grant's Testimonials
      • Paul's Testimonials
    • WCR Partner Testimonials
    • Grant's MS Thesis
    • Our Patients
    • Patients and Sports
    • Patients and Hobbies
    • Brace colors
    • Scoliosis Fashion
  • Locations
    • AC San Mateo, CA >
      • Inside AC SM
      • Advanced Technology
      • Stanford Children's Health Partnership
      • Local Hotels
      • Contact Us
      • Team Members
      • Our Practitioners >
        • Grant Wood
        • Paul Burnette
        • Steve Baum
        • Miguel Bustamante
    • AC Green Bay, WI >
      • Inside Wisconsin
      • Patient Testimonials
      • Contact Us
      • Emery Maloney
    • AC The Woodlands, TX
    • AC Fort Lauderdale, FL
  • Patient Resources
    • WCR Brace Clinics >
      • USA Clinics
      • China Clinics
      • Canada Clinics
      • Australia Clinics
      • WCR Brace Clinic Finder
    • WCR Certified Practitioners
    • Professional Contacts & References
    • Forms & Insurance
    • Clinical Photos and X-rays
    • Scoliosis Rehab PT, CA
    • Blog
  • Events
    • Brace Clinic Calendar
    • Sosort 2022 - San Sebastian, Spain
    • Past Events >
      • Advancements in Conservative Treatment of Scoliosis 2018 >
        • Award for Advancements in the Conservative Treatment of Scoliosis
      • Past USA WCR Clinics and Conferences
      • Advancements in Conservative Treatment Of Scoliosis 2017
      • Shanghai Clinic
      • AAOP Meetings
      • BSPTS Schroth PT Training
    • Past SOSORT Conferences >
      • sosort2019 San Francisco - CA
      • SOSORT2018 Dubrovnik/Croatia
      • SOSORT2017 Lyon/France
      • SOSORT2016 Canada
    • Northeast Region Re-Align Clinic
  • Services
    • Scoliosis & Spine Online Learning
    • Prosthetics
    • Orthotics >
      • Pediatric Orthotics
      • Cranial Remolding Band
  • Hope's Embrace® Undershirts
  • Wall Grids
  • WCR Brace Fitting Evaluation
  • For PTs/Orthotists
  • WCR Measurement Order Form
  • Masterclass Conferences
  • Careers
    • Front Desk - ACSM