 Knee osteoarthritis (KOA) affects millions of people worldwide. To date, there’s no cure for OA so medical professionals prescribe palliative care to patients who’re diagnosed with osteoarthritis.
The knee brace is a commonly used treatment for KOA. Your Orthotist can prescribe you one based on your symptoms, severity of the disease and a few other factors. In this article, we’ll discuss five scientifically proven benefits of using knee orthosis for osteoarthritis. A Bit About the Osteoarthritis of the KneeOsteoarthritis (OA) is a degenerative condition that often appears in weight-bearing joints of the older populations. The knee joint is the most common area for OA. It’s caused by a loss of the joint cartilage, wear and tear of the joints, obesity, metabolic causes or as a consequence of trauma. Repeated stress on the joint such as that due to running or playing aggressive contact sports is also a major contributing factor for knee osteoarthritis. KOA usually appears after the age of 45 and patients can manage the condition for several years before needing knee replacement surgery. However, the cumulative stress over the years can increase the severity of OA at onset or decrease the effectiveness of conventional treatments. The main symptoms include moderate or severe pain in and around the knee joint, difficulty in walking, loss of range of motion, stiffness and cracking sounds whenever you move the joint. Your doctor confirms the diagnosis based on the X-ray results. The severity of knee OA is categorized in four grades according to the level of joint space loss; with grade 1 being minor loss and grade 4 being the most severe. Benefits of Using Knee Orthosis for Osteoarthritis of the KneeUsing a knee orthosis for OA reduces the need for a total knee replacement (TKR) surgery later on. Medical research concluded that using the brace decreases the need for opioids and pain-relieving injections, which is a win for patients suffering from knee osteoarthritis. There’re several other benefits of using knee orthosis, some of which include:
Since knee osteoarthritis is caused by a decrease in the natural joint space due to articular cartilage loss, this separation created by the brace increases comfort levels and also protects the joint structures from further damage due to excessive articular contact stress.
A knee brace helps shift the weight away from the region of highest contact, thus reducing the pain. The knee joint is divided into the medial and the lateral portions and most patients have OA in one of these compartments [called unicompartmental knee OA]. At this stage, offloading the most damaged area with a knee orthosis decreases pain and improves the ability to walk.
In such cases, a knee orthosis such as a hinged brace or a polypropylene knee sleeve provides three-dimensional external support to compensate for the loss of internal stability. It’s also worn as a preventive measure to reduce wobbling of the knee during walking or standing.
Hence using the knee orthosis directly contributes to reduced disability due to osteoarthritis. Your muscle strength improves as a result of the increased weight-bearing activities you can perform while wearing a brace as compared to without one. Knee orthosis also improves the range of motion and the rate of bending [flexion] and extension of the knee during walking.
A knee orthosis corrects the knee alignment by providing stability and a medially or laterally directed force to counter the misalignment during walking. That improves the gait pattern of patients suffering from knee osteoarthritis. Types of Knee Orthosis for Osteoarthritis There’re different types of knee orthosis for the various severity levels of knee osteoarthritis. Your Orthotist is the best judge to decide which orthosis can help you the most. Here’re the three most common knee orthoses for osteoarthritis:
If your osteoarthritis is located in the medial compartment then your Orthotist will prescribe you the Valgus unloading brace to shift the bodyweight to the lateral side, which is the less damaged compartment. The offloading brace is made of rigid plastic with foam padding, steel struts and belts for added support.
They’re made of polypropylene and also provide a compression force to the region. That’s done to reduce the swelling associated with osteoarthritis.
In this model, the hinge is placed at the level of the knee with the straps above and below the joint. Low-grade evidence suggests that it improves walking posture and fixes malalignment. Final Words Technology and medical research have improved the quality and variety of knee orthosis for osteoarthritis. If you suffer from knee pain due to OA, then visit our clinic and get an orthosis fitted for your joint. Our certified Orthotists can identify your functional limitations and prescribe you the knee orthosis perfect for your needs.
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 Being told that your child needs an orthosis is difficult to hear for any parent. But learning about the brace, how it works and what it helps with can ease the transition to accepting the diagnosis.
The SMO brace is safe for kids to use. It’s small enough to go inside the shoe and comfortable enough for your kid to walk, run and play in the jungle gym with it. At our clinic, we regularly meet with patients who need the SMO brace. And we also educate the parents on everything they need to know about this orthosis. If you’re new to this term then keep reading for valuable information on Supramalleolar orthosis that caregivers should know! What Is the SMO Brace? SMO or the Supramalleolar orthosis are braces that support the foot and ankle region. We’ve talked about AFOs before and the SMO is very similar to that, but this brace is much smaller than the Ankle Foot Orthosis and ends just above the ankle. 1. The Structure of the SMO brace The Supramalleolar orthosis is made of a mixture of different materials, same as the AFO and other orthotic braces. Thermoplastic, acrylic and carbon fiber are the most commonly used materials. Although the SMO braces are available off the shelf, most Orthotists customize them to each patient for best results. Since these are prescribed early on in life, you might have to get the SMO brace refitted a few times as your child grows. 2. Who Should Wear the SMO Brace? Children with a poor muscle tone often pronate [turn inwards] their feet when walking and crawling. Supramalleolar orthosis is prescribed for them to improve their walking and to help increase their tone. Babies and toddlers with Downs Syndrome, Cerebral Palsy, gross motor delay and such conditions which result in hypotonia often need to wear the SMO brace. The duration they’ve to wear the brace for varies according to the level of recovery the Orthotist is going for and the stage of your child’s crawling or walking. 3. What’s the Best Age for Wearing the SMO Brace? Often, there’s no specific age to start wearing the Supramalleolar orthosis. But the general rule of thumb is; the earlier the better. Your Orthotist will prescribe the brace once your kid begins to bear weight either in standing or walking. Kids can comfortably wear and benefit from it up to the age of 2 or 3 years. 4. What Structures Does the SMO Brace Stabilize? The SMO brace is similar to the AFO. The difference being that the Supramalleolar orthosis only stabilizes the ankle and the foot instead of also the region above the ankle. That’s why it’s prescribed for toddlers with a deformity located specifically in or around the foot and the ankle region. 5. Benefits of Wearing the SMO Brace Wearing the SMO braces increases your kids’ confidence in walking and balancing themselves. The SMO brace adds to the stability of the ankle and improves the foot muscle tone. It aligns the heel in the neutral position which helps develop the arch of the foot. Indications for Wearing the SMO Brace The primary indication for wearing the SMO brace is foot pronation [flat feet] which is due to hypotonia in toddlers. Although all toddlers naturally have flat feet because their arches are not yet developed, the kids with pathological flat feet need the Supramalleolar orthosis to compensate for the missing arch. If the flat feet condition is not addressed early on, it can lead to several secondary conditions such as knock knees, hip issues and an increase in the spinal curves. Here’re the foot conditions SMO bracing is used to correct: 1. Hyper Pronation or Flat Feet Flatfeet in kids is due to the three issues; lack of an arch, heel eversion and toes pointed outwards. SMO brace applies pressure on all three regions to bring them towards the midline. Your child has to wear the brace until the ligaments and the arch are strong enough to maintain the correct alignment without the orthosis. 2. Hypermobile Ankle or Foot Hypermobility is due to a laxity of the ligaments that stabilize the ankle. That increased range of movement also contributes to instability in walking. The SMO brace controls the range of motion at the ankle and provides external stability to prevent dislocation. Toddlers can balance themselves much better while standing and walking with the help of the SMO brace. 3. Decreased Muscle Tone (Hypotonia) The decreased muscle tone in kids prevents them from mastering balance and gait patterns. Using the SMO early on in life helps them develop the muscle strength necessary for walking. Proper weight-bearing positions also tend to increase the tone enough to allow your kids to catch up with their milestones and peers. 4. Congenital Clubfoot Deformity The infants’ foot is turned inwards or even upwards in the clubfoot deformity due to a shortening of the tendons. The Supramalleolar orthosis along with proper stretching is prescribed to correct the deformity and allow kids to stand and walk normally. How Can You Know If Your Child Needs the SMO Brace? Some deformities are obvious enough for you to realise that your child needs additional help to develop normally. Other times, the signs are much subtle. If you notice developmental delays, toe walking or difficulty balancing then you should approach a professional and get a diagnosis. The paediatricians perform a full checkup of the babies during each visit. If there’s an issue, that’s when you’ll find out. A proper diagnosis should guide your next steps. You can contact an Orthotist to find out which device is best for your child and follow the guidelines s/he shares with you. Final Thoughts The world of orthosis is scary for most parents, but what helps is having a great Orthotist and a support system to get you through the difficult times. Supramalleolar orthosis is used by toddlers all over the world. Most kids grow out of it and live a healthy life with little or no trace of deformity. Contact us for a free consultation from our experienced Orthotists and learn more about the SMO brace. We’ve got branches all over the United States so book an appointment at any one of our clinics today.  These days, we see a lot of babies wearing colorful helmets. That’s because they suffer from a flat head or some other condition that requires extra protection and a dynamic force on their skull. Plagiocephaly is becoming more common due to babies sleeping on their backs, which is a safe way to lay babies down because it protects them from Sudden Infant Death Syndrome (SIDS). In this article, we’ll discuss the flat head condition, its causative factors and treatments with a focus on orthotic treatment. Let’s dive right in. Overview of Plagiocephaly Plagiocephaly is simply the flattening of a baby’s head. It usually goes away on its own as the bones develop and fuse to create a round shape. In severe cases, however, treatment is required. Plagiocephaly can happen to anyone if proper precautions are not taken, but it’s mostly reported in premature infants since their skull bones are much softer and pliable. 1. Causes of Plagiocephaly Plagiocephaly has various causes, which can be prenatal to postnatal but more times than not the actual cause of Plagiocephaly is unknown. Prenatal causes which lead to Plagiocephaly include a small uterus, twins or unusual pressure on the head during pregnancy although these lead to only mild Plagiocephaly. Other causes include sleeping in the same position [known as positional Plagiocephaly], muscular torticollis and craniosynostosis. 2. Severity Levels of Plagiocephaly Almost all babies have some level of asymmetry of the head when they’re born. And the bones align themselves as the skull matures. The severity of Plagiocephaly is determined by two scales; the Cranial Vault Asymmetry and the Cephalic Ratio. The results help classify your baby’s Plagiocephaly in one of the three categories of mild, moderate and severe. When you visit the Orthotist for assessment, s/he measures the baby’s head to determine what kind of treatment, if any, is required to correct the skull shape. 3. How’s Plagiocephaly Diagnosed? The most prominent symptom of Plagiocephaly is flattening of the head from one side. It’s diagnosed based on the test performed by the Orthotist or a paediatrician. Other symptoms include facial asymmetry, mismatched ear levels, prominent blood vessels and palpable bony ridges around the flattening. 4. Plagiocephaly Treatment Options Oftentimes the Plagiocephaly will fix itself once your baby starts to lift his head and move around. Various treatments of Plagiocephaly include:
Orthotists are a part of the multi-disciplinary team of medical professionals who treat your child’s Plagiocephaly. From paediatricians to neurosurgeons and physical therapists, several team members decide on the best treatment approach for your baby based on the severity of the condition. The cranial band is the generally preferred orthotic treatment for this condition. But that’s not the only treatment. Babies aged less than 2 months old rarely ever need a cranial band. In their case, proper positioning and exercises are enough to correct the deformity. 1. How Does the Cranial Band Work? The cranial band is also known as the baby helmet and the cranial orthosis is made of a rigid thermoplastic material. It offers support to the growing skull while applying gentle pressure to the bones. Each cranial band is customized with an opening close to the flattened region. The main purpose of wearing the baby helmet is to realign the skull bones. 2. How Long Does Your Baby Have to Wear the Cranial Band? The duration of wear depends on how early you start treatment. For babies aged less than 6 months, 12 weeks of wearing the cranial band is enough time to correct the Plagiocephaly. On average, the treatment lasts for three months. The time increases with an increase in the Plagiocephaly severity and the age of the baby. Your baby has to wear the helmet for 23 hours a day. 3. How to Care For Your Baby and Their Helmet The good news is that the baby helmet is not uncomfortable for the kiddos. When your baby first starts wearing the cranial band, we recommend one hour off and one hour on. That helps babies get used to wearing it and also gives you an idea of how much your baby will sweat in the orthosis. You’ve to follow your Orthotist’s guidelines while cleaning the cranial orthosis and washing your baby’s head. And reach out to them in case your baby looks uncomfortable in it because that could mean that there’s an issue with the cranial band. Scientific Evidence for Effectiveness of Cranial Band Therapy There’s some controversy around the use of the cranial band for Plagiocephaly. But various researches have concluded that baby helmets are effective for reducing flat head deformity. One study found that the effectiveness of the cranial band for Plagiocephaly increases if the treatment is started early, before 24 weeks of age. Here, researchers found that 83% of their sample had a positive result after using the cranial orthosis. Another research conducted on 18 months and older babies also concluded that the cranial band reduces the deformity if it’s worn for the prescribed duration. However, they also found that the treatment lasts for around 16 months when it’s started later in the baby’s life. Final Thoughts Plagiocephaly is a big word and scares most parents who’re hearing it for the first time. But the condition is much more treatable as you’ve read above. If you’re looking for a treatment plan for your baby’s Plagiocephaly or need a cranial orthosis fitted, then reach out to us for a free consultation. We’ve got clinics all over the country and experienced Orthotists to help you. |
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March 2023
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