How much do you know about orthoses
With the popularization of rehabilitation medicine and the development of orthopedic technology, all kinds of orthopedics have been continuously developed and applied. In the past, orthosis was used as an external support device for the purpose of alleviating the dysfunction of the skeletal and muscular system of limbs and spine, which was used to correct various kinds of body movement disorders in clinical practice. In recent years, due to the continuous improvement of orthopedic production level, it has been gradually used in the treatment of paraplegia, hemiplegia, cerebral palsy and so on.
Orthosis is a general term of external appliances assembled in human limbs, trunk and other parts. Its purpose is to prevent or correct the deformity of limbs and trunk, or to treat the diseases of bone, joint, nerve and muscle, and to compensate its function. Its basic functions mainly include stability and support, fixation and correction, protection and load, compensation and assistance.
Classification of orthoses
Upper limb orthosis
According to the function, it can be divided into two categories: fixed and functional. The former has no motion device, which is used for fixing, supporting and braking; the latter has motion device, which allows body movement or is used for controlling and helping body movement. The upper limb orthoses mainly include shoulder elbow wrist hand orthoses, elbow wrist hand orthoses, wrist hand orthoses, hand orthoses, etc. In clinical rehabilitation, the upper limb orthosis can be used for the rehabilitation of brachial plexus injury, shoulder muscle paralysis, hand spastic deformity, upper limb arthritis, upper limb fracture, burn, and limb correction and rehabilitation of patients with cerebral palsy and hemiplegia.
The main functions of upper limb orthoses include:
1. Prevent excessive muscle tension, such as flexion of fingers;
2. Correction of deformities, such as claw shaped hands;
3. To prevent joint contracture, such as elbow flexion contracture;
4. Support wrist and hand in functional position;
5. Enhance muscle strength;
6. Improve functionality.
Lower extremity orthosis
Its main function is to support body weight, assist or replace limb function, limit unnecessary movement of lower limb joints, maintain stability of lower limbs, improve posture when standing and walking, and prevent and correct deformity. Lower limb orthoses mainly include hip knee ankle foot orthoses, knee orthoses, knee ankle foot orthoses, ankle foot orthoses and foot orthoses. Among them, ankle foot orthosis is the most commonly used one, which can prevent and correct the varus of foot, effectively control the back extension and plantar flexion of ankle joint, fix the functional position of ankle joint, so as to prevent and correct the varus of horse's foot and restrain the spasmodic acropodia. The lower limb orthosis can be used in the rehabilitation of paraplegia patients and the treatment of hemiplegia, fracture and deformity of lower limb. Especially, it plays an important role in the improvement of stroke rehabilitation. It can improve the hemiplegic gait of stroke patients, make them stand again and recover their inability.
It is necessary to pay attention to the selection of lower limb orthoses. After wearing, there should be no obvious compression on the limbs. For patients with lower limb edema, the orthoses should not be close to the skin.
The main functions of lower limb orthosis include:
1. Protect weak or painful musculoskeletal segments;
2. Fix the lower limb joint with disease to prevent deformity;
3. Correct the deformity, compensate the function of paralyzed muscle, and improve the walking gait of patients;
4. It can reduce the load of the limbs, promote the formation of callus and accelerate the healing of the fracture;
5. Preoperative and postoperative preparation and consolidation of surgical results;
6. Improve and promote the early recovery of function.
It is mainly used to fix and protect the spine, correct the abnormal mechanical relationship of the spine, relieve the local pain of the trunk, protect the pathological part from further damage, support the paralyzed muscles, prevent and correct the deformity, and achieve the purpose of rectifying the spine disease by supporting the trunk, limiting Yu Dong and readjusting the alignment of the spine. It is a kind of device to prevent and correct the deformity of the body caused by various injuries. It is an indispensable part and important means of rehabilitation treatment. It mainly includes neck orthotics, thoracolumbar and lumbosacral orthotics.
Application of orthosis
1. Examination and diagnosis: including the general condition, medical history, physical examination of the patient, the range of motion and muscle strength of the joint where the orthosis is to be made or worn, whether the orthosis has been used or not, and the use of the orthosis.
2. Prescription of orthosis: indicate the purpose, requirement, variety, material, fixed range, position, distribution of force, use time, etc.
3. Pre assembly treatment: mainly to enhance muscle strength, improve the range of joint activity, improve coordination ability, and create conditions for the use of orthotics.
4. Orthosis production: including design, measurement, drawing, mold taking, manufacturing and assembly procedures.
5. Training and use: before the formal use of orthotics, try on (initial inspection) to understand whether the orthotics meet the prescription requirements, whether the comfort and alignment are correct, whether the power device is reliable, and make corresponding adjustments. Then, teach the patient how to put on the orthosis, how to put on the orthosis for some functional activities. After the training, check whether the assembly of the orthosis conforms to the biomechanical principle, whether it achieves the expected purpose and effect, and understand the feeling and reaction of patients after using the orthosis. This process is called the final examination. After the final examination is qualified, it can be delivered to patients for official use. Patients who need to use orthoses for a long time should be followed up every 3 months or half a year to understand the effect of using orthoses and the changes of their condition. If necessary, they should be modified and adjusted.