Equipment
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What is Early Intervention?
Much has been written about the importance of a child’s first five years of life.
Therapeutic Equipment
Therapeutic equipment is equipment that is used to help your child achieve a new level of development. These can include standers, walkers, compression vests and orthotics to name a few. This type of equipment should be used under the supervision of a therapist or physician. Your therapist is a great resource to help you decide which of these is appropriate for your child.
My child needs braces – what are they? Why do we need them?
Braces are a device to help control or prevent secondary problems with the foot, ankle, knee, or hip. For example, secondary problems may include making the knee too flexible, causing tightness in muscles, or breaking down different joints in the foot which can lead to arthritis later in life. Braces can be made out of a variety of materials, including different kinds of plastics, foam, Velcro, fabric, and plaster. The most typical physical therapy brace is an ankle-foot orthosis. This can range from an off-the-shelf shoe insert, to a custom-made brace that comes below the knee.
Orthoses can provide many different functions. They can provide stability and control when muscles are too weak to work properly, thus enabling a child to be more efficient in moving around. Orthoses can align the joints to prevent the development of deformities and other problems later in life, such as arthritis and ankle, knee, hip, and back problems. They can also inhibit high tone (tighter feeling muscles) or decrease tone in the lower extremities in a child with neurological impairments, thus enabling a child to use their muscles more normally.
Are all Orthotics and Prosthetics Companies the same? How do I choose a company to make my child’s braces?
Look for a pediatric specialist, not just a clinician making smaller braces and limbs.
Look for an orthotics and prosthetics company with certified staff dedicated to evaluating and formulating orthotic and prosthetic devices which are unique to children’s special needs. Clinical staff should keep abreast of the latest technology available through continuing education.
Because Pediatrics Should Never Be Plain
Children are not just small adults, they require special consideration through their developmental stages. A pediatric orthotist should cater to a child’s growing needs. The orthotics industry has come a long way over the years, offering children many options in patterns, colors and fabrics to customize your child’s orthotics. The orthotics, splints and prosthetics should be customized and functional but also fun! Providing these options is important to allow your child to maintain some control and feel good about themselves!
Team Treatment Concept
The team should provide all aspects of orthotic and prosthetic treatment, working closely with physicians, physical therapists, occupational therapists and most importantly, the family.
How and When to Contact an Orthotics and Prosthetics Company
Patients: When you have received a prescription from your medical professional, you should set up an appointment with a pediatric practitioner. In Western PA, De La Torre Orthotics and Prosthetics has proven itself to be a leader in the pediatric market. Visit their website to find their locations in Western Pennsylvania and to view commonly utilized devices or call (412) 599-1158.
Therapists in Western PA: If you would like a consultation from a pediatric practitioner, call (412) 599-1158. Link to the De La Torre Orthotics and Prosthetics website to find their locations in Western Pennsylvania and to view commonly utilized devices.
TLSO: Thoracolumbosacral orthosis
This is one of two main types of braces used to correct the lateral (sideways) curve of the spine in scoliosis. Your doctor will decide if this brace is appropriate based on the degree and direction of curvature of the spine. The TLSO is an underarm brace, which means that it fits under the arm and around the rib cage, lower back, and hips.
The other main types of brace for treating the spinal in scoliosis is the Milwaukee brace which can be worn to correct any curve in the spine.
All braces for scoliosis can be custom made or can be made from a pre-fabricated mold. All braces must be selected for the specific curve problem and fitted to each patient. To have their intended effect, the brace must be worn every day for the full number of hours prescribed until the child stops growing.
There are many kinds of pediatric walkers. Some just provide a framework simply for balance purposes only, while others can provide almost full support for a child. Below is a list of different features a pediatric walker might offer:
- An anterior walker (one the child pushes forward)
- A posterior walker (one a child pulls)
- Two-wheeled
- Four-wheeled
- Ratcheted wheels (to prevent a walker from moving backward)
- Swivel wheels (to allow a child to steer a walker without picking it up to maneuver it)
- Brakes
- Pelvic supports
- Trunk supports
- Forearm supports, with or without straps to help a child hold onto the walker
- Different gripped handles
- Straps to help control a child’s legs
- A seat for the child to turn around and take a rest if endurance is an issue
- Baskets to help transport items
- Collapsible (for transporting)
- Height adjustability to grow with a child
Standers are a piece of equipment that provides what the name implies – a place for your child to stand! They can come with a wide range of support and different options, such as:
- Different angles your child can be positioned in, from being almost on the tummy, to standing fully upright, to lying on the back
- Comes with straps and support systems from full support to partial support
- Can come with a tray to provide a place to play with toys or eat
- Can be a place to sit and work on sit to stand activities
- Adjustability to grow with the child
Standers can provide many purposes, such as:
- Giving your child the experience of standing through his or her legs in proper body alignment to help muscle and bone development
- An opportunity to work on vision in a different position
- Providing an opportunity for play and to learn in different positions
- An opportunity to work on head and trunk control
- Help a child gain or maintain flexibility
- Help decrease spasticity (tight muscles)
- Providing health benefits (such as decreasing skin breakdown by providing another position for the child to be in, it improves cardiopulmonary function, can help digestion, etc.)
- Allow a child to interact in a more socially appropriate position in school
Pediatric forearm crutches are a cross between regular crutches and a cane. Instead of supporting weight just under the armpits, a child is able to get support through the forearms and hold onto a handle. Children who might use forearm crutches are:
- Able to walk very slowly independently, but can keep up with their peers much better using forearm crutches
- Able to walk very slowly independently, but use forearm crutches to conserve energy to do other activities
- Have good enough balance not to use a walker, but still need support in order to walk
- Use forearm crutches to enable them to access more environments than a walker
There are many different kinds of pediatric wheelchairs. Some are manual (self-propelled by the child or caregiver), while others are electric (motorized). Typically, a physical therapist evaluates a child’s abilities, and determines how much support and what specialized equipment is needed to maximize a child’s independence. What environments a wheelchair is going to be used in also plays a role in what kind is best for the child.
Gait trainers are equipment that can provide many different support options to allow a child to move independently in his or her environment. Some look like a walker, with a lot of support options that can gradually be taken away as a child gains balance, strength and coordination. Other gait trainers look like a bicycle seat on wheels, with a lot of different support pads and straps. Benefits of gait trainers include:
- Give a child independence to explore his or her environment and work on cognitive development
- Help a child learn and strengthen normal walking patterns
- Provide social development by providing an opportunity for children to interact with their peers
- Promote exercise to improve cardiac function
- Provide weightbearing through the legs to promote proper muscle and bone development
Specialized strollers are like regular children’s strollers, but provide more support options and larger weight limits. Some allow a family easier transportation by its ability to collapse and fit in the car, and they are made durable enough to be able to be tied down for bus transportation. Options include:
- Different type wheels depending on terrain
- Head support
- Trunk support
- Hip positioning
- Foot rests
- Ability to tilt in space
De-rotation straps are special straps to help a child whose legs turn inward to straighten out. It spirals around the leg to provide a line of pull the opposite direction. These straps try to adjust the legs to provide a more correct position while a child does activities, mainly in standing.
Benik is a garment that is form fitted and made out of light neoprene. Its goal is to basically:
- Provide biomechanical stability by exerting forces to manage tone, muscle pull, and deformity
- Provide deep pressure for better body awareness
SPIO is a garment that is form fitted and like a “second” skin. It is made out of a thicker Lycra material. It is similar to Benik, but its main purpose is to provide deep pressure for better body awareness.
Add-A-Bands
Add-A-Bands are an assistive device designed to facilitate the development of normal movement patterns in children with low muscle tone and/or lax hip ligaments. The latter may contribute to excessive flexibility, making it difficult to develop an adequate base of support from which to attain a good position to move. Consequently, a child may have difficulty moving with ease and efficiency, and undesirable habits may develop such as moving from sitting to lying through the middle of wide split legs. When properly adjusted, Add-A-Bands facilitate the optimal base of support at the knees and/or feet of a child when the spacing of his or her legs is excessively wide. Combinations of movements at the hip joints are then permitted without restriction other than limiting excessive widening.
Add-A-Bands can also be used as a positioning assist to limit excessive widening of the legs with children experiencing muscle weakness or paralysis from nerve damage.
Every Hatchbacks shoe incorporates a patented Rear-Entry hinge system called “Easy Fit” that’s as simple as 1, 2, 3. The “Easy Fit” system is designed to facilitate ease of entry and egress from the shoe by pivoting open at the hinge. The shoe remains firmly closed by a Velcro fastener that is also very easy to use.To make an Elite shoe, we took our “Easy Fit” system and created a custom last molded around a brace. This new last provides extra width around the toe box, extra girth around the ankle, and more room around the heel. This means that most children will be able to wear Hatchbacks Elites that are the same size as their foot. No more wearing shoes two sizes too big! We took this specialized last and added a lightweight sole, quality materials, extra tough stitching, and great contemporary styling.