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Uploaded byAinaa Khan
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Orthotic treatment of polio myelitis

This document discusses poliomyelitis (polio) and the use of orthoses in rehabilitation. It notes that polio is a viral infection that affects the spinal cord and causes muscle weakness. Orthoses like braces, ankle-foot orthoses, and knee-ankle-foot orthoses are prescribed to support weak or paralyzed muscles and prevent deformities. The duties of orthopedic teams are to use exercises and appliances like orthoses to help patients regain muscle power and reduce disability. A variety of orthoses are described for different parts of the lower body depending on the muscles affected by polio.

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Rabia Mustafa King Edward Medical University
 Poliomyelitis, literally meaning “gray spinal cord inflammation.”  It is a viral infection.  It is contagious usually spread from person to person.  Only harmful to humans
 Background:  Orthotic treatment in the context of rehabilitation medicine is a frequently applied intervention to promote mobility.  Orthoses should be used until no further recovery is anticipated.  orthoses are given in stage of greatest paralysis.
 Appropriate orthotic appliances are prescribed to prevent deformities due to muscle imbalance.  Static joint stability usually can be controlled by orthoses  Dynamic joint instability eventually results in a fixed deformity that can not controlled with orthoses
 No specific treatment.  Pt. either will or will not recover the muscle power depend upon the severity of neurological damage.  Duties of orthopedic team are to prevent deformities, to assist returning muscle power by gradual exercises, and to reduce residual disability in final stage by the provision of appropriate appliances or by operations on joints or muscles.
 The upper limbs the following are commonly prescribed   Spinal brace:  To support a weakend spine  Abdominal support:  To check abdominal protrusion when the abdominal muscles are weak  Knee calliper:  To hold the knee extended in case of severe quadriceps paralysis  Below knee brace:  To stabilize a flail ankle or foot  Ankle foot orthoses:  To hold the foot up when the Dorsiflexion muscles are paralysed
 If the hip abduction power is poor (i.e., < 2), the appliance will include a pelvic band with a hip joint (hip-knee-ankle-foot orthoses) to prevent the lurching gluteus medius gait.
 A knee-ankle-foot orthosis (KAFO) is an orthosis that covers the knee, ankle and foot.  When the quadriceps power is 2 or below, the knee has to be stabilized and hence a knee-ankle-foot orthoses (full or above-knee calliper) is prescribed.  Motion at all three of these lower limb areas is affected by a KAFO.  can include,  stopping motion  limiting motion  assisting motion in any or all of the 3 planes of motion saggital, coronal, and axial.
 A knee orthosis (KO) or knee brace is a brace that extends above and below the knee joint and is generally worn to support or align the knee.  KO prevent flexion or extension instability of the knee
 An ankle-foot orthosis (AFO) is an orthosis or brace (usually plastic) that supports the ankle and foot  When the power of muscles controlling the hip and knee are normal and the weakness is only in the dorsiflexors or plantar flexors of the ankle or invertors or evertors of the foot, the patient is prescribed an ankle-foot orthoses (below-knee orthoses or calliper).
 AFOs are externally applied and intended to control  position  motion of the ankle  compensate for weakness  or correct deformities.  It is used to support weak limbs, or to position a limb with contracted muscles into a more normal position.
 The Milwaukee brace, also known as a cervico-thoraco-lumbo-sacral orthosis or CTLSO.  Milwaukee brace are use in 3 ways to treat the scoliosis  As a corrective apparatus  Hold the spine in position  A substitute for surgery
 Is that of biomechanical back up to the clinical team. From the point of view of the person with polio, the Orthotist provides orthoses (splints).  These include insoles to persons’ shoes, foot Orthoses, ankle-foot orthoses (AFO), knee ankle foot orthoses (KAFO) (Short or long callipers), and spinal jackets.  .
 In some cases, orthopaedic the majority of AFOs and KAFOs (callipers) are now made to a cast, Footwear is also prescribed  Old style orthoses of sidebars andT-straps are not so common anymore and use lightweight plastics.
 These orthoses are normally lighter and fit directly inside footwear.This often means footwear does not have to be Adapted and walking is made easier.  The Orthotist, when making orthoses, considers skeletal alignment, joint integrity and ease of walking
Orthotic treatment of polio myelitis