The document provides details on the Wilmer Carrying Orthosis (WCO), a shoulder orthosis developed in the 1960s. It describes the biomechanics of shoulder subluxation and limitations of other treatments. The WCO works by suspending the arm near the elbow, using gravity to push the humerus back into place. This avoids loading the neck and allows for neutralization of the subluxation. Conventional orthoses rely on forces around the arm, neck or shoulder, which can cause slipping and are not effective for permanent use. The WCO's biomechanics provide balanced forces to correctly position the humerus without taxing other areas.
The document discusses prosthetic knee joints, classifying them based on axis type and control mechanisms. It describes single-axis knees that provide stability but lack swing phase control and polycentric multi-axis knees that more closely mimic natural knee motion. Control mechanisms include manual and automatic locking, hydraulic/pneumatic resistance, and microprocessor units that sense gait to adjust resistance for different surfaces.
presentation is about Orthosis and prosthesis. It gives Classification of Orthosis. It describes structure, function, Indication and uses of Orthosis. Also describes different types of Prostheses, their parts and function.
Socket variants in upper extremity prosthesis.pptx1POLY GHOSH
The document discusses various socket designs for different levels of upper limb amputations. It describes the key factors in socket design such as maximizing range of motion, stability, and force distribution. For transradial amputations, common socket designs include supracondyler brims, external suspension sleeves, and internal roll-on locking liners. The Munster and Northwestern sockets are described as examples of supracondyler designs. For transhumeral amputations, designs include open shoulder above elbow sockets and closed encasulated designs. The document also discusses some novel designs like the TRAC, CRS, and ACCI sockets that aim to improve suspension, reduce motion at bone-socket interface, and control rotation.
This document provides definitions and descriptions of various hip, knee, ankle, and foot orthoses. It describes a hip-knee-ankle-foot orthosis (HKAFO) as an orthosis that stabilizes or locks the hip, knee, and ankle. The typical HKAFO consists of two knee-ankle-foot orthoses linked above the hip with a pelvic band or lumbosacral orthosis. It also discusses indications, principles, components, and fabrication of HKAFOs as well as other orthoses like reciprocal gait orthoses and hip orthoses.
This document provides an overview of upper extremity orthoses, including their objectives, nomenclature, designs, and specific examples. The main objectives of upper limb orthoses are protection, correction, and assistance. They are named based on the joints they cover, their function, condition treated, appearance, or designer. Designs include non-articular, static, serial static, dynamic, and more. Examples provided include wrist splints, elbow braces, shoulder slings, and finger orthoses. The document aims to classify and describe the various types of upper extremity splints and braces used in orthotic treatment.
Lower Limb Orthotics - Dr Rajendra Sharmamrinal joshi
This document provides information on lower limb orthotics. It defines an orthosis and describes their clinical objectives in treating conditions like pain, deformities, abnormal range of motion, etc. It discusses different types of orthoses like foot, ankle-foot, knee-ankle-foot orthoses. Principles of bracing like distributing forces over large areas and applying forces to control joints are covered. Characteristics of an ideal orthosis in terms of function, comfort, cost are outlined. The document also discusses shoes, foot orthoses, ankle-foot orthoses made of plastic, metal and patellar tendon bearing designs.
Upper Limb Orthotics - Dr Sanjay Wadhwamrinal joshi
This document summarizes a presentation on upper limb orthotics. It begins by defining orthotics as externally applied devices that modify the neuro-musculoskeletal system. It then discusses objectives of orthotics like support and correction. Various upper limb conditions that may require orthotics are listed, along with types of orthotics. Design features, examples of specific orthotics, and evidence-based research on orthotics effectiveness are also summarized. The presentation aims to provide an overview of upper limb orthotics for rehabilitation purposes.
The document discusses prosthetic knee joints, classifying them based on axis type and control mechanisms. It describes single-axis knees that provide stability but lack swing phase control and polycentric multi-axis knees that more closely mimic natural knee motion. Control mechanisms include manual and automatic locking, hydraulic/pneumatic resistance, and microprocessor units that sense gait to adjust resistance for different surfaces.
presentation is about Orthosis and prosthesis. It gives Classification of Orthosis. It describes structure, function, Indication and uses of Orthosis. Also describes different types of Prostheses, their parts and function.
Socket variants in upper extremity prosthesis.pptx1POLY GHOSH
The document discusses various socket designs for different levels of upper limb amputations. It describes the key factors in socket design such as maximizing range of motion, stability, and force distribution. For transradial amputations, common socket designs include supracondyler brims, external suspension sleeves, and internal roll-on locking liners. The Munster and Northwestern sockets are described as examples of supracondyler designs. For transhumeral amputations, designs include open shoulder above elbow sockets and closed encasulated designs. The document also discusses some novel designs like the TRAC, CRS, and ACCI sockets that aim to improve suspension, reduce motion at bone-socket interface, and control rotation.
This document provides definitions and descriptions of various hip, knee, ankle, and foot orthoses. It describes a hip-knee-ankle-foot orthosis (HKAFO) as an orthosis that stabilizes or locks the hip, knee, and ankle. The typical HKAFO consists of two knee-ankle-foot orthoses linked above the hip with a pelvic band or lumbosacral orthosis. It also discusses indications, principles, components, and fabrication of HKAFOs as well as other orthoses like reciprocal gait orthoses and hip orthoses.
This document provides an overview of upper extremity orthoses, including their objectives, nomenclature, designs, and specific examples. The main objectives of upper limb orthoses are protection, correction, and assistance. They are named based on the joints they cover, their function, condition treated, appearance, or designer. Designs include non-articular, static, serial static, dynamic, and more. Examples provided include wrist splints, elbow braces, shoulder slings, and finger orthoses. The document aims to classify and describe the various types of upper extremity splints and braces used in orthotic treatment.
Lower Limb Orthotics - Dr Rajendra Sharmamrinal joshi
This document provides information on lower limb orthotics. It defines an orthosis and describes their clinical objectives in treating conditions like pain, deformities, abnormal range of motion, etc. It discusses different types of orthoses like foot, ankle-foot, knee-ankle-foot orthoses. Principles of bracing like distributing forces over large areas and applying forces to control joints are covered. Characteristics of an ideal orthosis in terms of function, comfort, cost are outlined. The document also discusses shoes, foot orthoses, ankle-foot orthoses made of plastic, metal and patellar tendon bearing designs.
Upper Limb Orthotics - Dr Sanjay Wadhwamrinal joshi
This document summarizes a presentation on upper limb orthotics. It begins by defining orthotics as externally applied devices that modify the neuro-musculoskeletal system. It then discusses objectives of orthotics like support and correction. Various upper limb conditions that may require orthotics are listed, along with types of orthotics. Design features, examples of specific orthotics, and evidence-based research on orthotics effectiveness are also summarized. The presentation aims to provide an overview of upper limb orthotics for rehabilitation purposes.
upeer limb ortosis is now a day use very fraquently. this ppt provide general guidelines and information on common parts of the orthosis and some recent advances.
This document discusses advances in hip disarticulation prostheses. It begins by describing hip disarticulation amputation and challenges with prosthetic fitting at this level. It then covers the evolution of prosthetic designs including traditional tilting-table models, the seminal Canadian design, and more recent designs incorporating lightweight materials and anatomical shaping. Key components like the socket, hip joint, and suspension methods are examined. The document emphasizes ongoing efforts to improve mobility, comfort and long-term prosthetic use for individuals with hip disarticulation amputations.
This document provides guidance on checking various aspects of a lower limb prosthesis. It discusses checking the prosthesis and patient's stump in general, as well as when sitting, standing, walking, and with the prosthesis removed. Checks include ensuring proper fit and alignment of socket components, comfort and stability of the patient, and identification of any potential issues. The document focuses on checkouts for above knee prosthetics but also briefly discusses below knee prosthetics. The goal of prosthetic checkouts is to assess proper functioning and make any necessary adjustments before training the patient.
The document discusses orthotic devices, including their purposes, types, materials, design considerations, and more. Some key points:
- Orthotic devices are externally applied to parts of the body to correct deformities, limit motion, relieve pain, and improve function. Common types include braces and splints.
- Indications for orthotics include pain relief, immobilization, deformity correction, symptom relief, unloading axial forces, and improving or assisting movement.
- Design considerations include weight, adjustability, function, cost, durability, fit, donning/doffing ease, and ventilation.
- Effects may include decreased pain, increased strength/function, improved proprioception and
This document provides information about transtibial (below the knee) amputations and prosthetics. It discusses the history and advancement of CAD-CAM technology for prosthetic socket design. It outlines principles for prosthetic alignment and construction. Biomechanics of the residual limb and socket interface are described. Assessment of the stump condition, range of motion, joint integrity, and muscle strength are discussed as important factors in prosthetic fitting and design.
This document discusses upper extremity orthotics for restoring mobility and quality of life. It covers common orthotic components for the shoulder, elbow, wrist, fingers and thumb. Static orthoses are used for positioning and prevention of deformities while functional orthoses provide assistance for tasks using internal or external power sources. Fracture/post-operative orthoses provide compression and positioning for proper healing. The document reviews specific orthotic designs for various conditions like carpal tunnel syndrome.
This document provides an overview of the history and types of spinal orthoses. It begins with a brief history of spinal orthotic use dating back to ancient times. It then describes various types of cervical, cervicothoracic, and thoracolumbosacral orthoses, including their indications, biomechanics, design features, and how they control spinal motion. Examples of custom-fit and prefabricated options are discussed. The document concludes with descriptions of specific orthosis designs like the halo, SOMI, and TLSO and how they immobilize different spinal regions.
This document discusses various orthoses used for the shoulder, elbow, and forearm. It begins by outlining the main objectives of upper limb orthosis as protection, correction, and assistance. It then describes different types of orthoses categorized by joint covered, function provided, condition treated, appearance, and designer. Examples of specific orthoses are provided like figure-8 axilla orthosis, lateral trunk shoulder-elbow-wrist orthosis, and static shoulder-elbow-wrist sling. Design variations are also covered such as static, serial static, and dynamic. The document provides details on several orthosis like Wilmer carrying orthosis and its standard and hands-free units.
This document discusses prosthetic gait patterns and deviations. It begins by explaining that amputee gait varies from normal gait, with increased energy expenditure and use of different muscle groups. Gait analysis is needed to identify deviations and their causes. Key aspects of transtibial and transfemoral gait patterns and common deviations are described, including excessive or insufficient knee flexion, lateral thrust, and vaulting or hip hiking during swing phase. Gait training involves static and dynamic evaluation, starting with activities off the prosthesis and progressing to ambulation with or without aids on different surfaces.
This document discusses lower limb prosthetics. It defines key terms like prosthesis, residual limb, and orthosis. It then describes the ideal characteristics of a prosthesis and factors considered in prescribing one, like amputation level and activity level. The major components of a lower limb prosthesis are also outlined, including the suspension system, socket, knee joint (for transfemoral prosthetics), pylon, and terminal device. Different types of each component are explained. Complications from prosthetics are noted.
A KAFO is a leg brace that controls knee and ankle movement. It is more energy intensive than FOs or AFOs due to compensatory movements needed to swing the leg. There are three main types - conventional metal, thermoplastic shell, and thermosetting shell. The document describes the components, designs, and joints of KAFOs including indications, advantages, and disadvantages of each. The goal is to select the appropriate KAFO design based on the individual needs of the patient.
Spinal orthoses are external devices that are applied to the spinal segments to manage various spinal conditions. They work by limiting spinal motion and decreasing load on the treated region. Common uses include treating unstable fractures, providing support after surgery or for osteoporosis, and relieving back pain. Spinal orthoses include cervical collars, halo devices, and braces that extend from the neck to the lower back. They work through principles like balanced forces, fluid compression, and serving as a reminder to restrict movement.
This document discusses different types of prosthetic knee joints, including mechanical single-axis and polycentric knees, and computerized knees that use microchips, hydraulics, or pneumatics to control motion. It describes the evolution of prosthetic knees from simple pendulums to advanced mechanisms with microprocessor control. Key factors in prescribing the appropriate knee include the user's ability to control stability, flex the knee in swing phase, and walk at different speeds.
Spinal orthotics are external devices that limit spinal motion, correct deformities, reduce loading, or improve spinal function. They include flexible braces made of fabric or elastic and rigid braces made of thermoplastics or metals. Cervical collars come in soft and hard varieties and are used for neck injuries or post-operatively. Thoracic-lumbar-sacral orthoses (TLSO) and lumbosacral corsets (LSO) are used for lumbar injuries or fractures. The halo cervical orthosis provides the greatest cervical immobilization using pins in the skull. Drawbacks of orthotics include discomfort, skin issues, and decreased function with prolonged use.
Orthotics are devices added to the body to stabilize, immobilize, or assist body parts. This document discusses different types of orthotics for the lower extremities, upper extremities, and spine. Common orthotics include foot orthotics, ankle foot orthotics, knee orthotics, and cervical orthotics. The document provides examples and descriptions of various orthotics, their purposes, and conditions they are used to treat.
Prosthetic management of symes and partial foot amputationSmita Nayak
prosthetic management of partial foot and syme's amputation is a very challenging task. Now a days the availability of advanced technology some how fulfilling the need of the amputee but not the fully.
An Immediate Post operative Prosthesis (IPOP) or Immediate Post-surgical fitting is a device that is applied before or after wound closure that protects the suture site and allows limited weight bearing and gait training. It serves as a bridge between surgery and a definitive prosthesis. IPOPs can be custom fabricated or prefabricated and are commonly used at the transtibial and transradial levels. Advantages include reducing phantom limb pain and sensations, earlier weight bearing and rehabilitation, and shorter recovery times. Air splints are a type of non-custom IPOP that provide uniform pressure distribution, easy inspection of incision sites, and partial weight bearing ability.
This document discusses rehabilitation and prosthetics for upper extremity amputees. It covers:
1. Exercises that should be started after amputation to improve range of motion, strength, and endurance, and avoid contractures.
2. Techniques for performing daily activities like bathing and dressing without a prosthesis by changing hand dominance or using the mouth/feet.
3. The main components of prosthetics including the socket, harness, mechanical elbow, and different terminal devices.
4. Advances in prosthetics technology including myoelectric hands, targeted muscle reinnervation, and future considerations like osseointegration.
Static and dynamic shoulder orthoses are used to support and position the shoulder and arm for a variety of injuries and conditions. Static orthoses like the gunslinger orthosis and airplane splint rigidly hold the arm in set positions of abduction and rotation. Dynamic orthoses like mobile arm supports (MAS) allow some motion of the shoulder and elbow using linkages and gravity assistance. MAS are indicated for patients with weak shoulder and elbow muscles to help perform functional activities while strengthening muscles. Both static and dynamic orthoses aim to prevent contractures, support healing, and enable early recovery of arm function.
The elbow joint is a hinge joint formed between the humerus, radius, and ulna bones. It allows flexion and extension movements. The elbow joint is stabilized by ligaments including the medial collateral ligament and lateral collateral ligament complex. Muscles such as the biceps brachii and triceps brachii are responsible for flexion and extension, respectively. The radioulnar joints allow pronation and supination movements of the forearm and are stabilized by ligaments like the annular ligament. Mobility of both the elbow and radioulnar joints is important for performing daily activities.
upeer limb ortosis is now a day use very fraquently. this ppt provide general guidelines and information on common parts of the orthosis and some recent advances.
This document discusses advances in hip disarticulation prostheses. It begins by describing hip disarticulation amputation and challenges with prosthetic fitting at this level. It then covers the evolution of prosthetic designs including traditional tilting-table models, the seminal Canadian design, and more recent designs incorporating lightweight materials and anatomical shaping. Key components like the socket, hip joint, and suspension methods are examined. The document emphasizes ongoing efforts to improve mobility, comfort and long-term prosthetic use for individuals with hip disarticulation amputations.
This document provides guidance on checking various aspects of a lower limb prosthesis. It discusses checking the prosthesis and patient's stump in general, as well as when sitting, standing, walking, and with the prosthesis removed. Checks include ensuring proper fit and alignment of socket components, comfort and stability of the patient, and identification of any potential issues. The document focuses on checkouts for above knee prosthetics but also briefly discusses below knee prosthetics. The goal of prosthetic checkouts is to assess proper functioning and make any necessary adjustments before training the patient.
The document discusses orthotic devices, including their purposes, types, materials, design considerations, and more. Some key points:
- Orthotic devices are externally applied to parts of the body to correct deformities, limit motion, relieve pain, and improve function. Common types include braces and splints.
- Indications for orthotics include pain relief, immobilization, deformity correction, symptom relief, unloading axial forces, and improving or assisting movement.
- Design considerations include weight, adjustability, function, cost, durability, fit, donning/doffing ease, and ventilation.
- Effects may include decreased pain, increased strength/function, improved proprioception and
This document provides information about transtibial (below the knee) amputations and prosthetics. It discusses the history and advancement of CAD-CAM technology for prosthetic socket design. It outlines principles for prosthetic alignment and construction. Biomechanics of the residual limb and socket interface are described. Assessment of the stump condition, range of motion, joint integrity, and muscle strength are discussed as important factors in prosthetic fitting and design.
This document discusses upper extremity orthotics for restoring mobility and quality of life. It covers common orthotic components for the shoulder, elbow, wrist, fingers and thumb. Static orthoses are used for positioning and prevention of deformities while functional orthoses provide assistance for tasks using internal or external power sources. Fracture/post-operative orthoses provide compression and positioning for proper healing. The document reviews specific orthotic designs for various conditions like carpal tunnel syndrome.
This document provides an overview of the history and types of spinal orthoses. It begins with a brief history of spinal orthotic use dating back to ancient times. It then describes various types of cervical, cervicothoracic, and thoracolumbosacral orthoses, including their indications, biomechanics, design features, and how they control spinal motion. Examples of custom-fit and prefabricated options are discussed. The document concludes with descriptions of specific orthosis designs like the halo, SOMI, and TLSO and how they immobilize different spinal regions.
This document discusses various orthoses used for the shoulder, elbow, and forearm. It begins by outlining the main objectives of upper limb orthosis as protection, correction, and assistance. It then describes different types of orthoses categorized by joint covered, function provided, condition treated, appearance, and designer. Examples of specific orthoses are provided like figure-8 axilla orthosis, lateral trunk shoulder-elbow-wrist orthosis, and static shoulder-elbow-wrist sling. Design variations are also covered such as static, serial static, and dynamic. The document provides details on several orthosis like Wilmer carrying orthosis and its standard and hands-free units.
This document discusses prosthetic gait patterns and deviations. It begins by explaining that amputee gait varies from normal gait, with increased energy expenditure and use of different muscle groups. Gait analysis is needed to identify deviations and their causes. Key aspects of transtibial and transfemoral gait patterns and common deviations are described, including excessive or insufficient knee flexion, lateral thrust, and vaulting or hip hiking during swing phase. Gait training involves static and dynamic evaluation, starting with activities off the prosthesis and progressing to ambulation with or without aids on different surfaces.
This document discusses lower limb prosthetics. It defines key terms like prosthesis, residual limb, and orthosis. It then describes the ideal characteristics of a prosthesis and factors considered in prescribing one, like amputation level and activity level. The major components of a lower limb prosthesis are also outlined, including the suspension system, socket, knee joint (for transfemoral prosthetics), pylon, and terminal device. Different types of each component are explained. Complications from prosthetics are noted.
A KAFO is a leg brace that controls knee and ankle movement. It is more energy intensive than FOs or AFOs due to compensatory movements needed to swing the leg. There are three main types - conventional metal, thermoplastic shell, and thermosetting shell. The document describes the components, designs, and joints of KAFOs including indications, advantages, and disadvantages of each. The goal is to select the appropriate KAFO design based on the individual needs of the patient.
Spinal orthoses are external devices that are applied to the spinal segments to manage various spinal conditions. They work by limiting spinal motion and decreasing load on the treated region. Common uses include treating unstable fractures, providing support after surgery or for osteoporosis, and relieving back pain. Spinal orthoses include cervical collars, halo devices, and braces that extend from the neck to the lower back. They work through principles like balanced forces, fluid compression, and serving as a reminder to restrict movement.
This document discusses different types of prosthetic knee joints, including mechanical single-axis and polycentric knees, and computerized knees that use microchips, hydraulics, or pneumatics to control motion. It describes the evolution of prosthetic knees from simple pendulums to advanced mechanisms with microprocessor control. Key factors in prescribing the appropriate knee include the user's ability to control stability, flex the knee in swing phase, and walk at different speeds.
Spinal orthotics are external devices that limit spinal motion, correct deformities, reduce loading, or improve spinal function. They include flexible braces made of fabric or elastic and rigid braces made of thermoplastics or metals. Cervical collars come in soft and hard varieties and are used for neck injuries or post-operatively. Thoracic-lumbar-sacral orthoses (TLSO) and lumbosacral corsets (LSO) are used for lumbar injuries or fractures. The halo cervical orthosis provides the greatest cervical immobilization using pins in the skull. Drawbacks of orthotics include discomfort, skin issues, and decreased function with prolonged use.
Orthotics are devices added to the body to stabilize, immobilize, or assist body parts. This document discusses different types of orthotics for the lower extremities, upper extremities, and spine. Common orthotics include foot orthotics, ankle foot orthotics, knee orthotics, and cervical orthotics. The document provides examples and descriptions of various orthotics, their purposes, and conditions they are used to treat.
Prosthetic management of symes and partial foot amputationSmita Nayak
prosthetic management of partial foot and syme's amputation is a very challenging task. Now a days the availability of advanced technology some how fulfilling the need of the amputee but not the fully.
An Immediate Post operative Prosthesis (IPOP) or Immediate Post-surgical fitting is a device that is applied before or after wound closure that protects the suture site and allows limited weight bearing and gait training. It serves as a bridge between surgery and a definitive prosthesis. IPOPs can be custom fabricated or prefabricated and are commonly used at the transtibial and transradial levels. Advantages include reducing phantom limb pain and sensations, earlier weight bearing and rehabilitation, and shorter recovery times. Air splints are a type of non-custom IPOP that provide uniform pressure distribution, easy inspection of incision sites, and partial weight bearing ability.
This document discusses rehabilitation and prosthetics for upper extremity amputees. It covers:
1. Exercises that should be started after amputation to improve range of motion, strength, and endurance, and avoid contractures.
2. Techniques for performing daily activities like bathing and dressing without a prosthesis by changing hand dominance or using the mouth/feet.
3. The main components of prosthetics including the socket, harness, mechanical elbow, and different terminal devices.
4. Advances in prosthetics technology including myoelectric hands, targeted muscle reinnervation, and future considerations like osseointegration.
Static and dynamic shoulder orthoses are used to support and position the shoulder and arm for a variety of injuries and conditions. Static orthoses like the gunslinger orthosis and airplane splint rigidly hold the arm in set positions of abduction and rotation. Dynamic orthoses like mobile arm supports (MAS) allow some motion of the shoulder and elbow using linkages and gravity assistance. MAS are indicated for patients with weak shoulder and elbow muscles to help perform functional activities while strengthening muscles. Both static and dynamic orthoses aim to prevent contractures, support healing, and enable early recovery of arm function.
The elbow joint is a hinge joint formed between the humerus, radius, and ulna bones. It allows flexion and extension movements. The elbow joint is stabilized by ligaments including the medial collateral ligament and lateral collateral ligament complex. Muscles such as the biceps brachii and triceps brachii are responsible for flexion and extension, respectively. The radioulnar joints allow pronation and supination movements of the forearm and are stabilized by ligaments like the annular ligament. Mobility of both the elbow and radioulnar joints is important for performing daily activities.
This document discusses upper limb orthoses and prosthetics. It describes various types of static and dynamic orthoses used to support, immobilize, or restore function to the shoulder, elbow, wrist, hand, and fingers after injury or impairment. Static orthoses help prevent deformities while dynamic orthoses can provide assisted motion. Body-powered and myoelectric prosthetics can replace missing limbs. Considerations for prosthetics include comfort, function, appearance, and cost.
The document summarizes different levels of upper and lower limb prosthetics. It describes the components and indications for various prosthesis types including shoulder disarticulation, above elbow, below elbow, wrist disarticulation, and hand prosthetics. It also discusses prosthetics for levels such as hip disarticulation, above knee, below knee, ankle disarticulation, and partial foot amputations. The document provides details on prosthesis design considerations and components for different amputation levels.
This document discusses orthotics and their use in rehabilitation. It begins by describing how bioengineering devices like orthotics play an important role in orthopedic and neurological rehabilitation by improving function and support. It then discusses different types of orthotics in more detail, including their components, classifications, indications for use, and general principles. Specific orthotics for the ankle, knee, and hip are also outlined.
1587222660-upper-limb-orthoses.pdf. In detailedRahulSingh3901
Upper limb orthoses include static and dynamic splints used to immobilize or facilitate movement of the hand, wrist, elbow and shoulder. Static splints are fabricated from thermoplastics to immobilize areas and position limbs, while dynamic splints incorporate elastic bands or springs to passively stretch tissues and prevent contractures. Proper splint selection depends on the injury, including fractures, nerve injuries or contractures, and specific splints are designed to address conditions like carpal tunnel syndrome or radial nerve palsy. Dynamic splints require careful adjustment of tensions to provide adequate stretching without pain.
Modern orthotic devices play a vital role in rehabilitation by improving function, restricting or enforcing motion, or increasing support. An orthosis is a mechanical device fitted to the body to maintain it in an anatomical or functional position. Orthoses utilize forces like rigidity or springs to limit or assist movement and correct deformities using a three-point system of counter forces. They are classified based on their function, region, and specific condition or injury and made of materials like plastic, metal, or carbon fiber considering strength, weight, and comfort.
The document discusses rehabilitation for amputee patients. It describes how the rehabilitation team approach was developed after WWII to treat injured soldiers. The team includes various medical professionals who work cooperatively. Rehabilitation involves evaluating patients' physical and emotional status, type of amputation, and fitting appropriate prosthetics such as those for below knee, above knee, or hip disarticulation amputations. Newer prosthetics like the C-Leg use microprocessors and sensors to dynamically adapt to a patient's gait.
An HKAFO is an orthosis that stabilizes the hip, knee, and ankle. It consists of an AFO connected to thigh sections and a pelvic band. The orthosis applies corrective forces at the skin surface that are transmitted through soft tissues to bones. Forces are balanced at joints to control movement. HKAFOs assist with gait and decrease weight bearing in conditions like paraplegia. Reciprocating gait orthoses use cables to induce reciprocal hip flexion/extension between sides, enabling paraplegic ambulation. Hip orthoses control movement after injuries or surgeries. Pediatric hip orthoses treat developmental dysplasia of the hip and cerebral palsy, maintaining hip ab
The document discusses the structure and function of the hip joint. It describes the hip joint as a ball and socket joint formed by the acetabulum of the pelvis and the head of the femur. The hip joint allows for flexion, extension, abduction, adduction, internal and external rotation. Weight bearing through the hip joint results in compressive and tensile forces that the bone adapts to through trabecular architecture. The primary weight bearing areas are the superior portion of the acetabulum and femoral head.
Orthoses are externally applied devices that modify the structural characteristics and function of the neuro-musculoskeletal system. They are used to immobilize, support, correct deformities, assist weak muscles, and substitute for absent motor function. The document discusses various types of orthoses for the upper limb including static/dynamic orthoses for the shoulder, elbow, wrist, hand, and fingers. It provides examples of orthoses used to treat conditions like nerve injuries, burns, rheumatoid arthritis, and spinal cord injuries. The principles and goals of orthosis prescription for different parts of the body and medical conditions are explained.
This document discusses biomechanics concepts related to total hip arthroplasty (THA). It begins by defining key terms like force, vector, moment, work, and Newton's laws of motion. It then discusses biomechanical factors specific to the hip joint and THA, including joint reaction forces, component positioning and orientation, impingement, range of motion, and fixation methods. The focus is on how component design and surgical technique can affect stability, range of motion, wear and longevity of the hip replacement.
This document discusses the biomechanics of the hip joint. It begins by defining biomechanics as the science examining forces acting on biological structures. It then describes the hip as both mobile and stable due to its strong bones, powerful muscles, and ligaments. The document goes on to discuss topics such as the femoral neck angle, acetabular version, muscles, joint reaction forces, gait biomechanics, and the effects of conditions like osteoarthritis. It concludes by covering the history and principles of hip biomechanics in total hip arthroplasty, including how procedures aim to decrease joint reaction forces.
This document discusses the management of chronic elbow instability. It begins by defining the anatomy and stabilizers of the elbow joint. It then describes the different types of elbow instability, including traumatic causes like acute dislocation and chronic lateral/medial instability, as well as non-traumatic causes. Diagnosis involves special tests to assess varus and valgus instability. Treatment depends on the type and chronicity of instability, and may include closed reduction, ligament repair/reconstruction, and external fixation. The goal of treatment is to restore the functional integrity of the medial and lateral collateral ligaments.
The document discusses the anatomy and biomechanics of the elbow complex. It describes the bones, joints, ligaments, muscles and range of motion of the elbow. Specifically, it details the articulating surfaces of the humerus, radius and ulna that make up the elbow joint. It explains how the ligaments provide stability and the functions of the main flexor and extensor muscles like the biceps, brachialis and triceps. Finally, it discusses how biomechanical factors like carrying angle and two-joint muscles can impact the elbow's range of motion.
The document discusses the anatomy and biomechanics of the elbow complex. It describes the bones, joints, ligaments, and muscles that make up the elbow. The elbow complex includes the humeroulnar joint, humeroradial joint, and proximal and distal radioulnar joints. It allows flexion/extension of the forearm and pronation/supination from the rotation of the radius. Key muscles like the biceps, brachialis, and triceps act across these joints to enable movement. Common injuries like tennis elbow and supracondylar fractures are also mentioned.
This document provides information about goniometry and range of motion measurements of various joints, including the shoulder complex. It defines goniometry as the measurement of joint angles using a goniometer. The document describes how to position and stabilize the individual and properly align the goniometer to measure flexion and extension of the shoulder joint. Flexion and extension occur in the sagittal plane around the medial-lateral axis. Normal range of motion for shoulder flexion is 165-180 degrees and for glenohumeral flexion is 100-115 degrees.
The document discusses the biomechanics of the hip joint and total hip arthroplasty (THA). It begins by defining biomechanics and describing the normal anatomy and biomechanics of the hip, including the forces acting on it. It then discusses the biomechanical considerations for THA, including restoring the hip center, lengthening the abductor lever arm, and decreasing the body weight lever arm to reduce joint reaction forces. The history of applying biomechanics to THA is reviewed, highlighting key concepts. Component position, size, and orientation are described as important biomechanical factors for ensuring stability and reducing wear.
- The document discusses the biomechanics and pathomechanics of the elbow joint. It describes the ligaments of the elbow, the articulations between the humerus, ulna, and radius, and the range of motion of the elbow joint. It also examines the muscles that flex, extend, pronate, and supinate the forearm, discussing their attachments, actions, innervation, and the effects of joint positioning on their function. Key concepts covered include torque, moment arms, classes of levers, and the screw home mechanism of the elbow.
Similar to Shoulder subluxation and Wilmer carrying Orthosis (20)
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2. Introduction
• Orthoses are orthopaedic appliances used to
support, align, prevent or correct deformities of a
body part or to improve function of movable
parts of the body (Edelstein and Bruckner,
2002”).
• The International Standards Organisation has
defined orthoses as: an externally applied device
used to modify the structural and functional
characteristics of the neuro-muscular-skeletal
system (Bowker et al.,1993).
3. CONT..
Orthosis can be defined as a mechanical construction
intended to improve a functioning part of human body
where the anatomical structures are still present.
Orthoses fulfill their task by exertion of forces on to the
anatomical structure.
Depending on the upper limb segment involved and
depending on the functional requirements a specific
pattern of forces between the orthosis and the body is
needed. Therefore no universal upper limb prthosis is
exist. However every orthosis needs to fulfill some basic
requirements concerning cosmesis, comfort and control.
4. Cont..
• The Wilmer Carrying Orthosis is the original ‘Wilmer’,
a shoulder orthosis (also known as shoulder brace or
shoulder splint), developed at Delft University of
Technology.
• The WILMER Orthosis is developed in the early
1960s by the WILMER group of the Mens section
Machine Systems of the current faculty Design
Construction and Production of the Delft University
of Technology. The initiator and large motor behind
the prosthesis and orthosis developments of this
group was Prof Ir JC Cool.
5. Types of WCO
1. Wilmer shoulder orthosis ( Standard unit,
Hand free unit and wrist free unit)
• Wilmer adjustable shoulder orthosis (Modified design)
2. Wilmer elbow orthosis
• Wilmer elbow orthosis for children
• Wilmer elbow extension orthosis
6. Wilmer shoulder orthosis (WSO)
• The WSO is designed for the patients with Brachial
plexus injury and hemiplegia who suffer a complete
paralyzed arm. In stroke patients an incidence of
shoulder subluxations reported ranging from 17% to
81% (Linn SL, et al )
• Orthosis is intended for people suffering from
a partially dislocated or completely dislocated shoulder
(luxation). This often painful situation prevents proper
functional use of the affected arm. The arm hangs from
its capsule and ligaments and in time dislocates further
and further.
7. Limitation of other available treatment
• The effect of some basic support techniques on subluxation
shown that effectiveness of these systems is limited. In
general they are unable to control the subluxation neutralize
longer periods (Birds, et al ).
• Less conventional treatments are available for example
microsurgical reconstruction post-plexus lesions. The ever-
advancing current improvements in microsurgery technical
techniques, as well as increased possibilities of regeneration
of zenu wen have contributed a lot to it improving the
perspectives of one small group of patients with plexus
lesions. Despite this, there is still a large one group of patients
with these techniques do not offer a solution.
8. Cont..
• Also treatment with functional electro- stimulation
(FES) is used in patients with shoulder subluxation as
due to loss of control over shoulder muscles. This
technique leaves during short-term use shows a
positive effect, but late after stopping treatment quite
quickly see the same problems as not patients treated
with FES (Linn SL, et already ).
• Due to the effective use of the forces in and on the
body WCO is the only one capable Orthosis to actually
make the subluxation permanent neutralize.
9. Specifications of the WCO
• Effective neutralisation of shoulder subluxation.
• Regain some of the arm functions.
• Reduced chance on oedema formation in hand, fingers and
forearm.
• Reduced pain and discomfort in arm and shoulder.
• No neck loading.
• Only minor limitation of arm mobility.
• Can be worn fully underneath clothing.
• High wearing comfort partly because of open and lightweight
construction.
• Custom made to perfectly fit the arm
• Light weight Orthosis: less than 170 gram
• Weight of shoulder strap: 75 gram.
11. Function
• Treating a shoulder (sub)luxation by wearing a sling
may reduce loading on the ligaments and capsule, it
doesn’t neutralise the (sub)luxation itself. On top of
that a sling needs to be worn over clothing, highly
limits arm mobility and it loads the neck.
• The use of the WILMER Carrying Orthosis does lead to
effective neutralisation of the (sub)luxation. The
Carrying Orthosis suspends the arm close to the elbow
leading to a slight misbalance of the weight of the
forearm in reference to the weight of the upper arm.
12. Cont..
• When the forearm is directed downwards by gravity,
the upper arm is, at the same time, pushed upwards,
leading to the head of the upper arm finding its
support in the shoulder joint again.
• The Carrying Orthosis is equipped with a shoulder cap
that leaves the neck and often painful shoulder head
unloaded. The design of the Carrying Orthosis allows it
to be worn fully underneath clothing. There is only a
mild limitation of arm mobility. The predominantly
horizontal position of the forearm reduces the chance
on oedema formation.
13. The WILMER carrying orthosis standard
unit, supports the paralyzed arm, wrist and
hand
14. Standard Unit – With hand support
• The standard unit is used when full hand support
is required.
• The hand support brings the hand to a stable rest
position.
• The curved edge ensures that the hand does not
slip from the support.
• The perforated plastic (PE) hand support has
rounded edges, giving a comfortable hand
support, which is well ventilated, but also easy to
clean.
15. WILMER hands-free unit which optimally
supports the paralyzed arm and wrist ensuring
optimal hand and finger mobility
16. Hands-free unit – With handspoon
• The model with a hand spoon is used by people
whose control over the fingers of the hand is still
(partly) present, but have insufficient control over
the wrist.
• Through a small perforated hand spoon placed in
the palm of the hand, the wrist is supported, but
the fingers and thumb remain free so that
(limited) functionality is possible.
• This creates an optimal combination of control
and functionality.
17. WILMER wrist-free unit which optimally supports the
paralyzed arm ensuring optimal wrist, hand and finger
mobility
18. Wrist-free unit
• The wrist-free unit leaves both wrist and hand
free.
• Ideal for people with good control over hand
and wrist.
• This gives you maximum freedom and
functionality at your hand.
• Comfortable suspension of frame on the
forearm.
• Adjustable wrist straps.
21. Specials
• Occasionally, a complete individual hand
orthosis is produced that is connected to the
WCO’s frame.
• This happens, for example, if there is severe
spasticity around the hand and fingers.
• The original Carrying Orthosis model is a more
convenient choice in that case than
the Wilmer2 Carrying Orthosis
23. CONT..
• The humeral head shares only a very small
articular surface with the scapula. The structure
of joint shows clearly that the shape stability of
this joint is limited. Muscles provide compression
of this joint causing humerus against the scapula
remains pressed.
• The down and laterally sloping edge of the
scapula articular surface ensures that, at
sufficient compression force, the gleno-humeral
joint remains stable. For this compression force is
mainly the m.supraspinatus responsible.(Fig 2)
24. CONT..
• EMG studies (Basmajian, et al.)showed that the
activity of the m.supraspinatus (along with the
morphology from the down and laterally runaway
articular surface of the scapula) contributes to
the resistance of it healthy gleno-humeral joint
against subluxation.
• The more vertical working m. biceps, m. triceps
and most of the m. deltiod thus fulfill a lot
smaller to no role in the active stabilization of the
joint against subluxation.
26. • The stability of the joint is only for a very small part in the
form of the articular surfaces. Haircut and Ties (3)(Fig 1), but
above all an active contribution of the muscles (especially m.
supraspinatus) are necessary to ensure the integrity of the
joint.
• Loss of muscle around the shoulder (and so especially failure
of the m. Supraspina- tus) as a result of, for example, a CVA or
a brachial plexus lesion leads to that there is no longer an
active compression of it the gleno-humeral joint. The
humerus no longer grows active against the articular surface
of the attracted scapula.
27. • As a result of the mass of the arm and of the to
downward and laterally divergent joint plane of the
scapula(Fig 3) the haircuts and bands of the joint more
or less more permanent tensile loads.This continuous
load leads to one viscous deformation of this
anatomical structures: they stretch.
• Due to the low dimensional stability of the joint (Fig 1)
is only a small one elongation of these structures
sufficient to vertical stability of the joint is not to
guarantee more. With others words: the humerus
subluxates.
28. Biomechanics of conventional orthosis
used for shoulder subluxation
• When using a orthosis for a shoulder subluxation
is in first attempted to subluxation to lift. From a
mechanical perspective this means that there is
one somewhere on the arm upward force is
required which the downward gravity on the arm
compensates.
There are actually only three techniques to do that.
1. The first technique is through a support point
under the armpit. This technique, like used in, for
example, the Bobathsling (Birds I, et al ), uses the
shape of the head of the humerus.
29. Cont…
• The idea is to use one roll a
force in the patient's armpit
can induce those in the neck
of the humeral head can push
it up. The humeral head
geometry, however, leaves
immediately, that this can
only be done by this also to
push out (laterally). That is an
unwanted side effect,
because bring the viscous
structures around again the
joint (capsule and bands)
further can be stretched.
30. Cont..
2. The second technique is to raise the arm pull with a cuff
around the upper arm ( Fig 4).
• The cuff is placed in such, orthotics pulled tightly around the
upper arm. By tightening the cuff a normal force of the cuff
generate on the skin and vice versa(Fig 5). Because of this
normal force, there arises also a frictional force (of skin on
cuff and vice versa). The frictional force depends on the
prevailing friction coefficient μ via:
F friction = μ.F normal
• A small coefficient of friction requires therefore high normal
forces around the required frictional forces (necessary to
mass of the arm) generate.
• The problem now is that the friction coefficient in contact
with the human skin is not constant.
32. Cont..
• The human skin is capable of being ephemeral
generate very high frictional forces, but because
of perspiration, among other things this cannot
be sustained for long. Sometimes very low
coefficient of friction of the human skin in
upward, required very strong normal forces.
• Then required forces are generally too high for
permanent contact with the skin support. The
result is therefore ultimately skin crawls under
the cuff and thereby re-creating the subluxation.
33. CONT..
3. The third technique is to generate one upward force against
the 90 ° flexed forearm.
• This technique is widely used in all kinds of models slings
and mitellas.(Fig 6)
• This techniques mechanical perspective is most promising.
We can't really do much with orthotics more than applying
well selected compressive forces. In this technique the arm
is lifted by two pressure forces on the forearm, so that
would can work.
• To be able to properly assess whether and how the sling of
fig 6, is able to neutralized shoulder subluxation
permanently a free-body sketch (VLS) of this situation are
displayed (Fig 7).
36. CONT..
• The VLS in Fig 7 shows that there is none balance. Balance
of forces demands it seems that F mass is equal to the sum
of F b1 and F b2 . However, F mass has another (smaller)
arm in relation to the elbow than the resultant of F b1 and
F b2 . The sum of the moments relative to the elbow is
therefore not equal to zero.
• The forearm will by the ruling forces want to flex
further. Even if we do it support point of F b1 closer to the
elbow sliding (beyond F mass ) goes wrong. theory we can
for the forearm then balance of forces and balance of
moments to get. However, that will be relatively large
F b1 lead and a much smaller F b2 . If we analyze that
situation for the VLS of the sling itself (right part Figure 7),
then there again no moment balance.
37. CONT..
• In theory this could still be accomplished via a frictional force at the
support point with the neck. However, the same analysis as for the
upper arm cuff of Figure 4 also applies here. Long-term high friction
generate forces on human skin undesirable and practically not
feasible. The VLS demands from the sling itself as a result that
F b1 and F b2 are (approximately) the same size.
• The result is therefore again the situation where the resulting
moment in the bottom want to flex. In general it is the situation of
this group of patients around the elbow so that it is internal (with
muscle force) to stabilize this flexing moment is not possible.
• The arm will then also flex, the sling slips around the neck, its
support point of F b2 comes up and it support of F b1 (and with it
the elbow, upper arm and humerus) drops to down.
• The default response is then to tie the sling shorter, but that does
not change the interplay of forces: the sling continues to slide along
the neck and the subluxation persists after a relatively short time
return.
38. Cont…
• In the three above-described supporting techniques, a lot
of attention has been paid to the choice of where the up
working force must seize the humerus must be back in
place to get.
• It is for a good orthosis however at least as interesting to
consider think about where the reaction force of the
Orthosis should be in a downward direction
engage. ( Newton 's 3rd law requires that the upward force
on the arm, intended to push back the humerus, in
opposite direction through the arm on the orthosis will
work.
• The orthosis is also possible only stay in place if he is
elsewhere leans on the body. In that place it will body on
the orthosis one up need to generate targeted force and
the orthosis on the body one downgenerate targeted force.
39. Cont…
• In Figure 7 this force is represented as F neck . Now on that F neck
is the same size as F mass . In other words, the mass of the arm
hangs completely on the neck. Remember that we're talking about
an orthosis here for permanent use. The subluxation goes on no
longer automatically and the user of the orthosis will be the rest of
it have to use life. Taxing the neck with the mass of the arm is then
not a good idea either. Also the way of support as in Figure 4 is less
successful
• Hereby solution there is a vertically oriented load (F shoulder ) on
the humerus region (Fig 8). That is not such a good idea either for
this patient population.
• In summary, it can be said that the conventional solutions to deal
with a orthosis to neutralize shoulder subluxation serene little from
a mechanical perspective be effective. This explains the meager
results of these systems in practice.
42. Cont..
• The size of F humerus depends on the degree of imbalance
between Fmass and Fresultant . A bigger imbalance
(chosen more proximally suspension point of the shoulder
support) to a greater upward force on the elbow (F elbow )
and thus to one greater F humerus and vice versa.
• Other opted orthosis generally supports the humerus
region and neck region respectively
• The WILMER Orthosis is opted for support in the region
correctly between the two. There also occurs the
interaction of F shoulder through a soft shoulder
patch. This is one happier location chosen for is carrying
the permanent load of the arm, than the humerus region
or the neck region.
43. • The weight of the forearm forces the upper arm
upwards, thereby neutralizing a shoulder
subluxation. One suspension point on the
forearm is sufficient for the orthotic function. The
point is created by a tension band that suspends
the arm on the shoulder. A shoulder cap
transmits the suspension force to the body. A
chest strap keeps the shoulder cap in place. All
components are situated near the limb and
therefore the orthosis can be worn underneath
the clothing without problems.
44.
45. • In Fig ‘a’ the forces acting on the subsystem of the forearm
are shown.
• In Fig ‘b’ shows the return of the forces in elbow, where the
forces acting on the subsystem of the arm also shown.
For the equilibrium a reaction force in the shoulder is needed.
• In Fig ‘c’ the subsystem of forearm and upper arm are
combined to the system of the complete arm. The force in
the elbow is now an internal force system. The resulting
gravity force of the complete arm acts distally of the
suspension force. The reaction force in the shoulder ensure
the equilibrium of forces and indicates the successful
neutralization of the subluxation.
47. Cont..
• The action line of the effective suspension
force of a mitella or hemisling lies distally to
the C.G of the bent arm. Therefore no
subluxation correcting force can exist.
• In Wilmer the displacement of the action line
of the suspension force proximal to the C.G
results in an attractive orthosis structure. The
total system acts like a balanced arm.
48. 3C Philosophy
• Cosmesis: Orthosis is in unlike many alternative orthotics,
like slings completely under clothing. The carrier of this
orthosis will therefore be less noticeable, which greatly
contributes to the cosmetic of the facility.
• Comfort: Light in weight. The lower part only weighs 170
g. The shoulder bandage only 80 g. This linked to the open
structure of the orthosis (prevented perspiration problems)
makes the orthosis pleasant to wear.
• Cotrol: The subluxation of the shoulder neutralized by in a
smart way of the forces in and on the body itself to
use. This is a good example of implicit body control.
49. Wilmer adjustable shoulder orthosis
In order to facilitate donning and doffing of the
clothes an adjustable version of the orthosis
developed by pushing against a knob principle that
is located near the elbow in the suspension strap an
unlocking action is performed. The arm with the
orthosis can now be extended. Bringing the arm
back in the 90 deg flexed position engages the lock
again, enabling the orthosis function. The working
and the fitting procedure of this adjustable
shoulder orthosis same as standard version.
50. Wilmer elbow Orthosis
• This is a dynamic orthosis degined for the
patients with paralyzed elbow. A paralyzed elbow
can be brought into flexion by maintaining
shoulder abduction angle more than 90 deg.
• More abduction angle is not acceptable in both
functionally and cosmetically.
• Addition of orthosis helps to reduced the
abduction angle to get required elbow flexion. So
there always requirement of an orthosis to get
function.
51.
52. Cont..
• The wilmer elbow orthosis is a unilaterally construction
with two hinged frame bars made from stainless steel
tubing.
• The orthotic forearm can be positioned by anteflexion
pulse.
• Orthosis fitted to the patient arm by two fitting on
either side of the elbow joint. Orthosis only loads the
skin by the normal forces not the shear forces. Fittings
are made up of perforated plastic sheet. So the
perspiration not hampered.
• The fittings are supported only in their centre so they
adopt the shape of the arm easily.
53.
54. • A force analysis in the orthosis of elbow shows that a
one sided hinge is free from torsional moment during
normal operation.
• A locking mechanism is added to the orthosis to enable
the patient to reatain the flail arm in the flexed
position independent of the abduction/ anteflexion
angle.
• In this locked position the arm + orthosis is suitable to
lift and carry objects. Second locking position at the
near extended arm enables pushing or clamping of
objects, this is useful in donning and doffing.
55. Locking mechanism
• Patient can flex and extend the elbow over the whole range of
motion from ‘A to D’ without interference of the locking
mechanism.
• If the patient wants to switches from flexion to extension in the
small angle area indicated with C the locking mechanism will
engage and lock the arm against extension in an approximate 90
deg flexed position.
• To unlock the arm patient has to flex the arm into area D. The lock
near extended position engaged by a switch from extension to
flexion in the small angle area indicated with B. An extension into
area A unlocks the mechanism.
• This locking mechanism can restrain some activities, like driving a
car. So to prevent unwanted locking the mechanism can be
disengage by pulling knob located at the wrist region and second
pull engages the locking mechanism again.
56.
57. • Advantages of Wilmer elbow Orthosis
1. Restores some elbow function
2. Comfortable to wear
3. Light weight
4. Invisible to wear underneath the cloth
5. Easy donning and doffing
6. Automatic locking mechanism
58. Wilmer elbow Orthosis for children
• For the child below age of 4
years
• The Orthosis consists of two
hinged bars with a spring
attached in between them. Four
fittings transfers forces between
the Orthosis and the arm vice
versa. No locking mechanism is
incorporated. Weight varies
from 35 gram to 80 gram. With
this Orthosis the child actively
flex his arm. The possibilities to
play and development is
enhanced.
59. Wilmer elbow extension Orthosis
• Indication for this
Orthosis is the muscle
spasm.
• The Orthosis consist of
two hinged bars, fixed
on the arm with four
perforated body
adaptive fittings. An
adjustable spring
mechanism extends the
Orthosis.
60. Conclusion
• The Wilmer shoulder Orthosis known as the
only Orthosis neutralizes a shoulder
subluxation.
• Elbow Orthosis enable someone with flail arm
to actively flex and extend the elbow and the
locking mechanism having several advantages.
61. References
1: Linn SL, Granat MH, Read KR; Prevention of
shoulder subluxation after stroke with electrical
stimulation; Stroke 1999, 30 , 963-968.
2: Smith RO; Okamato GA; Checklist for the
prescription of slings for the hemiplegic
patient; Am J Occup Ther 1981, 35-2 , 91-95.
3: Cool JC; Biomechanics of Orthoses for the
subluxed shoulder; Prosthet Orthot Int
1989, 13 , 90-96.