Re: DAFO thread
Baxter, Steve
Description
Collection
Title:
Re: DAFO thread
Creator:
Baxter, Steve
Date:
1/7/2002
Text:
I guess I'll get my two cents in too. I think all the responses to this
issue make their own points. I don't believe in P.T.'s molding and fitting
DAFO's to CP kids. My main reason for this is that it is difficult at best
to find a PT who has the clinical expierence in pathological gait to
correctly evaluate and apply biomechanical principles to achieve a
successful outcome. Now, let me throw a disclaimer on this. I have taken
Beverly Cusik's course ( 11 years ago), and feel now as I did then that she
has a huge amount of knowledge and expierence concerning CP kids that has
helped me tremendously. From an Orthotists point of view, DAFO's as with
anything else we do, needs to be used in appropriate situations to allow the
oppurtunity for greatest success. Example, you can use them on a CP child
with 30 degrees of crouch due to fixed knee contractures to provide knee
extension, but why would you? As an Orthotist you know it won't work.
That's where part of our role comes into play, education. I deal with this
scenario weekly not only with clinical PT's but also with PT's from our Gait
Lab. We use the custom made NDT foot plate on all our devices, because I
feel you get a better fitting device, with better alignment at the foot and
ankle. How? If you our molding a footplate on a child you will pay more
attention to the alignment of the foot and ankle. You can also check it, and
adjust it prior to wrapping. I have seen Orthotists present describing how
to cut an AFO 3 times to get an alignment, that should have been done during
the wrapping process. Is something like that still accurate??
Ok, sorry for the speech, happy new year
Steve
Steve Baxter C.O., Director
Department Of Orthotics
Shriners Hospital for Children, Houston
713-793-3867
<Email Address Redacted>
> -----Original Message-----
> From: John Russell [SMTP: <Email Address Redacted> ]
> Sent: Monday, January 07, 2002 12:35 AM
> To: <Email Address Redacted>
> Subject: [OANDP-L] DAFO thread
>
> Hi all on the OandP List
> Regarding this DAFO's thread, so why then when we are the experts, in the
> last 15 years of our professional careers we have not improve on the DAFO
> design?
> My thought is that we are in our own little worlds, with minimal oversight
> of the total outcomes of our products, and what we do. This is how we can
> say for a spastic kid, that standard AFO's, metal AFO's with T-straps, or
> bivalve AFO's work just fine.
> So what is the main goal of all of these AFO's is just to get no
> complaints?
> Would it be better to have our basic goal to stop the progression of the
> deformities?
>
> What we need is a Spotlight on these and any other design in a public
> form.
> This could be just like a chili cook off contest or a wine tasting
> contest,
> where people or companies would make AFO's for more than one person and
> then
> be judged, by experts, patients, and audience.
>
> Please no replies with out any name or e-mail address.
>
> John Russell
> Language, Borders, Country
> e-mail <Email Address Redacted>
>
>
issue make their own points. I don't believe in P.T.'s molding and fitting
DAFO's to CP kids. My main reason for this is that it is difficult at best
to find a PT who has the clinical expierence in pathological gait to
correctly evaluate and apply biomechanical principles to achieve a
successful outcome. Now, let me throw a disclaimer on this. I have taken
Beverly Cusik's course ( 11 years ago), and feel now as I did then that she
has a huge amount of knowledge and expierence concerning CP kids that has
helped me tremendously. From an Orthotists point of view, DAFO's as with
anything else we do, needs to be used in appropriate situations to allow the
oppurtunity for greatest success. Example, you can use them on a CP child
with 30 degrees of crouch due to fixed knee contractures to provide knee
extension, but why would you? As an Orthotist you know it won't work.
That's where part of our role comes into play, education. I deal with this
scenario weekly not only with clinical PT's but also with PT's from our Gait
Lab. We use the custom made NDT foot plate on all our devices, because I
feel you get a better fitting device, with better alignment at the foot and
ankle. How? If you our molding a footplate on a child you will pay more
attention to the alignment of the foot and ankle. You can also check it, and
adjust it prior to wrapping. I have seen Orthotists present describing how
to cut an AFO 3 times to get an alignment, that should have been done during
the wrapping process. Is something like that still accurate??
Ok, sorry for the speech, happy new year
Steve
Steve Baxter C.O., Director
Department Of Orthotics
Shriners Hospital for Children, Houston
713-793-3867
<Email Address Redacted>
> -----Original Message-----
> From: John Russell [SMTP: <Email Address Redacted> ]
> Sent: Monday, January 07, 2002 12:35 AM
> To: <Email Address Redacted>
> Subject: [OANDP-L] DAFO thread
>
> Hi all on the OandP List
> Regarding this DAFO's thread, so why then when we are the experts, in the
> last 15 years of our professional careers we have not improve on the DAFO
> design?
> My thought is that we are in our own little worlds, with minimal oversight
> of the total outcomes of our products, and what we do. This is how we can
> say for a spastic kid, that standard AFO's, metal AFO's with T-straps, or
> bivalve AFO's work just fine.
> So what is the main goal of all of these AFO's is just to get no
> complaints?
> Would it be better to have our basic goal to stop the progression of the
> deformities?
>
> What we need is a Spotlight on these and any other design in a public
> form.
> This could be just like a chili cook off contest or a wine tasting
> contest,
> where people or companies would make AFO's for more than one person and
> then
> be judged, by experts, patients, and audience.
>
> Please no replies with out any name or e-mail address.
>
> John Russell
> Language, Borders, Country
> e-mail <Email Address Redacted>
>
>
Citation
Baxter, Steve, “Re: DAFO thread,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/218264.
