replies to Head Support
Aryeh
Description
Collection
Title:
replies to Head Support
Creator:
Aryeh
Date:
8/23/2002
Text:
Original post:
>I have a case of an elderly, non-spastic woman who cannot support her head
>for more than a few moments. The patient's daughter came up with a
>recommendation for a product or device called a Kellog brace. Aside from
>not ever having heard of a Kellog brace, what can anyone recommend to
>support the head for long term wear? I am of course concerned about
>breakdown of the skin under the jaw. I also am not actually seeing this
>person, the daughter is close by, but her mother is in another country.
>There is no difficulty in sending devices to the mother as there are
>practitioners in her area who could probably fit it properly.
Replies:
I've made a custom neck brace for a similar patient that should work. But
you'd need to be able to get a cast of her neck and shoulders in neutral
position. The finished orthosis is made of aliplast and is soft. But
reinforcements can be laminated into it if needed. From what you say, I
doubt they'd be needed. Let me know if you want more info.
We have fit several patients with head positioning problems with modified
SOMI's head band not chin as primary support.
Try a SOMI. pt. can alternate between head band and chin support. Or, USMC
makes a pinless halo that may be more comfortable.
Get patient to pick out a favorite baseball cap. Put a piece of 1 elastic
webbing down from the back to a T of 1 1/2 elastic around the chest under
the arms. The T goes at the spine. Use double chafes on both straps for
adjustment. I have used this on Parkinson, Lou Gehrig's, and MS patients
with success.
How about a simple soft cervical collar?
Is a diagnosis known? The last patient that I saw with such a description
had ALS. Mobility declined rapidly, and the person became wheelchair
reliant. The head was supported in the wheelchair.
What about using a minerva or the HALO device that is noninvasive, I think
USMC makes it. JenLee, CO
Look at the link below. The Fillauer torticollis orthosis has been used for
this condition. It is available custom fabricated or we will sell you just
the 5 way adjustable joint. We have international distributors.
Try the USMC Non-Invasive Halo. There is a Medical Grade Silicone Forehead
Band and the same on an adjustable chin strap (your patient might not need
the chin strap, so it can be removed. If there is a problem with skin
breakdown due to the silicone, simply remove it by pulling the stitching and
replace it with your choice of material, felt, velcro loop,
neoprene, etc. This brace was designed to hold a patient stable to a
point "almost" as efficiently as a Pinned Halo and more so than a
Minerva type brace. It has an anterior chest plate with padded back straps.
The back straps and occipital shell are attached with quick disconnects so
cleaning of the pads for your patient is a snap, very little adjustment to
these straps will be necessary if at all. Simple. Since your patient
doesn't need nearly absolute stabilization the one-size fits all chest plate
(heat moldable) can be trimmed and skeletonized, as can the occipital shell.
The adjustment rods can also be trimmed and be put in almost any conceivable
position. This brace is expensive, about $600, but I think it it
well suited to your application, with some modifications, as it is overkill
for your patients needs.
I used to be a tech rep for USMC until about last year. I felt that USMC
should design a simpler, cheaper version of this brace style just for the
needs of your patient, ALS patients and the like. Customers that have used
it have given me good feedback on it's use, especially where comfort was
concerned. USMC is now Seattle Systems, so contact them for more
information.
Try USMC's Yale Cervical Orthosis with a thorasic extension and a simple
head band to support the head by going around the forehead and avoiding the
pressure on the jaw or just use a SOMI with the same forehead strap and no
chin support.
>I have a case of an elderly, non-spastic woman who cannot support her head
>for more than a few moments. The patient's daughter came up with a
>recommendation for a product or device called a Kellog brace. Aside from
>not ever having heard of a Kellog brace, what can anyone recommend to
>support the head for long term wear? I am of course concerned about
>breakdown of the skin under the jaw. I also am not actually seeing this
>person, the daughter is close by, but her mother is in another country.
>There is no difficulty in sending devices to the mother as there are
>practitioners in her area who could probably fit it properly.
Replies:
I've made a custom neck brace for a similar patient that should work. But
you'd need to be able to get a cast of her neck and shoulders in neutral
position. The finished orthosis is made of aliplast and is soft. But
reinforcements can be laminated into it if needed. From what you say, I
doubt they'd be needed. Let me know if you want more info.
We have fit several patients with head positioning problems with modified
SOMI's head band not chin as primary support.
Try a SOMI. pt. can alternate between head band and chin support. Or, USMC
makes a pinless halo that may be more comfortable.
Get patient to pick out a favorite baseball cap. Put a piece of 1 elastic
webbing down from the back to a T of 1 1/2 elastic around the chest under
the arms. The T goes at the spine. Use double chafes on both straps for
adjustment. I have used this on Parkinson, Lou Gehrig's, and MS patients
with success.
How about a simple soft cervical collar?
Is a diagnosis known? The last patient that I saw with such a description
had ALS. Mobility declined rapidly, and the person became wheelchair
reliant. The head was supported in the wheelchair.
What about using a minerva or the HALO device that is noninvasive, I think
USMC makes it. JenLee, CO
Look at the link below. The Fillauer torticollis orthosis has been used for
this condition. It is available custom fabricated or we will sell you just
the 5 way adjustable joint. We have international distributors.
Try the USMC Non-Invasive Halo. There is a Medical Grade Silicone Forehead
Band and the same on an adjustable chin strap (your patient might not need
the chin strap, so it can be removed. If there is a problem with skin
breakdown due to the silicone, simply remove it by pulling the stitching and
replace it with your choice of material, felt, velcro loop,
neoprene, etc. This brace was designed to hold a patient stable to a
point "almost" as efficiently as a Pinned Halo and more so than a
Minerva type brace. It has an anterior chest plate with padded back straps.
The back straps and occipital shell are attached with quick disconnects so
cleaning of the pads for your patient is a snap, very little adjustment to
these straps will be necessary if at all. Simple. Since your patient
doesn't need nearly absolute stabilization the one-size fits all chest plate
(heat moldable) can be trimmed and skeletonized, as can the occipital shell.
The adjustment rods can also be trimmed and be put in almost any conceivable
position. This brace is expensive, about $600, but I think it it
well suited to your application, with some modifications, as it is overkill
for your patients needs.
I used to be a tech rep for USMC until about last year. I felt that USMC
should design a simpler, cheaper version of this brace style just for the
needs of your patient, ALS patients and the like. Customers that have used
it have given me good feedback on it's use, especially where comfort was
concerned. USMC is now Seattle Systems, so contact them for more
information.
Try USMC's Yale Cervical Orthosis with a thorasic extension and a simple
head band to support the head by going around the forehead and avoiding the
pressure on the jaw or just use a SOMI with the same forehead strap and no
chin support.
Citation
Aryeh, “replies to Head Support,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/219503.
