presented by Deborah A. Schwartz
Orthoses for mobilization, both dynamic and static progressive orthoses, can be used to help clients regain tissue length or joint motion when injuries or clinical conditions have caused tissue shortening and stiff joints. Therapists require core knowledge in upper extremity anatomy and understanding of biomechanical principles of orthotic fabrication to select dynamic orthoses as an intervention for clients requiring mobilization of joints of the upper extremity. Therapists also need hands-on practice to make well-fitting and appropriate dynamic orthoses for a variety of diagnoses affecting the upper extremity. They require awareness of pattern-making guidelines, the fabrication process using thermoplastic materials, and advanced knowledge of appropriate dynamic outrigger systems to aid in their orthotic design.
Deborah A Schwartz is a hand therapist with over 34 years of experience as a practicing clinician. She has worked at Orfit Industries America for the past ten and a half years promoting product awareness and offering a variety of educational programming on orthotic fabrication. Debby is an active member of the American Society of Hand Therapy (ASHT) and has participated in the International Federation of Societies of Hand Therapy (IFSHT) meetings as well. She has presented on a variety of hand therapy topics at both national and international conferences and has written a number of articles for hand therapy publications, including the Journal of Hand Therapy, the British Journal of Hand Therapy, HAND, www.exploringhandtherapy.com, and OT Practice. Debby completed her Doctorate of Occupational Therapy at Rocky Mountain University of Health Professions. She presently teaches orthotic fabrication workshops for Orfit Industries America for both student Occupational Therapists and advanced clinicians. She is also an adjunct professor at the Occupational Therapy department of Touro College in New York City, where she teaches orthotic fabrication and an elective on Hand Therapy. Debby is currently writing several book chapters for hand therapy references and collaborating on a textbook of orthotic fabrication.
This chapter will introduce the viewer to orthoses for mobilization and discuss how dynamic orthoses are used in the treatment of specific upper extremity conditions. The chapter will cover the indications and goals of dynamic orthoses for mobilization, contraindications and precautions for their use, review basic anatomy of the upper extremity and advanced biomechanical principles of orthotic fabrication.
This chapter will introduce the viewer to a dynamic MCP extension orthosis used post-operatively for clients recovering from extensor tendon repair or following MCP joint arthroplasty. The dynamic orthotic fabrication techniques along with an appropriate rehabilitation protocol will be covered. The chapter will highlight the pattern-making process, fabrication steps, important guidelines for adding outriggers and checking the correct fit, and precautions for the use of dynamic orthoses.
This chapter will introduce the viewer to a dynamic wrist orthosis used as a functional assist orthosis for clients with weak wrist extension. A review of the relevant wrist and hand anatomy is included along with a discussion of the fabrication steps and techniques and a proposed wearing schedule. The chapter will cover the pattern-making process and full fabrication steps. Important guidelines for adding coils as outriggers, checking for the correct fit, and precautions for the use of dynamic orthoses will be included in the discussion and video.