presented by Deborah A. Schwartz
Therapists require core knowledge in upper extremity anatomy and pathologies and an understanding of the biomechanical principles of orthotic fabrication in order to select static progressive orthoses as an intervention for clients requiring increased passive mobilization of joints, or lengthening of soft tissue contractures of the upper extremity. Therapists also need hands-on practice to make well fitting, well designed and clinically appropriate static progressive orthoses. They require knowledge of the pattern making process, the steps of fabrication using thermoplastic materials and appropriate static progressive 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.
Static progressive orthoses for mobilization are a unique orthotic device that can be used to elongate shortened soft tissue and mobilize stiff joints. The tension in the orthosis is adjusted by the patient as instructed by the clinician. This chapter will review the goals of static progressive orthoses for mobilization and look at several different outrigger systems so that participants can understand how to identify which outrigger might be the most appropriate for the selected orthosis. The pattern making process will also be outlined in detail. Key anatomical landmarks will be identified for pattern making.
This chapter will introduce the viewer to a static progressive orthosis used in the rehabilitation phase to promote increased passive range of motion in stiff MCP joints. The stiffness and lack of motion of the MCP joints is common following trauma to the wrist and hand, surgery of the wrist, distal radius fractures and/ or metacarpal or phalangeal fractures. In this chapter, we will discuss the fabrication techniques for a static progressive orthosis to increase flexion at stiff MCP joints. Pattern making, fabrication steps, important guidelines for adding the outriggers and checking the correct fit, wearing schedules and precautions for the use of static progressive orthoses will be covered.
Static progressive orthoses for mobilization are used to help elongate shortened soft tissue and move stiff joints. This chapter will introduce the viewer to a static progressive finger flexion orthosis useful for helping a client regain passive PIP and DIP finger joint motion. The chapter will cover the pattern making process, fabrication steps, important guidelines for adding the outriggers and checking the correct fit, and precautions for static progressive orthoses.