Dynamic Treatment Interventions Raise Big Challenges; Have Larger Payoff

LEIPZIG — One of the largest challenges in O&P and orthopedics
is to treat the whole human system and not just the source of the problem,
according to an investigator here.

Speaking on the topic of neuro-orthopedics at the 13th ISPO World
Congress, Dr. Leonhard Döderlein explored the impact of neuro-orthopedics
on the locomotor system and offered insight on where the field could go in an
effort to develop more effective treatment options.

  Leonhard Döderlein
  Leonhard Döderlein

According to Döderlein, neuro-orthopedics can be applied to
patients with cerebral palsy, stroke, traumatic brain injury, poliomyelitis,
spinal muscular atrophy and multiple congenital contractures.

Despite the known definitions of these conditions, they lack proper
neuromuscular classification, Döderlein explained.

“It is not an automatic procedure,” he said regarding the
selection of treatment modalities and conditions. “It is a process.”

Knowing when to step in with intervention is crucial for a positive,
long-term outcome for the patient.

“Early orthopedic intervention allows for improved motor
learning,” Döderlein said.

Additionally, early intervention prevents further contractures and
deformities. This is most useful in cases of multiple congenital contractures.

“The greater the deformity, the more challenging [the
treatment],” he said.

Later orthopedic intervention is effective in situations where pain is
associated with the deformity and in decompensated situations, he said.

To establish better guidelines, Döderlein recommends conducting
more research to get to the root of the main problem. He asserted that there is
just not enough evidence currently available.

“I would like better cooperation between people in the field,”
he said. “I would like to ask you to study principles instead of

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