Compromise Key for Orthotists Treating Adults with Childhood Onset Disability

ATLANTA — Aggressive modifications to AFOs for pediatric patients may not be well tolerated by adult patients with childhood onset disabilities such as cerebral palsy, presenter Michelle J. Hall, CPO, FAAOP, vice president, Gillette Lifetime Specialty Care told the audience at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.

“Our patients are followed throughout their life, but sometimes they come from the pediatric side and transfer over and we keep doing the same thing over and over again,” Hall said. “The patient is happy because the treatment is always the same. But we really need to reassess and make sure the particular design is still appropriate for the patent.”

One of the overlooked variables of treatment, according to Hall, is understanding that the patient is now the decision maker, as opposed to their parent or guardian. This requires more compromise and compassion from the orthotist. Hall described one of her patients who simply refused to wear his plastic AFO.

“Orthosis abandonment is pretty common,” Hall said. “Those who abandon their orthoses complain of pain, callusing, pressure or poor cosmesis. I had to personally learn how to compromise and negotiate with these patients. We need to be cognizant of orthosis use or disuse.”

For more information:

  • Hall MJ. Treating the adult with childhood onset disability: Implication for orthotists. Presented at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium. March 21-24. Atlanta.

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