BOSTON – The fabrication of custom thoracolumbosacral orthoses can seem time consuming for many orthotists, but new materials have simplified the process, according to a presenter here at the American Orthotic and Prosthetic Association National Assembly.
Jacqueline Valdez, CO, said that thoracolumbosacral orthoses are often bulky and heavy. So, she began looking for ways to improve the conventional orthosis used for patients with scoliosis.
“A lot of these patients have poor regulation of their core temperatures; the body temperature gets high and they can’t tolerate the brace for long periods of time,” Valdez said. “We also need to look at managing hip displacement that can become more problematic over time.”
Her primary goals were to increase abduction and stretch hip adductors to improve hip alignment, prevent excessive addiction during sitting, standing and walking, and optimize sitting and standing posture. She wanted to achieve these goals with an automatic transition from neutral, walking, standing, to abduction, sitting.
Valdez began working with a material called 3-D Lite, originally used in the aeronautics industry, which is breathable, easily molded at low temperatures and comes in varying widths of 3 mm, 5 mm and 7 mm.
“We actually took a common SWASH low profile orthosis and removed all of the textiles,” she said. “We then took the 3-D Lite material and incorporated it into our SWASH to fabricate our custom device.”
According to Valdez, the material is extremely lightweight and breathable and can be molded directly on the patient, eliminating the need for a cast molding. The material is also remoldable, should the device need to be refabricated.
“All of our goals were accomplished,” she said. “We had adequate trunk support with minimal core temperature issues, less hyper-lordosis, minimizing the chance of spondylolysis, and the hips were stabilized in any position for future, limiting adductions.”
For more information:
Valdez, J. New material and technique. Presented at the American Orthotic & Prosthetic Association National Assembly 2012. Sept. 6-9, Boston.