David,
Would agree with Javier, regarding what is the the goal of the orthoses.
In regard to the foot, the most common presentation is toe walking. This is due to the fibrosis created by the dystrophic changes leading to contracture of the gastro-soleus complex. The toe walking also occurs in relation to the muscle weakness present which is principally proximal to distal. This creates weakness primarily in the quads leading to instability in knee flexion. Quite commonly toe walking can occur to provide knee extension and therefore stabilise the knee.
Perhaps this may help in understanding why the orthoses were removed?
Tony Achilles
-----Original Message-----
From: A group for the academic discussion of current issues in podiatry [mailto:[log in to unmask]] On Behalf Of Javier Ordoyo
Sent: 24 November 2004 10:38
To: [log in to unmask]
Subject: Re: DMD and Foot Orthotics
Dear David,
Could you tell us the design, goals and materials used on these FO?
Regards,
Javier Ordoyo
Private Practice
-Barcelona- Spain
-----Mensaje original-----
De: A group for the academic discussion of current issues in podiatry
[mailto:[log in to unmask]] En nombre de David Kingston
Enviado el: miércoles, 24 de noviembre de 2004 11:27
Para: [log in to unmask]
Asunto: DMD and Foot Orthotics
A colleague of mine recieved a letter from a young patients mother about 8
months after providing foot orthotics. The child was recently diagnosed
with Duchenne Muscular Dystrophy.
The letter quted Orthopaedic Surgeon and Physiotherapist from a prominent
therapy centre as saying:
"...that patient X should not continue to wear the insoles. They were both
of the professional opinion that the insoles were restricting him, due to
his condition and had his diagnosis been made earlier would not/should not
have been fitted for him."
Comments please.
Thanks.
-----------------------------------------------------------------
This message was distributed by the Podiatry JISCmail list server
All opinions and assertions contained in this message are those of the
original author. The listowner(s) and the JISCmail service take no
responsibility for the content.
to leave the Podiatry email list send a message containing the text leave
podiatry to [log in to unmask]
Please visit http://www.jiscmail.ac.uk for any further information
-----------------------------------------------------------------
-----------------------------------------------------------------
This message was distributed by the Podiatry JISCmail list server
All opinions and assertions contained in this message are those of
the original author. The listowner(s) and the JISCmail service take
no responsibility for the content.
to leave the Podiatry email list send a message containing the text
leave podiatry
to [log in to unmask]
Please visit http://www.jiscmail.ac.uk for any further information
-----------------------------------------------------------------
-----------------------------------------------------------------
This message was distributed by the Podiatry JISCmail list server
All opinions and assertions contained in this message are those of
the original author. The listowner(s) and the JISCmail service take
no responsibility for the content.
to leave the Podiatry email list send a message containing the text
leave podiatry
to [log in to unmask]
Please visit http://www.jiscmail.ac.uk for any further information
-----------------------------------------------------------------
|