An upper limb orthosis is a specialized external device designed to enhance the structure, function, or mobility of the upper limb (shoulder, arm, forearm, wrist, hand, or fingers). These devices, which include splints, braces, slings, and other aids, are crucial in supporting rehabilitation, preventing further injury, and improving quality of life for individuals with upper limb impairments or conditions. Here’s a more detailed look at their functions and applications:

Functions and Benefits

Prevent Injury:

By stabilizing the limb and providing support, orthoses can help avoid strain or exacerbation of an injury. They are often used post-surgery or after acute trauma to ensure proper healing.

Reduce Pain:

Pain reduction is achieved by immobilizing or supporting the affected limb, minimizing unnecessary movements that could aggravate pain or inflammation.

Improve Function:

Orthoses can assist in tasks like reaching, grasping, or lifting by compensating for muscle weakness or coordination deficits. This is especially useful for individuals with neuromuscular conditions such as stroke or cerebral palsy.

Enhance Balance:

The upper limb plays a significant role in maintaining overall postural stability. An orthosis can provide stability to weakened muscles, contributing to better balance during movement.

Boost Strength:

Certain dynamic orthoses are designed to provide resistance during movement, promoting muscle strengthening over time.

Improve Control:

For individuals with tremors, spasticity, or involuntary movements, an orthosis can offer controlled support, allowing for smoother and more deliberate actions.

Optimize Alignment:

Conditions like wrist drop or contractures can be addressed by positioning the limb in its optimal alignment, preventing deformities and improving functionality.

Restrict Movement:

In cases of healing fractures, ligament tears, or joint instability, orthoses can immobilize the limb or limit its range of motion to prevent further damage.

Materials and Customization

Upper limb orthoses are typically crafted from durable and lightweight materials such as:

• Thermoplastics: Moldable at high temperatures, offering a snug and customized fit.
• Casting Materials: Used for immobilization and precise shaping.
• Metals: Incorporated into braces for added strength and durability.
• Fabrics: For comfort, especially in slings or soft supports.

Customization is vital for ensuring the orthosis meets the specific anatomical and functional needs of the user. They are designed to contour the limb for a secure fit and to accommodate individual variations in size, shape, and the condition being treated.

Applications

• Post-Trauma Rehabilitation: Following fractures, dislocations, or surgeries.
• Neurological Conditions: For stroke survivors, individuals with multiple sclerosis, or those with spinal cord injuries.
• Chronic Pain Management: For conditions like arthritis or repetitive strain injuries.
• Pediatric and Geriatric Use: Tailored designs for age-specific needs.

Upper limb orthoses play a critical role in medical rehabilitation and functional enhancement, providing support, improving independence, and promoting a better quality of life for individuals with diverse needs.

A spinal orthosis is a mechanical device that applies external pressure to the spine to support, correct, or immobilize it. They are used to treat a variety of spinal conditions, including:

• Traumatic spine injuries
• Degenerative changes from aging
• Post-operative healing
• Chronic neck strain
• Cervical arthritis
• Radiculitis
• Herniated disc
• Shoulder pain
• Whiplash injury
• Thoracic pain

Spinal orthoses can be prefabricated or custom-made. They work by applying pressure at specific points on the body to create a corrective force. The pressure is applied through a three-point pressure system, which means that the device has three points of contact with balanced opposing forces.

Walk fluidly, walk safely, and walk all day

Microprocessor Controlled Orthosis is our proven, world-renowned microprocessor controlled technology. This lifechanging intelligent orthotic allows people with impaired mobility, due to partial paralysis in their lower limbs, to walk again. Instead of a locked knee brace, cane or wheelchair, this system provides the freedom to participate in regular daily activities. Preventing complications like osteoporosis pressure sores.

Freedom to move all-day

This gives the user the ability to take part in activities like walking their dog, taking public transport, going to music festivals, attending sporting events, traveling, and other normal daily activities.

Benefits

Slim & Lightweight

• Slim & Lighweight
• Controlled Stance Release
• Spring Assist
• Manual Lock & Free Mode Options
• Simple & Easy to Read Digital Display
• Battery Powered for Convenience
• Flexible Configuration options
• Remote FOB key or Manual Control Buttons

Indications

• Quadricep weakness
• Flaccid paralysis of lower limb
• Resultant paralysis from orthopaedic injury or procedure
• Insufficient knee control
• Spinal injuries
• Stroke wearers (mild tone only)
• Poliomyelitis
• Patient can initiate swing phase from their hip
• Hip flexion power 2+ (Oxford scale)
• The wearer can stand independently
• Minimum user weight 50kg
• Maximum user weight including carrying weight 100kg

Contraindications

• Unable to initiate hip flexion to initiate swing phase from muscle power or with compensatory movements
• Knee or hip flexion contracture greater than 10 degrees
• 10 plus degrees genu varus or valgus that can’t be reduced
• Significant muscle tone/spasticity (mild can be managed)
• Compromised trunk control
• A leg length discrepancy more than 15cm
• Muscle conditions that prevent control of an orthosis including moderate or severe spasticity
• Lack of sensory or cognitive ability necessary to operate and perceive device controls and indicators respectively

Stump care

Massage, Tapping, Desensitisation and Scar Mobilisation.

Desensitisation is believed to reduce pain, help with tolerance and touch in the residual limb and may help the patient with an amputation adjust to his or her new body image that now includes limb loss. Massage and tapping can be started early on and could be done over the soft dressing or when it is off. All these techniques could be done by the therapist and also taught to the patient/family member to do. Also, instruct the patient how to perform desensitization and distraction techniques to reduce the phantom pain.

Massage

• Massage the entire residual limb with 1 or 2 hands by doing soft gentle kneading. Be cautious over the sutured area after scar is totally heal.
• Once the sutures or clips are removed you can increase the pressure on the deeper muscles and soft tissue.
• 5 Minutes 3-4 a day or as needed to reduce phantom limb pain.
• Gently massage the proximal residual limb, to include pressure points in the inguinal region

Tapping (after clearance from surgical team)

• The residual limb should be tapped with fingertips (not the fingernails).
• When the sutures or clips are still in then gentle tapping could be done over the suture line
• This could also be done over the Rigid or soft dressing
• Once the sutures are removed a slapping motion could be done on the residual limb

Desensitisation

• This helps to make the residual limb less sensitive to touch and will improve the tolerance to touch.
• 2-3 times a day when the soft dressing is off (this could be done during or after bathing)
• Start by using a soft material, like a cotton ball, to gently rub the skin in circular motions.
• Progress by using a rougher material, like a paper towel, and then progress to a towel or cloth until you can tolerate these materials.

Scar Mobilisation

• This will keep the scar from adhering to the underlying tissue as it could be the cause of pain and blisters when the patient starts wearing a prosthesis.
• Performed when the soft dressing or compression is off.
• The patient can do this daily when taking a bath
• Place two fingers over a bony portion and by keeping the fingers on the same spot make a circular motion for 1 minute.
• Repeat this over and around the bone on the residual limb
• After wound healing, this could be done over the incision line to mobilise the scar tissue

Stump Skincare

To prevent adhesion of the surgical incision scar on the stump after the surgery, a deep friction massage is performed vertically around the scar line. The prosthesis is worn following stump maturation through desensitization and stump reduction.

Ideal Stump

The ideal stump is one that is well-healed, has a good vascular supply, soft and mobile scars, minimal pain, minimal edema, a length sufficient for biomechanical leverage but not too long to restrict choices for prosthetic components, and large surface areas for distribution of pressure.

Post-operative care – Immediate post-operative prosthesis (IPOP)

The immediate postoperative prosthesis has been purported to allow early functional gain with potential physical and psychological benefits to patients. An IPOP is a complete prosthesis with an upper or lower extremity socket and appropriate components attached.

The IPOP is an application of a rigid cast immediately postoperatively within the operating theatre and attachment of a temporary prosthesis soon thereafter.

Pre-prosthetic training

Our teams will focus on preparing your residual limb for a prosthesis. This will involve skin care, muscle strengthening, pain management, and limb shaping.  Our clinician will guide you toward reaching goals to maximize independence and prepare the limb for prosthetics.

In case of swelling or edema on the stump you have to manage the dynamics of body fluids for which you might have to wear a shrinker or compression sock to control the swelling should be expected. Interventions during the pre-prosthetic training period include therapeutic exercise, range of motion, assistive device training, wheelchair mobility, residual-limb shaping, soft-tissue mobilization, and positioning.

The shoes are specifically designed to keep your feet healthy if you have neuropathy, nerve damage, or an existing foot injury. Orthopedic shoes are shoes designed to give more comfort to those with bunions, corns, or other foot problems. Not everyone who wears orthopedic shoes has diabetes.

The shoes are specifically designed to support or accommodate the mechanics and structure of the foot, ankle, and leg.

Orthopedic footwear features

Orthopedic shoes correct three main dysfunctions:

• a deformity (toes, unevenness of the length of the lower limbs, etc.)
• instability (following a toe amputation for example)
• difficulty in putting on shoes (rheumatoid arthritis, dwarfism, etc.)

Diabetic Shoes are designed to enhance comfort and provide the ultimate protection for diabetic feet and are the best shoes for diabetics with neuropathy.

Diabetic footwear features

• Smooth fabric interior,
• Paddedwith foam that eliminates irritation.
• Enhance protection with FDA approved materials.

They are engineered with stretchable uppers that conform to the contours of the foot, easing pressure and enhancing comfort.

The wide toe box along with the extra depth design ease pressure on bunions and hammertoes and swollen feet, offering the best shoes for diabetic swollen feet.

Knee Braces

Knee braces are supports that you wear for a painful or injured knee. Some people use them to prevent knee injuries during sports. Braces are made from combinations of metal, foam, plastic, elastic material and straps. They come in many sizes, colours and designs.

A knee brace is one tool in managing the discomfort of knee osteoarthritis. A brace might help reduce pain by shifting your weight off the most damaged portion of your knee. Wearing a brace in acute or chronic condition can improve your ability to get around and help you walk farther comfortably.

Functional braces

These give support to knees that have been injured in the past. Athletes often wear them after a major injury has healed. They stabilize the knee and control motion to prevent another injury.

Rehabilitative braces

These are usually used for a period of weeks right after an injury or surgery. They keep the knee stable but still allow limited movement while it is healing. Some doctors haven’t seen a benefit from these braces and no longer recommend them.

Unloader braces

These are designed to relieve pain in people who have arthritis in their knees. They shift the weight (“unload” it) from the damaged area of the knee to a stronger area.

Prophylactic braces

These are designed to protect knees from injuries during contact sports such as football. They have become popular among athletes. Research has not proven that they work, but studies are ongoing.

Knee sleeves

These are not technically braces, but they are the most common type of knee support. They are designed to provide compression around the knee joint. This helps support the knee, and can control pain and swelling. 

Types of Knee Braces:

• Hinged Knee Brace – The Hinged Knee Brace provides mild MCL and LCL support in a low-profile design. The classic pull-on design offers a uniform fit. An adjustable horseshoe buttress can be positioned and trimmed for multiple applications. The front thigh (FT) version is a hybrid with pull-on calf and wraparound thigh allowing for adjustability for atypical legs.
• Post-Op Knee Brace – Post-Op knee brace delivers a patient centric design to provide unprecedented comfort, simplicity, and support during post-operative knee rehabilitation. The brace is designed to provide protected, controlled range-of-motion (ROM) for patients recovering from knee surgery or those who have knee injuries or instabilities.
• OA Knee Brace – O A Knee Brace provides patients with medial compartment off-loading for unicompartmental osteoarthritis. The adjustable hinge technology, which provides an effective valgus load to the knee. The hinge utilizes thumbwheel dial design that allows patients to easily adjust the level of offloading without using a tool. The flexible polymer provides an intimate, contoured fit, that keeps the brace in place all day long.

Hip Brace

Hip being a ball and socket joint needs protection till its bony maturity in newborns like CDH, DDH, Perthes disorder and osteo-arthritis. Hip Brace delivers a patient-centric design for unprecedented comfort, simplicity, and support during post-operative hip rehabilitation.  It helps deliver effective, functional ROM restriction in 15° increments. Easy-to-use abduction/adduction push buttons and malleable hip and thigh shells help provide an individualized fit for increased patient comfort and compliance. The adjustable compression belt with easy-grip pull tabs anchors the hip joint, and the padded thigh cuff increases optimal alignment.

Features:

1. Integrated belt compression with cinching straps
2. Malleable hip and thigh frames
3. Precise ROM Adjustments
4. Telescoping Height Adjustment
5. Laterally placed abduction paddle with three-point pressure
6. Customized Fit
7. Lightweight, slim-profile design

Ankle Braces

An ankle brace is a brace that is worn around the ankle to protect it or for immobilization while allowing it to heal from sprains and other minor injuries. Ankle braces are used to immobilize the joint while providing heat and compression to the bones.

Whether you want to prevent an ankle injury, have chronic ankle pain or are recovering from an ankle injury, an ankle brace is an essential piece of protection. Ankle braces provide support and protection from a variety of ailments and injuries including arthritis, plantar fasciitis, tendonitis, sprains, ankle pain, and inflammation.

Types of ankle braces

• Ankle Sleeves are made of neoprene or knit fabric, and are designed to provide a primary level of protection along with moderate compression. Ankle sleeves provide support and relief from pain, swelling, and inflammation, often recommended for those with tendonitis, arthritis, plantar fasciitis or injury.
• Ankle Supports with Straps are similar to ankle sleeves, but utilize an additional strap system over the sleeve, providing advanced protection and increased compression. Straps will typically come in a figure 8 or figure 6 configuration. Figure 8 wraps provide a full wraparound compression, which maximizes the compression level you can tighten the brace to. Figure 6 braces provide more protection from lateral movement, and are recommended for situations where you may be vulnerable to rolling your ankle and spraining it.
• Lace Up Ankle Braces utilize a shoelace design, providing maximum support and allowing you customize the tightness of the laces from top to bottom.

Ankle Foot Orthoses

Ankle foot orthoses AFOs are external biomechanical devices utilized on lower limbs to stabilize the joints and improve the gait and physical functioning of the affected lower limb. AFO is used as a supportive device and aid for ambulation through different gait stages by providing foot clearance, used to limit or assist ankle and foot ROM like; dorsiflexion, and plantar flexion, improving balance, decreasing the risk of falling, helping with weak musculature of lower legs, and to return to previous activity or facilitate patient mobility.

The most common reason you may need an AFO is foot drop, an inability to raise one foot while walking, which results in toes dragging on the ground. Foot drop is caused by weakness or paralysis on one side of the body, usually from a brain or nerve condition.

Types of AFOs

• Solid Ankle AFO: Solid ankle AFO is used to treat conditions including excessive pronation, heel inversion or eversion, forefoot abduction or adduction, and gait instability. Solid ankle AFO provides maximum ankle stability.
• Articulated AFO: Articulated AFO is used to treat conditions including excessive pronation, heel inversion or eversion, forefoot abduction or adduction, and knee instability. Articulated AFO provides controlled ankle movement.
• Floor Reaction AFO: Floor reaction AFO is used to treat conditions including excessive pronation, heel eversion, forefoot abduction, and crouch gait. Floor reaction AFO provides optimal dorsiflexion stop mechanics for crouch gait patterns.
• Posterior Leaf Spring (PLS) AFO: Posterior leaf spring (PSL) AFO is used to treat conditions including foot drop, heel eversion, forefoot abduction, and gait instability. The PSL AFO controls plantarflexion at the heel strike and maintains dorsiflexion during the swing phase of the gait cycle.
• Carbon Fiber AFO: They are modern dynamic and semi-flexible AFOs with lightweight, have 10-15 degrees for footplate the tilting start at the metatarsal to give biomechanical energy return for easy “push-off”. They are the best choice for an active person to encourage the normal gait pattern, and control torsion forces

Durable medical equipment (DME) is equipment that helps you complete your daily activities. It includes a variety of items, such as walkers, wheelchairs, and oxygen tanks.

• Is durable, meaning it is able to withstand repeated use
• Serves a medical purpose
• Is appropriate for use in the home, although you can also use it outside the home

DME that Medicare covers include, but isn’t limited to:

• Hospital beds
• Wheelchairs
• Rollator
• Canes
• Commode chairs
• Crutches
• Nebulizers & nebulizer medications
• Pressure-reducing support surfaces
• Walkers

Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) category, Medicare Part B also covers:

• Prosthetic devices that replace all or part of an internal bodily organ
• Prosthetics, like artificial legs, arms, and eyes
• Orthotics, like rigid or semi-rigid leg, arm, back, and neck braces
• Certain medical supplies
• OTS body braces
• Shoes & Inserts

CAM Boot, Pneumatic Boot

Pedorthics

Pedorthics is managing and treating conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting pedorthic devices. Pedorthics uses footwear and Insoles to help ease and treat these foot-related problems.

Medical Conditions Treated with Foot Orthotics

Medical conditions that are treated with inserts and/or orthotic shoes can be very specific or simply be based on pain an individual perceives in their foot. Some of the most common conditions are:

Plantar fasciitis (PF)

This condition is one of the more common foot injuries treated by podiatrists. It is very painful and often caused by abnormal foot mechanics or overuse.

Rheumatoid arthritis (RA)

This disease attacks all of the joints in the body resulting in inflammation, cartilage damage, bone breakdown, and dislocation of the joint itself. Many patients with RA will recognize the symptoms in their feet first.

Posterior tibial tendon dysfunction (PTTD)

The posterior tibial tendon is one of the key support structures of the foot, helping the foot to function while walking. PTTD is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in the flattening of the foot. This condition is the primary cause of flat feet in adults identified as Adult Acquired Flatfoot (AAF).

Diabetes / Neuropathy

Diabetes is the leading cause of non-accident-related foot amputations. Having diabetes can lead to nerve damage and circulatory issues often referred to as peripheral arterial disease (PAD). See our special section covering Diabetic Foot Care.

Generalized foot pain

There are a variety of other painful foot conditions that can be treated with orthotics. They include general foot fatigue, heel spurs, Achilles tendonitis, and bunions.

Custom offerings at MIH 

The treatment consists of a physical examination and “in the case of orthotics” a casting of an individual’s feet is performed. These casts create molds which are then used to fabricate the custom orthotics. The style is selected based on the needs of the individual. The orthotics can be made to wear in custom shoes, dress shoes, athletic shoes, or casual shoes.

Custom Foot Orthotics

Your feet may not be the first area that comes to mind when trying to get to the root cause of your back and joint pain, but it’s worth investigating as part of the problem. When you have structural abnormalities in your feet, it forces your feet to be out of alignment. This creates a domino effect of improper alignment, which travels from your ankles to your knees, through your hips, and to your spine, creating possible pain points throughout your body.

Using custom orthotics allows you to realign your body’s foundation and create a more balanced skeletal structure. Foot orthotics can help positively affect upward by changing your body mechanics and helping your feet absorb more impact when you walk, run, or stand. This added shock absorption can reduce pain in your back, ankles, knees, and hips, significantly improving your life quality.

Benefits:

• Instant Foot Pain Relief
• Optimized Comfort
• Improve Balance
• Reduce Muscle Fatigue
• Improve Blood Circulation
• Correct Your Posture