Pediatric Case Studies Part 1: Orthotic Decision-Making

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This course presents examination/evaluation of 3 children whose management included orthoses: a child with Sever’s Injury, a child with Spastic Diplegic Cerebral Palsy, and a child with Down Syndrome. An examination of lower body alignment will be demonstrated in a child with Sever’s. Key biomechanical features of alignment and movement patterns common in Cerebral Palsy and Down Syndrome will be discussed. The importance of focusing on the child’s goals related to lifting their limitations in functional activities and participation will be discussed; working backward to identify potentially modifiable factors will be used to help the therapist prioritize examination components. Another goal of intervention will be to minimize the development or progression of deformity that could ultimately limit function. The need to balance optimizing current function with enabling holistic developmental progression and fitness while preserving hip location and minimizing long-term stresses on knees, feet, and backs will be discussed.

This course is part of a four course series:.

Meet your instructor

Lisa Selby-Silverstein

Dr. Selby-Silverstein is a Professor at Neumann University teaching in the Physical Therapy Program. She previously was on faculty at Thomas Jefferson University, where she also was Director of the Human Performance Laboratory. She has been a PT in rehabilitation settings, gait laboratories, developmental centers, early…

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Chapters & learning objectives

1. Examination of Standing Alignment, Gait, Pain, and Mobility in a Child with Sever’s Injury

A standing biomechanical examination, including critical components of passive ranges of motion, lower body posture and alignment, will be demonstrated. There will be an emphasis on factors that should be considered in developing a plan of care that could include orthoses. Options for quantification of pain and limits to mobility will also be discussed.

2. Examination of Standing Alignment and Gait in a Child with Spastic Diplegic Cerebral Palsy (CP)

Examination and description of standing alignment and gait in a child with Cerebral Palsy will be presented. There will be an emphasis on factors that should be considered in developing a plan of care that includes orthoses.

3. Examination of Standing Alignment and Gait in a Child with Down Syndrome (DS)

Examination and description of standing alignment and gait in a child with Down Syndrome will be presented. There will be an emphasis on factors that should be considered in developing a plan of care that includes either foot orthoses or supra-malleolar orthoses (SMOs).

More courses in this series

Scientific Basis for Orthosis Prescription to Improve Gait in Children

Lisa Selby-Silverstein

Overview of Orthoses and Alternatives to Improve Gait in Children

Lisa Selby-Silverstein