February

A Publication of Westcoast Brace & Limb

The Westcoast Wire Volume 8, Issue 1

An Upright Solution for CP Kids

February 2007

The newest development in hands free upright standing for children with neuromotor impairments is now available through Westcoast Brace & Limb. After three years of development with therapists, orthotist and engineers Sky Medical has created the Triumph Ambulatory Orthotic System (TAOS) to help children experience the world in an upright fashion through this hands-free walker.

but also acts as a therapy tool to encourage proper gait. Another primary goal of the TAOS was to create something that is easy for the parents use with the child at home. The TAOS has a sit-to-stand and “easy dock” system for joining the orthotic element with the mobility base. Even more functional is the fact that the product is compartmentalized to allow quick break-down and transport both in the home and for therapy.

Also, sign up today for the Westcoast Brace & Limb EXPO on June 20th to get CEU training on the TAOS.

The product is unique in that has both an orthotic component and a mobility base. The combination of both not only creates support

If you would like to find out more about this product please call Greg Bauer, Westcoast Brace & Limb. 813-985-5000.

The unique paddle design actually imitates what I do as a therapist with my hands. It draws one leg into extension while the other leg moves forward into flexion, thus facilitating the reciprocal pattern of gait.

Inside This Issue WCBL 2007 Expo The Prosthetic Experience June 20th, 2007

2

Looking For An O&P Speaker?

2

The Treatment of Plagiocephaly

2

Post-Polio Syndrome and Patient Profile

3

Ask the Prosthetist Jason Kahle, CPO Westcoast Brace & Limb

3

The sit to stand feature is also a big plus. Many parents have commented on how much easier it is to get their child into the device.

The Westcoast Wire is a free newsletter produced quarterly by Westcoast Brace & Limb. If you have any comments or questions, please call : (813) 985-5000 Write to us at: 5311 E. Fletcher Ave. Tampa, FL 33617 Or E-mail us at: [email protected]

Therapist Testimonial Suzanne Davis RPT The TAOS is designed like no other hands-free walker. The alignment it provides is critical to helping children develop strength and better motor patterns.

TAOS Benefits: * Provides a safe upright environment * Enables your child to enhance his or her ambulatory skills * Builds self esteem and independence * Acts as another set of hands for your therapist—making it an indispensable tool for gait correction and body support * Encourages many physiological improvements --children utilizing the this system see improvements in range of motion, bladder and bowel, respiratory health, head and trunk control, and overall strength

The TAOS is an excellent therapeutic tool and works well with children of varying abilities gain better coordination, strength, symmetry, and an improved gait pattern. I have used the TAOS with children who have difficulty with head control and have no form of independent mobility and have been thrilled to see these children get up on their feet, hold their heads up and start taking steps!

Save The Date - June 20, 2007 Westcoast Brace & Limb Annual Expo Physicians,Therapists, and Patients Invited

Register Today for the 2007 Westcoast Brace & Limb Expo: The Prosthetic Experience Mark your calendars for the 2nd Annual Westcoast Brace & Limb Expo, The Prosthetic Experience, June 20th. “The goal of the Expo is to provide a forum for patients, physicians, therapists, and product manufacture’s to share information on the advancement of prosthetic technology,” states Greg Bauer, President and CPO. “We found great success in 2006 as our first year and have decided to incorporate several suggestions and feedback from our patients for our 2007 event,” added Bauer. Some of the changes include a patient pre-evaluation prior to the event to ensure the patients’ goals are met the day of the expo. The event is called The Prosthetic Experience to emphasize the objective of

providing information and resources for the patient to help educate on new products and procedures available. There will be several vendors with demonstrations as well as therapists to answer questions or provide tips in amputee patient. The Expo is open to amputees, family members, physicians, therapist, case managers and anyone else who wants to learn more about prosthetics. There will be food, prize giveaways, and lots of interaction for attendees with Florida licensed and ABC certified prosthetic specialists, therapist and physicians. Vendors are invited to attend and will get the opportunity to have a table at the expo or present on their products and ser-

vices. For more information or call Sarah at 813-985-5000 or check out our web site www.wcbl.com in the coming months.

Need An O&P Speaker? Westcoast Brace & Limb has highly qualified orthotists and prosthetists on staff who have experience speaking on a variety of O&P topics in all types of settings. For more information about the speakers or topics, please call Sarah at (813) 985-5000. We also can provide CEU credits for many of our programs.

Early Intervention: Important In Achieving Positive Outcome In The Treatment of Plagiocephaly Reprint from Fall/Spring 2004

sleep position, premature birth, intrauterEarly recognition and intervention in the ine positioning, birth trauma and orthotic treatment of cranial asymmetries muscular torticollis. Regardless of the is crucial in obtaining successful results. cause or deformity, early treatment can These results can be seen in recent case be the key to successful results. studies of Westcoast Brace & Limb paThe ideal starting age of treatment is betients. tween four and six months old. Skull Cranial asymmetries are generally classified into three categories or a combination of those categories. Plagiocephaly is characterized by an obliquity of the skull with a flattened area on the back of the skull and a frontal prominence opposite of the flattening. Brachycephaly refers to a short and wide head shape resulting from the width of the skull being too large in ratio to the length. This ratio is referred to as the cephalic index. A normal cephalic index is approximately 78% width to length. The third classification, scaphocephaly is characterized by a long and narrow head shape. The deformities can be the result of several different causes including infant

Page 2

growth is most rapid during the first few months after birth and begins to slow as the child nears one year of age.

Figure 1 (top) At the child’s initial evaluation, left frontal and right occipital flattening, and right anterior and left posterior bossing was seen. Figure 2 (bottom) - The patient now has equal transcranial measurements and improved cranial width to cranial length measurements.

The success of early treatment can be seen in the case of a 3½-month-old male with a combination of plagiocephaly and brachycephaly. At initial evaluation, the child’s oblique transcranial dimensions showed a difference of 20mm with left frontal and right occipital flattening, and right anterior and left posterior bossing (See Figures 1 and 2). The cephalic index was calculated to be 100%. After an ini- wearing the remolding orthosis, the patial break-in period, the patient wore the tient ments and a significantly improved cranial remolding orthosis cranial width to cranial length ratio (See Figures 2 and 4).Along with early recog23 hours a day, and was seen every two nition and treatment, patient compliance weeks for follow-up measurements. At 7 and regular follow-up is essential in ½ months old, after four months of achieving successful results.

The Westcoast Wire

Post-Polio Syndrome Patient Profile: Dave Scafidi The polio epidemic that hit the United States in the early-mid 20th century brings back chilling memories to anyone who was directly impacted or had a friend or love one survive polio. Polio at the time was a complex condition that a left a unique and different impact on anyone diagnosed with the disease. Now some 40-50 years later survivors who thought they had learned to beat or cope with the horrible disease, are now facing a new and unwelcome reoccurrence of past ailments. Post-polio syndrome has been found in over 60% of previous polio patients. According to the National Center for Health Statistics, there are an estimated one million polio survivors in the United States. A very scary realty is the lack of expertise or experience with treatments. Because this group is an aging generation the demand for research and funding is very limited. The nature of the illness is an aftereffect of a disease once treated. The symptoms are similar to the ones from being diagnosed the first time around. Patients complain of deep muscle aches and uncontrollable twitching or spasms. However, with post-polio the symptoms come on at a more gradual pace very different to the first time around. The treatment is also very different from the first methods used when the polio was diagnosed. There are no drugs available for post polio. The key prescription for health is to CONSERVE. Everything the patient did when they were first diagnosed – pushing hard, building strength, fighting the disease is not the way to handle treatment as an aging patient. Physicians are urging rest, relaxation, to slow down, to take it easy and to conserve. This is quite a shift in mentality for most survivors.

Volume 8, Issue 1

Dave Scafidi was pronounced dead at birth. Now at age 42, Scafidi, a polio survivor is very much alive and kicking and understandably skeptical of any diagnosis concerning his health. He has learned to ride the roller coaster of emotions that come with a disease like polio but has taken the leading role in determining his health care plan of action. Scafidi was diagnosed with polio at two months of age and spent the first of quarter of his life, up to age 12 being shuffled to various medical specialists and hospitals trying multiple treatment plans for his illness. He was a tough kid and did not let the disease hold him back or slow him down. He played baseball like all the other kids and was even the catcher with only one fully functioning arm. Recently he noticed fatigue and muscle weakness similar to his childhood ailments. He went to several specialists and was even told that he may not have ever had polio. That’s when Scafidi did what he used to do, his own research and diagnosis when he came across Postpolio syndrome. Living in Florida he was able to locate a specialist in the field of Post-polio, Dr. Burton Marsh in Ocala who confirmed he was indeed suffering the effects of the earlier treated disease. Unfortunately the treatment plans of the past – just push through with strength and determination is not the advice for post-polio syndrome. Scafidi is trying to slow down and rest when he can but managing a new catering business, opening a restaurant, and hot air ballooning on the weekends keeps him constantly on the go. “I know I’ve got to slow down and sometimes it’s not even a decision that I am able to make. My body just stops. But, my brain is moving so fast that I get very frustrated. Life is too short to sit around!” said Scafidi.

Ask the Prosthetist: Jason Kahle, CPO Q: How soon after an amputation can a patient be fitted for a prosthesis? A: The timing on when to fit for a prosthesis post-amputation depends on two factors. The first critical point of review is the edema level. Post surgery there is substantial swelling that is controlled through a shrinker or ace wrapping. At the point when the distal circumference equals the circumference on the knee the patient is ready to be fitted. Secondly, the amputation suture line must be fully healed with all sutures or staples removed before the patient can be fitted for the prosthesis. There should be no fluid discharge from the suture site. (Each patient will heal at a different rate depending on his or her compliance to care instructions and their individual resilience.) Q: How do you determine which prosthesis should be worn by the patient? A: There are hundreds of feet, knee and sockets on the market. Prosthetists spend a majority of their time analyzing, testing, fitting, and training with the various components and are a great source ofinput for the final product determination. Page 3

Some of the common considerations include the patients age, weight, activity level, and condition of the residual limb. The patients weight has a major impact on the functionality of the product therefore several manufactures have a weight limit recommendation. Also, there are products that suit a patient’s lifestyle more than others. For example, a golfer may need something that allows more torsion so an adapter would be recommended that enables the rotational force needed during a golf swing. Also, there are products that can enable various heel heights so that woman can adjust according to her shoe selection. Age often times is a big factor in determining a component choice. Younger more active patients need a higher functioning prosthesis than a more mature and static patient. And finally, the shape and size of the residual limb is a very important factor in the proper fit of various types of prosthesis. The best thing is to work with your prosthetist and let them do a full evaluation before you make a final decision on the proper components and design.

North Tampa Office 5311 E. Fletcher Ave., Tampa, FL 33617