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OBJECTIVES

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At the end of this chapter, all students are expected to:

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  1. Describe the types (categories) and functions of trunk, spinal, and cranial orthoses.

  2. Identify and describe the parts of trunk, spinal, and cranial orthoses, including the materials, componentry, and designs that are used in contemporary appliances.

  3. Describe the impairments that may be improved by trunk, spinal, or cranial orthoses.

  4. Discuss applications for trunk, spinal, and cranial orthoses and their impact on patients' functional abilities.

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Physical Therapy students are expected to:

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  1. Determine the need for a trunk, spinal, or cranial orthosis based on examination findings.

    1. Evaluate client examination findings, including preorthotic prescription examinations, lower quarter biomechanical assessment, and gait and functional analyses, to diagnose impairments that may be improved with a trunk, spinal, or cranial orthosis.

  2. Develop appropriate goals for a trunk, spinal, or cranial orthosis based on a client's impairments and functional requirements.

  3. Describe the biomechanical methods employed in trunk, spinal, and cranial orthoses to achieve the orthotic goals.

  4. Develop and execute a search strategy to locate research evidence for the effects and effectiveness of trunk, spinal, and cranial orthoses and to identify best practices for orthotic prescription.

  5. Recommend an appropriate orthosis as part of a plan of care for individuals with specific impairments of the trunk, spine, or cranium.

  6. Examine and evaluate trunk, spinal, or cranial orthoses for acceptable fit, function, comfort, and cosmesis.

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CASE STUDIES

Tyrone O'Neal is a 17-year-old high school football player who sustained a T8 fracture in an auto accident in which he was thrown from the car. Tyrone is also presented as a case study in Chapter 16. His accident occurred 2 weeks ago, and he received immediate decompression and spine stabilization surgery at a trauma center. Despite prompt treatment, he still has a complete spinal cord injury (ASIA level A) with neural motor and sensory levels at T12 bilaterally. His medical condition is stabilizing, and he will be discharged to a rehabilitation hospital shortly to begin more intense rehabilitation. Although hardware to stabilize his spine and support the segmental fusion was put in place during his surgery, Tyrone's surgeon wants him to use a spinal orthosis during his active rehabilitation for protection of the fusion.

Janice DiSimone is a 12-year-old child who was just diagnosed with adolescent idiopathic scoliosis (AIS). She has a double thoracolumbar curve. The thoracic curve, which is the primary curve, is a right 30° curve with the apex at T9, and the secondary lumbar curve is a left 26° curve at L3. She is premenarche, and her iliac apophyses are rated as Risser 1. Janice is very athletic and participates in many very active sports, including soccer, gymnastics, as well as other sports.

Sarah Schultz is a 72-year-old retired secretary and widow who has just recently been diagnosed with osteoporosis. Unfortunately, this diagnosis was not made until she went to the doctor with complaints of unrelenting back pain ...

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