Neuromuscular disorders include a large group of medical conditions that affect the Central Nervous System (brain and spinal cord) or the Peripheral Nervous System (muscles, nerves and the connectors between muscles and nerves).
Cerebral Palsy (CP) is the leading cause of childhood disabilities, occurring in 3.3 per 1,000 live births according to the Centers for Disease Control. CP does not progress but some symptoms may change during the child’s development. Other neuromuscular conditions include Muscular Dystrophy, which is a group of more than 30 inherited genetic disorders that lead to progressive weakness and muscle degeneration, and Spina Bifida, which is a neural tube birth defect that damages the spinal cord and nervous system.
Symptoms vary widely by person and condition, both in type and severity, but may include increased or decreased tone, loss of muscle mass, weakness, muscle twitching, shaking, cramping, stiff or tight muscles (spasticity), walking on the toes, a crouched gait, drop foot, numbness and tingling. Although there is no cure for these conditions, treatment can improve motor skills and ambulation.
Solutions may include:
- Lower limb orthoses: These braces range from shoe inserts to ankle-foot orthoses (AFO) to bracing solutions that continue further up the leg, including knee-ankle-foot orthoses (KAFO) and hip-knee-ankle-foot-orthoses (HKAFO).
- AFOs are the most common and vary greatly in the design and the types of materials used. AFOs may be solid or hinged at the ankle and may have a removable foot plate. Most AFOs are made of plastic but can also be made from leather, carbon fiber, silicone or metal.
- AFOs are a commonly accepted way to improve ankle movement, foot alignment and all aspects of a child’s gait, including walking speed, step length and stride length. They can also provide positive benefits to the knees and hips.
- A commonly accepted principle of treating neuromuscular conditions with AFOs is to adjust or “tune” AFOs, ideally in combination with the child’s shoes, to improve their effectiveness.
- Spinal orthoses: Thoracolumbosacral orthoses (TLSOs) correct spinal curvatures, scoliosis, and can improve balance and stability as well as control of the extremities, head, neck and trunk.
- Functional electrical stimulation (FES): The combined treatments of dynamic assist bracing and electrical stimulation appear to be effective in reducing upper extremity tone and improving dexterity and grip.
Your orthotist is the member or your healthcare team who will find the best orthotic solution(s) to meets your child’s treatment goals. He or she will then ensure that the braces are doing their job and are as comfortable as possible for your child.