Guidelines and examples for orthotic treatment of children and youth in case of myelomeningocele

Orthotic fitting for children and youth with MMC is mostly a fixed part of the orthopedic treatment team. Depending on the neurological status and the remaining motor function, the use of insoles, DAFOs, GRAFOs, RGOs, stabilizing corsets, as well as different types of seating systems might be necessary.

An important part of the assistive devices is the social integration in terms of inclusion, improvement of autonomy and mobility, as well as the compensation of dysfunction, painlessness or prevention of damage of the body system. All these guidelines and facts are part of the new compendium “Standard of the orthotic treatment for children and adults with neuromotor disorders” published by the neuro-orthopedic task force.

Another part in this compendium is the essential cooperation between the patient including his family and the interdisciplinary teams for orthopedics, pediatrics, therapy, and orthotics. These guidelines, combined with the definition of standards, should guarantee the best treatment for the patient as possible and create transparency for insurance groups and other disciplines.

A team of experts in neuro-orthopedic treatments created this compendium by integrating the national and international papers. It should build the basic treatment of patients with neuromotor disorders in different life periods. The main part of this classification are the functional criteria combined with the typical disorder picture and the therapeutic target.

Including the matrix for orthopedic treatments designed by Prof. Ferrari, it should be possible to define the most presumable appliance for each lesion level and to plan the needed supply for the future.

To guarantee the best result for the patient, it is important to take any static change into account while using and designing splints or other orthopedic devices.

An overview of orthotic treatment based on patients examples and graphic animations should help to understand the different types of devices and make it possible to look forward to the future.