There are many potential approaches to rehabilitation following stroke or other neurological insults. Some centres use casting and orthoses.
This event brings together practice from two different sites using casting as an early intervention and share their reasoning and approach.
Early mobilisation post stroke is emphasized as a key component to rehabilitation. The recently updated National Clinical Guideline for Stroke (2023) recommends people with weakness after stroke should be taught task-specific, repetitive, intensive exercises or activities to increase their strength. Exercise and repetitive task practice should be the principal rehabilitation approaches, in preference to other therapy approaches. Additionally, the guidance emphasizes that people with limitations of dorsiflexion or ankle instability causing balance limitations after stroke should be considered for ankle-foot orthoses.
Learning of any kind is dependent on having the appropriate demands on a system. Learning is reinforced by repeatable, consistent, and frequent demands on a system. The biggest demands on our lower limbs is gravity and ground reaction force. Ground reaction force generates moments about our weight bearing joints to which our neuro-muscular system must react to provide the accelerations, decelerations and stabilisation required to produce the smooth and stable pattern we know as gait. This study day will aim to explain the importance of alignment to produce normalised demands on our neuromuscular system, in order to elicit a more normal response after stroke.
Within the day, we will describe a simple clinical test to identify patient response to normal alignment and how orthotic techniques can ensure repeatable optimal alignment as part of a treatment plan. We will highlight the importance of early intervention to prevent secondary complications such as contracture, worsening spasticity and delayed optimisation of function for patients. This is highlighted with a discussion around case studies.
We appreciate the financial challenges on training so have kept costs to a minimum and cost includes lunch and all refreshments.
We hope delegates will share their experiences to add to the day.
We hope you enjoy the event.
Paul Charlton MSc
Orthotist and organiser
On behalf of FORTH (Forward Orthotic Thinking) Peacocks Medical Group
Queries to Paul@Peacocks.net