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An Open Letter to Caretakers and Therapists for Children with Diplegic CP
Progressive GaitWays president and founder Beverly (Billi) Cusick writes:
“I’ve seen hundreds of families of children with diplegia, in consultation sessions in which I routinely undertake an orthopedic assessment and evaluate postural control, movement strategies, and existing orthoses. Common denominators have emerged that appear to operate to contribute to common problems of contracture development and recurrence, and to diminishing movement skills so often seen with advancing age in children with diplegia.
“I’ve composed the attached letter for caretakers and therapists of children with diplegia to bring them together in their understanding of the sources of many common musculoskeletal problems, and of the fundamental skills and strategies that are needed for effective remediation.”
Clinicians are welcome to download and share this letter with their colleagues, clients, and prescribing physicians.
Training & Events Calendar
Instructor: Beverly (Billi) Cusick, PT, MS, NDT, COF
The content covered in this program includes the following topics:
Foot and ankle anatomy, biomechanics, development, and pathomechanics in relation to body weight orientation over the base of support and to designing orthotic modifications to optimize foot development and function.
Characteristics of and factors contributing to healthy foot development.
Elements of gait development that relate to and support foot development.
The kinesiology and pathokinesiology related to – and in support of – the safe and effective use of below-knee casts and orthotic interventions designed to improve postural alignment and control and to reduce developmental, flexible foot and ankle deformities that commonly occur in the presence of central nervous system dysfunction, hypotonia, and ligament laxity in childhood. Discussion of orthotic options includes Elaine Owen’s Tuned AFO/Footwear Combinations, heel lifting and weight-line training, and orthotic posting and foot packaging principles and strategies.
Common developmental foot deformities are identified and described in terms of plane-based anatomical components. Musculoskeletal assessment procedures are reviewed as the findings lead the clinician to a systematic clinical decision-making process regarding orthotic design in terms of desired load-bearing foot and limb joint alignment, magnitude of segment enclosure, degrees of freedom provided or restrained, and posting options. Soft-tissue extensibility findings are also used in the documentation of the effects of assorted orthotic intervention strategies.
Labs feature closely-supervised trials of several ankle and foot assessment procedures, with findings applied to orthotic posting and design. Assessment tools and materials will be provided for undertaking posting trials to preview effects of proposed orthotic modifications.