New Paradigms in Pediatric Equinus Deformity Management
A One-Day Review of Sciences & Strategies for Optimizing AFO’s
The landscape of considerations of ankle function in balance and gait, and of strategies for managing ankle plantarflexion contracture – i.e., equinus deformity – is changing to embrace the roles of the somatosensory system and postural control both as causative factors and intervention strategies. Instructor Beverly Cusick, PT, MS, COF, C/NDT reviews the relevance of ankle function in postural control, and discusses the physiology of muscle transformation and the role of spasticity in contracture formation. The content features challenges to the rationale and effectiveness of common equinus deformity intervention paradigms including stretching, blocking ankle plantarflexion at 0° with orthoses, injecting the gastrocnemius muscle with toxin, and surgically lengthening any aspect of the triceps surae muscle-tendon unit. The course presents new orthotic and training strategies, based upon the work of Shirley Sahrmann, Mary Weck, and Elaine Owen, with emphasis on children with pyramidal-types of cerebral palsy.
Beverly (Billi) Cusick, PT, MS, COF is an internationally-known pediatric physical therapist whose specialty is the management of lower extremity deformity, particularly in children with cerebral palsy and other CNS deficits. Ms. Cusick received her BS in PT from Bouve College at Northeastern University (Boston), and her MS in Clinical and College Teaching for Allied Health Professionals from the University of Kentucky in Lexington. She is an Associate Professor for the Rocky Mountain University of Health Professions – Pediatrics Program – Provo, Utah (2006-present) and is NDT basic- and baby-trained. Since 1978 she has written or co-authored over a dozen publications. She has guest-lectured at annual conferences of the APTA, the NDTA, and the American Academy of CP and Developmental Medicine; at the ISPO Consensus Conference for Orthotics in CP; for the British Association of Prosthetists and Orthotists; and most recently at the International Conference on Cerebral Palsy in Sydney, Australia. Ms. Cusick is the founder of Progressive GaitWays, LLC and the inventor, President, and Chief Medical Officer of TheraTogs, Inc.