presented by Kathy Martin
Children with hypotonia often experience gross motor delays and excessive foot pronation. This course will review the variety of orthotic options available for hypotonia related over-pronation, ranging from simple foot orthoses to custom made supramalleolar orthoses. Evidence from the peer-reviewed literature about the efficacy of these orthoses will be reviewed to summarize what is currently known and identify the gaps in our understanding that still exist.
Dr. Martin received a BA in Athletic Training from Purdue University in 1987, an MS in Physical Therapy from the University of Indianapolis in 1990, and a Doctor of Health Science from the University of Indianapolis in 2003. She joined the faculty of the Krannert School of Physical Therapy at the University of Indianapolis in 2000, and is currently a Professor. Her clinical background includes early intervention and inpatient pediatric general acute care. Dr. Martin teaches the pediatric portion of the DPT curriculum, and her research efforts have been focused on orthotic effectiveness, and children with Down syndrome. Dr. Martin is currently the Chair of the Education Committee for the Academy of Pediatric Physical Therapy and has been actively involved in identifying best practices in pediatric physical therapy professional education. She is also the 2008 winner of the Indiana Chapter of the APTA Frances Ekstam Award for outstanding contribution to the physical therapy profession.
This chapter will present an overview of the biomechanical dysfunction of the foot and ankle with hypotonia. It will also review of the common options for orthotic intervention for children with hypotonia. The emphasis will be on the key features of each style of orthosis.
This chapter will review the peer-reviewed studies about orthotic efficacy for hypotonia. This will include a critical analysis of the strengths and weaknesses of the overall body of literature. Important outcomes from each study will be summarized.
There is no clear consensus in the literature regarding the most effective type of orthosis for hypotonia. The gaps in our evidence will be identified and expert recommendation given as to how to make decisions about orthoses for children with hypotonia. This will include simple evaluation techniques.
Because the evidence is not conclusive about which type of orthosis is best for children with hypotonia, additional factors need to be considered. This chapter will explore those additional factors that should assist in the decision-making process. Consideration of specific outcomes to track to confirm the appropriateness of the orthosis will also be discussed.