Introduction: Orthotics have been used for centuries to help people with disabilities

What is Orthotic?

Orthotics is a specialty within the medical field concerned with the design, manufacture, and application of orthoses. An orthosis (plural: orthoses) can be defined as “an externally applied device used to modify the structural and functional characteristics of the neuromuscular and skeletal system” Orthotics combines knowledge of anatomy, physiology, pathophysiology, biomechanics, and engineering.

Orthoses are generally indicated for patients who may have a condition such as spina bifida or cerebral palsy or may have experienced a spinal cord injury or stroke. At the same time, orthoses are also found in order to optimize performance in sports.

The History Orthosis

keywords: history of continuous gait orthosis

We can trace back the origins of this discipline somewhere in 1741. in which the theory of human anatomy, skeletal structure, and methods to correct deformations of the bones was demonstrated. The author of the volume was Nicolas Andry, a French doctor, and writer, who played a key role in parasitology and orthopedics. Later this book “orthopedie” was translated into English in 1743 as “Orthopaedia” The father of orthopedic studies is considered to be the 18th-century Swiss doctor, Jean Andre Venel. Venel specialized in the treatment of deformations in children In 1780 he set up the world’s first-ever orthopedic clinic in Orbe where he offered orthopedic and rehabilitation services. It was the first clinic where children with skeletal deformation received comprehensive treatment. In his institute, he pioneered the production of various orthotic devices to treat children. By the 19th century, Hugh Owen Thomas, a surgeon, considered the father of orthopedics in the UK, created the ‘Thomas splint’, ‘Thomas collar’, and multiple lower limb and hip orthoses to name a few he also developed the method of examination of deformation in a lying position. The first orthoses were made of leather and metal. Today, orthotics are made up of a wide range of materials such as plastic, carbon fiber, and even 3D-printed parts.

Orthotics facts

Orthotics can be classified into two major categories: 1) bracing and 2) footwear modifications. we will be discussing some interesting facts about orthosis that you probably didn’t know about it before! -Orthotics are designed to correct or improve the biomechanics of the patient’s body. They can also be used for the prevention of injuries if worn regularly.

The earliest evidence of orthosis dates back to Ancient Egypt where they were used as a treatment for various disorders including foot deformity and spina bifida. The field of orthotics has transformed from a traditional craft-based industry into a modern professional clinical specialty.

The Modern Era of orthotic

The modern era of lower limb orthotics can be reasonably considered, which began during the early 1970s. Prior to then the design and construction of lower limb orthoses had not changed substantially since the beginning of the century.

The age of modern orthosis At the beginning of the 20th century the first modern orthoses and orthopedic splints were invented. These were the first solutions for body support. The only significant change in practice seen in recent years had been the introduction of thermosetting resins to produce plastic shells. Two revolutionary designs, the PTB Brace and the UCLA Long Leg Brace (Scott 1971) owed a lot more than their material featuring in the rapidly developing field of prosthetics. While at a parallel time period the evolution of orthosis was on the rise The pioneering developments of Engen in Houston had recognized the enormous potential and opportunities for the use of thermoplastic materials in orthotic construction this can justifiably be described as revolutionary.

 The introduction of the new material would have far-reaching implications. In addition to the obvious benefits in terms of cost and weight, it was also possible to create parts with a more anatomically correct shape than had previously been possible. They were less likely to cause skin irritation and could be molded into a variety of different forms without compromising their strength or stability. The first phase of the innovation process often involves a lot of trial and error. While many materials are explored, it is usually polypropylene that emerges as the most versatile and easily applied within the comparatively unsophisticated environment of a typical orthotic workshop.

There are some pieces of evidence that push a huge use of polypropylene in the orthotic field: A comparatively unknown general practitioner published a brief article in the year 1968 describing the use of polypropylene to fabricate below-knee braces for children with spina bifida after visiting the clinic in Houston. This represented a critical turning point for the future development of orthotics as it marked the first time that a doctor had used this material for this purpose.

The sudden emergence needs a more logical approach

The sudden emergence of a whole new range of orthotic designs in the 1970s led to the need for a more logical approach to the prescription of orthotics. Patient/orthosis matching was one of the consequences of this phenomenon. The jargon phrase to describe this process was ‘patient/orthosis matching’. Virtually all the orthotic manuals and textbooks available at the time tended to classify patients by reference to their medical diagnosis and routinely used terms such as ‘drop foot brace’ or ‘hemiplegic brace’ to describe both devices and their clinical applications. These practices had many pitfalls, but a more logical approach to describing both the orthosis user and their device was required if the goal of matching them was to be realized.

Perry proposed a model of normal physical activity and identified the body tissues and systems that contributed to each element of it. He then proceeded to propose a classification of ‘functional loss’ which completely eliminated the need for diagnostic labels to describe the disorder needing treatment. It was not until 2003 that the Prosthetics and Orthotics Technical Committee of the International Standards Organization (ISO) devised and published a standard (ISO 2003) which formalized the original ‘Perry/AAOS’ approach.

In recent years the huge development of orthotic devices is noticed. Modern orthotic braces are friendlier or we nowadays commonly refer to as bio-compatible for the patients, thanks to materials and design. Somewhere along the way, the leather straps were replaced by Velcro straps which are bio-compatible to the skin, and leather orthopedic shoes were replaced by dynamic ankle braces made of light carbon fibers. The orthopedic industry has advanced tremendously and so have the people who use them. We have evolved from having just a few models of static braces to now having hundreds of different models, each designed for specific applications.

Conclusion

Orthoses started as an unpatriotic-looking “clunky” contraption on the patient’s legs, but now it is a more sophisticated modern orthotic that is not only better for the patient and their injury but looks better too. It is clear that the world of orthotics will continue to be around to benefit patients when they need it most. Orthotics and prosthetics are very important to the medical field. They help people who are suffering from injuries or disabilities maintain their mobility and independence. Orthotics and prosthetics have come a long way since they were first introduced in ancient times, but they have always had one goal: to provide comfort for those who needed it most.