Be safe this weather, consider Yak Trax or NEOS.

YakTrax can be found at: www.yaktrax.com

NEOS Over Shoes can be found at: http://www.overshoesonline.com/

CAF was “Established in 1997, the foundation recognizes the athletic greatness inherent in all people with physical challenges and supports their athletic endeavors by providing unparalleled sports opportunities that lead to success in sports — and in life.”

The CAF has five programs to help athletes; Access for Athletes, Operation Rebound, Catch a Rising Star, Reach High and Project N.E.X.T.  Access for Athletes is the CAF’s  flagship program.  This funding program steps in where rehabilitation and health insurance end by providing funding grants for equipment such as sports wheelchairs, hand cycles, mono skis and sports prosthetics, as well as resources for training and competition expenses for physically challenged individuals.

Access for Athletes grants are distributed annually. Applications are available September 1st every year and must be postmarked by December 1st. Grant awards are announced in early April. Check out the application or read the FAQs for more information at their website: www.challengedathletes.org 

Here at Bio Medic, we feel that being able to help amputees return to the sports and activities they enjoyed prior to amputation is of paramount importance.  With the assistance of the CAF, we help return our athletes and sports enthusiasts alike to the court, field, track, etc! 

I hope this blog has helped raise awareness to the opportunities that exist for all amputees.  Whether you would like to return to running, or you already run and would like funding to travel to an event, the Access For Athletes Program is here to help!

One of the patent models featured in this exhibit was of a below knee prosthesis with a new and improved knee joint mechanism for a joints and corset style design.  This patent (#29494) was called “artificial Leg” and was from 1860 – created and submitted for patent by Benjamin Jewett of Guilford NH.  This patent model is a great specimen of many prosthetic designs of the past!  The model had wonderful crafted joints and a leather corset design with patella cap.  It was an exoskeletal design made out of wood with a wooden foot.  The foot was really interesting in that it was wood until the ball of the foot, at which point, there was a “joint” of sorts and the toes appeared to be of a softer material, though probably also wood.  I would speculate that the joint in the foot was used to allow for easier roll-over, simulating to our own anatomical proximal toe joints.  I have never seen this style foot in person, though there were several pictures of similar feet in my book from prosthetic school.  I found the patent to this prosthesis’ knee joints online at: Prosthetic knee joint patent.  This is the first time that I have ever actually read a patent.  Its descriptions and design is a really unique piece of American prosthetic history.  You can check out the Smithsonian’s web link to this exhibit at: Smithsonian exhibit. 

I have now returned from my brief vacation, but I can’t stop thinking about how wonderful it was to bump into such an amazing museum exhibit that even someone like me could find truly fascinating.

I recently returned from Atlanta, Georgia where I attended the 38th Annual American Academy of Orthotists & Prosthetists annual meeting & scientific symposium.  I set several goals for myself at this conference.  Aside from learning about new products and techniques, I really wanted to take home some evidence based practice strategies so that we here at Bio-Medic Appliances can better apply our knowledge to each patient that we work with, as well as better justify what we do for each patient.

One area of special interest to us is “bracing” for Idiopathic Toe Walkers (ITW).  ITW is derived from unknown causes, though 30% of ITW children have a family history of this dysfunction.  ITW differs from toe walkers that have underlying diagnoses such as cerebral palsy or autism.  It is also important to note that ITW is only considered abnormal if your child is 2 years of age or older.  Often in younger children, you may see some toe walking, but it’s not of concern unless it persists past the 2 year mark. 

Traditionally, ITW is treated with articulating Ankle Foot Orthoses (AFOs), with plantarflexion stops set at 90 degrees.  The plantarflexion stops prevent the child’s feet from pointing down past 90 degrees and, therefore, eliminates the toe walking.  ITW children typically are otherwise “normal” with no additional differences or deficits.   Because there are no other differences or deficits that need to be treated, I’ve noticed recently that some doctors and even orthotists believe that utilizing AFOs on these children is over bracing.  In light of this newer concern regarding over bracing, there have been other “bracing” options explored.  
At the Academy conference I attended, one well presented research study showed some very interesting outcomes with respect to treating ITW.  Their study compared pre and post treatment gait analysis for a large group of children treated for ITW.  The children were either treated with AFOs, or Foot Orthotics (FOs) with carbon fiber foot plates.  The FOs corrected any foot and ankle alignment concerns, such as pes plano valgus (flat feet), and the carbon fiber foot plates prevented flexion at the metatarsal-phalangeal joints (ball of the foot).  The concept behind treating ITW children with FOs and carbon fiber footplates is that by supporting the foot and ankle complex with a custom molded foot orthotic and restricting toe walking with the full length footplate, the children will be unable to toe walk and/or will not subconsciously revert to doing so, due to the support of the foot orthotic itself. 

The outcome of this study showed through gait analysis that the in-brace gait is 100% corrected with AFOs and the in-brace gait was only 67% corrected with the FOs.  Post treatment, however, there was regression with 50% of the kids treated with AFOs and no regression with the kids treated with FOs.  It is also important to note that the researchers asked many questions of the children’s parents and the data showed that only 28% were happy with their childrens’ outcomes with the AFOs, whereas 60% were happy with their childrens’ outcomes with the FOs. 

In the end, this study made two suggestions to those treating toe walkers.  They suggested that we first consider a clinical progression of care that starts with FOs, which, if determined to be ineffective, progresses to AFOs.  Second, they suggested and reinforced that starting with FOs in the ITW kids was determined to be an appropriate treatment path, and that this should not be considered appropriate research/finding for any other toe walking populations, such as Autism or Cerebral Palsy because this was not within the scope of their research. 

What did I take home from this research presentation?  Well, as the saying goes: “there is more than one way to skin a cat.”  While treatment options vary around the country, here at Bio-Medic Appliances we most often treat toe walking with articulating AFOs.  This study is a nice reminder to be open to other options and to really take a good hard look at each child we work with, to ensure that the treatment we choose for him/her is the most appropriate option.

Holiday Friendly Diabetic Meals

Join the Camp No Limits family: www.nolimitsfoundation.com, Bio-Medic Appliances did!

I am VERY excited to be heading over to Rome, Maine to volunteer as a camp counselor at Camp No Limits tomorrow through Saturday!  Camp No Limits is a non-profit organization 501 (c)(3) providing camps for children with limb loss, and education, mentorship, and support to these children and their families.

This will be my second time volunteering at this camp.  Camp No Limits is an amazing place for children with limb loss to socialize with other children and for their parents to socialize with other parents.

Check out their web site: www.nolimitsfoundation.org

If you are an amputee and have wanted to give back to the amputee community, consider volunteering.  If you have a child with limb loss, sign them up for camp!  This camp is a life changing experience for all the campers, parents, staff and volunteers, don’t miss out!

Attending a national conference on pediatric care can be a heart wrenching task.  There are so many symptoms, syndromes, diseases, etc. that wreak havoc on our pediatric population.   Learning about all of these disorders, especially those that are life threatening, is a tough pill to swallow.   Knowing that there is such a large worldwide community with the common goal of improving children’s quality of life and level of function is heartwarming.   The ACPOC conference truly serves as a forum for shared dedication to improving the care of our pediatric population. 

This year’s ACPOC conference included many new presenters:  physicians, physical therapists, occupational therapists and prosthetists/orthotists.  One topic discussed was meningococcemia/bacterial meningitis.  Complications with contracting meningococcemia are especially personal for me because when I was in college at Villanova University, one of my fellow classmates died from it.  In recent years, I have worked with a wonderful advocate within the Meningitis Foundation of America to educate healthcare workers and families about the prevention.   Although there are simple solutions to preventing this horrific disease, educating the public remains an uphill battle. 

I have a fondness and interest not only in the prevention of this disease, but in the limb salvage of those that survive it.  At this year’s ACPOC conference a return lecturer spoke on his surgical treatment for children fortunate to survive meningococcemia/bacterial meningitis.  He strongly supports delaying any sort of amputation, barring wet gangrene, until the child’s body has itself delineated a point on each limb where the healthy tissue stops.  This surgeon is a pioneer of using wound vac systems on children’s limbs in order to draw circulation into the extremities to promote increased healing and more distal limb salvage.   The impact of this treatment gives children longer, more functional limbs and often retains elbow and knee joints.   Improved limb salvage gives these children the potential to have increased function not only with their residual limbs, but with their prostheses.  In some cases, it has been shown that using wound vac systems can prevent amputation. 

The most unbelievable fact that I learned about meningococcemia/bacterial meningitis is that there are two vaccines for it, yet these vaccines are not commonly provided.  The awareness that there are in fact vaccines that could practically prevent this disease from occurring to children and young adults needs to be spread!  Please visit the Center for Disease Control’s website for more info on the vaccines; it could save your child’s life:  http://www.cdc.gov/meningitis/vaccine-info.html.

If you would like more information on meningitis and the disease called meningococcemia which is a bacterial infection that often results in death, or severe limb loss, please visit the meningitis foundation of America’s web site at:  http://www.meningitisfoundationofamerica.org.

I could go on and on about the necessity to educate families about insisting their children receive the meningitis vaccines.  It is not a required vaccine for schools or sports, yet the close interaction of children in those environments is exactly what puts children at risk.  If you would like more information on the wonderful surgical techniques that I learned about for limb salvage, or any information on the disease itself, I would be more than happy to help.

Alas this blog is getting long, check in soon to see what other thoughts are running through my mind!

~Sarah