Orthoses
Orthoses are physical devices worn externally on body parts to optimise the structural characteristics and functional outcomes of neuromuscular and skeletal systems of the body. Orthoses can come in a range of different materials from very rigid and stiff plastics to semi rigid plastics and foams to flexible elastomeric compressive fabric. Other names often used interchangeably are braces, splints, AFOs, SMOs, GRAFOs, hinged AFOs.
At Kids Focus Physiotherapy, we are proud to be the first physiotherapy centre in Singapore to prescribe and use both the ready-made and custom ranges of orthoses from Cascade Dafo. We are still the only physiotherapists in Singapore to prescribe custom Cascade Dafo orthoses. We have been providing this highly specialised service to our patients through an intimate and collaborative partnership with Cascade Dafo (based in Ferndale, WA, USA) since 2012. By providing just the correct level of support (not too much that it breeds dependence but just enough so that it facilitates), our prescribed orthoses are so specific and accurate that they can address the biomechanical insufficiencies while promoting better body kinematics and kinetics with comfort and aesthetics. Our prescribed orthoses work together with individualised physiotherapy to help children correct their gait abnormalities and improve walking efficiencies.
Since 2018, we have been working with DM Orthotics team at Redruth, Cornwall, UK to prescribe flexible compressive orthoses. We are the pioneer clinicians in Singapore to train and subsequently become certified to measure and prescribe DM Orthotics products. We feel very privileged to collaborate closely with Pam Cowans and Martin Matthews of DM Orthotics to bring these orthoses to the families we serve. DM orthoses help realign the spine and body parts and influence muscle tone and proprioceptive system. These influences help in postural correction of the spine and train muscles to work with improved tone and control. Relief from joint pains, decrease muscular fatigues and reduction of involuntary movements are also reported by users of DM orthoses. Both our neurotypical and special needs populations have benefitted in using DM orthoses. Our teen patients with scoliosis find DM orthoses more user friendly, comfortable and hence their compliance rates are high compared to traditional hard body braces.
Some flexible orthoses are made of neoprene. We are fortunate to be able to access and prescribe neoprene splints from Benik Corporation, Silverdale (WA, USA) for patients who are carefully evaluated to be suitable since 2010. In the correct patient and with the correct prescription, Benik neoprene splints is one of the most cost-effective options for patients with a wide range of needs. Benik has a highly knowledgeable and creative manufacturing team who is always willing to work with our extremely talented and innovative paediatric physiotherapists to create one-time splint that meets the unique needs of a single patient. This level of professional expertise and care results in outstanding outcomes for our patients.
Feet pain in children
How many of us parents have been woken up from our night slumber by our toddlers and young children weeping about their feet pain? Is feet pain a type of growing pains? Is growing pains a myth or mystery? At Kids Focus Physiotherapy, we err on the side of caution when we are faced with a family in such a situation. In majority of the cases, we have found that the pain reports are not random and are associated with type of day activities, footwear and personal medical histories.
Our management philosophy is to target the root causes of the feet pain, not just treat the feet pain. Our paediatric physiotherapists have advance training in paediatric orthoses prescription. However, we prescribe orthoses only as an adjunct to our overall management plan while focusing primarily on restoring mobility to stiff joints in the foot, ankle, knee or hip, strengthening weak muscles, improving flexibility in tight muscles, correcting gait abnormalities and using the correct footwear. All of these will alleviate the feet pains and steer our patients towards healthy feet and legs development.
Cerebral Palsy
This is a neurological disorder that is estimated to affect up to 4 per 1000 live births. It is also the most common motor disability in childhood. It affects one’s muscle tone (the amount of resting tension in muscle), posture and movements. It is usually diagnosed in infancy or early childhood. Caregivers often report that affected babies appear too stiff or too floppy when held, show unusual postures, exaggerated and involuntary movements and are delayed in achieving motor milestones. Many with cerebral palsy can walk with assistance, some can walk independently and even run a little. The neurological disorder does not worsen with age but some symptoms such as muscle spasticity and tightness usually get worse. Consequently, the functions (such as walking, sitting balance, climbing stairs etc.) of a person with cerebral palsy may be lost with age. Cerebral palsy is a lifelong disorder. However, with targeted physiotherapy management and support, a person with cerebral palsy can achieve and maintain a very high level independent or assisted activities of daily living.
Our paediatric physiotherapists have a proven track record of helping children with cerebral palsy. We utilise an anticipatory and preventive model of physiotherapy management to address the physical symptoms (such as muscle spasticity, stiffness, tightness, pain and weakness) and the functional consequences (such as poor posture and sitting balance, tip toe walking, lack of balance and coordination). Through the use assistive technology, mobility and strengthening exercise paradigm and gait training, we help our patients make and maintain functional improvements and motor activities.
We use scientifically validated and internationally recognised measurement tools to measure function and motor skills so that we can demonstrate to the children and families that we serve how they are doing compared to others from all around the world.
Kids Focus Physiotherapy 