Upper Extremity Orthotics for Children and Youth with Cerebral Palsy

Abstract

Children with cerebral palsy or similar neurologic conditions present to therapy with a multitude of soft tissue issues, joint instabilities, and postoperative needs. Upper extremity orthotic intervention techniques used in the adult population cannot be transferred easily to this population due to the presence of both irregular tone and developmental needs. This chapter reviews techniques of orthosis fabrication for the pediatric client with tone in the realms of postoperative orthoses, common contracture management orthoses, custom and prefabricated functional orthoses, and motor reeducation orthoses. Material and design recommendations are discussed for each intervention with focus on developmental needs and needs of the family unit as well. The effect of function during orthotic intervention is discussed for each type of orthosis exploring the relationship between body structure, function, and participation in larger contexts. The research on orthotic intervention with this population is scarce. Overall results from the studies that were reviewed are mixed and largely cannot be generalized due to small study size. More high-level research studies on these interventions are clearly needed.