Guideline for Orthotic Management of Lowr Extremity Disability and Custom Orthotic Seating. Orthotic Information for the Rehabilitation Team. / Wilfred Raab, W. Kaphingst y M. Rechsteiner

Vietcot Guideline for Orthotic Management of Lower Extremity Disability and Custom Orthotic Seating When organizations want to depict the needs of the disabled or the horror of war, they general-ly will use a picture of an amputee. This picture conveys a degree of the carnage and suffering caused by conflict. The amputee has suffered a great loss, but the paralysis caused by polio, birth defects, other diseases, and trauma is just as devastating. Polio is easily preventable but during political unrest, civil conflict and/or war, national immunization services are disrupted, and thousands upon thousands of new, preventable cases of polio occur. The number of cases of Cerebral Palsy, Clubfoot, Spina Bifida and other birth defects aiso increases in áreas of conflict. Some may be directly related to chemical agents used in deforestation or herbicides, and oth-ers are a result of inadequate pre and post-natal care. The incidence of trauma-related injuries as a result of road accidents and industrial accidents aiso increases in post conflict countries. National and local heath services are not generally equipped to independently handie the treat-ment of those with disability or the prevention of disability. There is a tremendous need to bring rehabilitative services to all those who suffer from the diseases, birth defects, and trauma that cause physical disability. This manual will help all those who provide direct patient services or who administer rehabilitation programs to better under-stand the orthotic services provided to those with mobility impairment. The authors have indicated early in the text that this manual was not written as a teaching manual for the Orthotist. They have not focused on the 'HOW' of orthotics but have done an excel-lentjob of describing 'WHEN' orthoses are indicated and the possible orthotic designs to con-sider. The authors aiso include an understandable description of the disease categories com-mon to Orthotics. Although this manual is not intended as a teaching text for the Orthotist, it does provide an excellent review of disease categories, pathomechanics, patient assessment, orthotic prescrip-tion, design selection, seating systems and check out. This manual aiso includes guidelines for realistically calculating costs of P&O services, a refer-ence list of publications and scientific journals, professional societies, Internet resources, P&O Schools, and component providers. This manual is an excellent resource ofinformation for those directly involved in the provisión of Orthotic services and aiso for those Administrators who mustjustify programs and expenditures. The costs of P&O services are high, but the costs to society for poor or inappropriate services are even higher.