Acquired brain injury and the orthotic approach
An overview of how brain injury affects movement and gait, and of supportive orthotic options.
What is acquired brain injury?
Acquired brain injury is a condition in which brain tissue is affected by a cause that is not present from birth but arises during life. It can develop for different reasons, such as a blow resulting from an accident, vascular events or the brain being deprived of oxygen for a period of time.
Depending on the affected area of the brain and the extent of the injury, the person may experience different symptoms. Movement, balance, muscle control and gait are among the areas where these symptoms are most frequently observed.
The recovery process varies from person to person and usually requires multidisciplinary teamwork. Exercise, physiotherapy and, where deemed appropriate, supportive orthoses may be considered as part of the treatment plan. Decisions on diagnosis and treatment are made solely on the basis of the physician's assessment.
What changes in the brain and nervous system?
The brain is the center that generates and regulates the movement commands sent to the muscles. When an area is affected, the signals carried by the nerve pathways passing through that area may change; this can lead to differences in muscle strength, muscle tone and the timing of movement.
- Reduced muscle strength or weakness in certain muscle groups
- Increased muscle tone (spasticity) and restricted movement
- Changes in balance, coordination and gait pattern
Main types of acquired brain injury
The grouping below is for general information; the clinical picture and course differ in each person, and the assessment is made by the physician.
Traumatic causes
Injuries caused by external blows to the head fall into this group. The effects may vary depending on the location and severity of the blow.
Vascular causes
Disruption of blood flow in a particular area as a result of events involving the vessels that supply the brain can affect movement and sensory functions.
Oxygen deprivation
Injuries that develop because the brain does not receive enough oxygen for a period of time can affect a wide range of functions.
Other causes
Conditions related to infection, inflammatory processes or masses in the brain can also lead to acquired brain injury.
Effects on daily life and gait
Gait is one of the areas in which brain injury is most noticeable. Weakness in the muscles that lift the foot can cause the toes to catch on the ground during a step; increased muscle tone can cause the foot and ankle to remain in an undesired position.
These changes can affect balance and the sense of confidence and can lead to difficulty in daily activities. Early and regular assessment helps in planning suitable support options.
The supportive role of ankle-foot orthoses
Ankle-foot orthoses may be considered as part of the treatment plan to support the foot and ankle in a suitable position. The aim is to help the foot move in a more controlled way during a step and to support gait.
- Supporting lifting of the toes during a step
- Keeping the foot and ankle in a more balanced position
- The orthosis is selected according to the person's muscle tone, activity level and the physician's assessment
The orthotic fitting process
Physician's Assessment
The fitting begins with a specialist physician's assessment and a prescription/medical report.
Measurement and Planning
The person's muscle tone, activity level and gait are assessed; the suitable type of orthosis and the service plan are determined.
Fitting and Adjustment
The orthosis is fitted; the fit and settings are adjusted to the individual.
Follow-up
Training on use is given; follow-up is provided for check-ups and, when necessary, adaptations.
Frequently asked questions
How does an orthosis affect gait?
Ankle-foot orthoses are a supportive part of the treatment plan; the aim is to support the foot and ankle and contribute to gait. Results vary from person to person and are determined by the physician's assessment.
Does using an orthosis replace exercise?
No. An orthosis is a support that complements the physiotherapy and exercise program. Fittings are planned under the guidance of the physician and physiotherapist.
How long is an orthosis used?
The duration and manner of use are determined by the physician according to the person's condition; because needs may change during recovery, regular check-ups are recommended.
This content is for information purposes; please consult your physician for diagnosis and treatment. Fittings are carried out at our licensed center locations in line with a specialist physician's prescription/medical report.
