The DynamicBracingSolutions Difference

Orthotic designs created by DynamicBracingSolutions are based on outcomes. The intended mechanical effects of each orthosis are considered before casting and fabrication begins. The goal of ambulation is to increase efficiency and function. The physical examination and the video graphic analysis of gait reveal the deficiencies and deviations that must be corrected to achieve this goal.

Each person has a different puzzle to solve. To help someone reach his or her maximum potential, it is imperative to study the person as a whole system. In turn, this system must be studied by its’ parts. Skeletal deviations are viewed in terms of how they affect the rest of the body as it moves. Such deviations result in movement patterns necessary to maintain balance and security issues. These compensations or substitutions further decrease efficiency.

All of the skeletal, neuro-muscular and compensatory deficits must be recognized in each of the three planes of motion. Triplanar control of forces at each segment, involving all levels is the basis for DynamicBracingSolutions. Solutions are developed based upon all of the information gathered and inventoried in the assessment. The ultimate solution is getting all of the segments to move in the right direction at the right time.

Skeletal deviations over time become deformities. Deformities can be functional or fixed. Functional deformities can be repositioned in a normal alignment. Normal alignment cannot be achieved with fixed deformities; however, fusions or coalitions are rarely totally fixed. Even surgical fusions break down over time. Remodeling is possible. Every degree of correction increases function.

There are three layers of skeletal deviation or displacement caused by:
1. Deformity
2. Neuro-muscular deficits (muscle weakness or absence)
3. Balance compensations
Each of these three layers must be inventoried in all three planes. DynamicBracingSolutions provides triplanar correction for all three layers of skeletal deviation.

Deviations detract from the net force of moving forward. Our bones have a particular (normal) position and alignment. Any bone or segment that deviates from the normal position or alignment detracts from the ability to move forward in an efficient manner. Walking becomes an effort as more energy is expended balancing and compensating than in moving forward. Every deviation that can possibly be corrected or maintained will add to the net force of moving forward. This increases velocity and efficiency.

Improving Function Through Structure

Static balance is the key to a successful outcome. Balance is the result of structural realignment. The true definition of an orthosis is to straighten or correct. The correction of skeletal deviations prevents deformity and provides for stability. This eliminates the need for compensations. Balance must precede ambulation. Only then can stance phase control be achieved. The stance phase is where structural control is key. Functional improvement is dependent upon balance and stance phase control.

Dynamic stance phase control is a major step forward. Standing or static structural control is essential for dynamic balancing. Understanding dynamic stance phase control and actually achieving it is what separates DynamicBracingSolutions from any other device or system. There is a fine line between structural control and allowing forward motion at the appropriate time in the gait cycle. It is this balance between stability and mobility that is the essence of efficient ambulation. A functional outcome in lower limb orthotics is based upon structural outcomes. Dynamic response bracing must measurably demonstrate structural and functional outcomes. If all of the structural deficits are not met by design, adding dynamic response can do more harm to joints and ligaments. This is a major concern since dynamic response is being used in conventional systems without the proper structural control.

A truly custom fabricated device should incorporate the intended mechanical effect, the design, the materials, the training and the outcome into an orthotic support system that improves the efficiency of ambulation. A cast impression in itself does not necessarily make the orthosis a custom device. To achieve optimal efficiency, all of the elements described must be met. Often it is assumed that all of these factors are considered and utilized. Past and current training in Orthotics does not provide the level of expertise required to solve the complex problems involving triplanar control, multi segmental involvement and dynamic response.

Given the present state of the art in Orthotics and the existing reimbursement, only a cursory subjective judgment can be made by the average practitioner; however, structural and functional outcomes are possible and measurable! DynamicBracingSolutions has taken Orthotics to the level of Prosthetic function by creating innovative designs that incorporate timing and symmetry to achieve optimal outcomes and improve the efficiency of ambulation.

The casting procedure for DynamicBracingSolutions incorporates each and every identifiable deviation. Structural control is provided for all segments throughout the walking cycle. Balance and stance phase control are emphasized. Support is placed where it is needed unlike traditional designs. Once this is understood, conventional orthotic technology will be viewed as solving symptoms rather than primary problems. The present state of the art orthoses are merely swing phase control devices that accommodate rather than correct deformity. The designs and materials are not capable of providing the structural triplanar control necessary at all three layers of skeletal deviations. To optimize balance and efficiency, all of the corrective forces are required, not just a few. DynamicBracingSolutions differs from conventional orthoses by applying all of the necessary corrective forces with innovative designs using advanced materials that allow for static balance and dynamic response.

The goal of DynamicBracingSolutions is to evaluate, cast, design an orthotic support system and provide a comprehensive solution to optimize the efficiency of ambulation.