24 May 2016
Aran has diplegia cerebral palsy, which manifests itself in tense muscles and spasms. The leg muscles are particularly susceptible and, over time, joints stiffen, reducing range of motion. Nerve fibres that run from the muscles back to the spinal cord play an integral role in this stiffness.
In 2011, Aran and his parents travelled to America to undergo a type of surgery called selective dorsal rhizotomy (SDR). The operation works by dividing these nerve fibres, which helps to reduce stiffness and spasticity. US advice after such surgery tends to recommend that children are put into regular shoes (plus insoles) as quickly as possible.
Despite the early, tentative success, Aran also experienced some setbacks, including a diagnosis of scoliosis, which required further orthotic treatment. “We were encouraged to get Aran out of orthotics and into shoes,” says his Mum, Kurda. “But, his ankle kept collapsing and we were getting nowhere.”
LOC’s Sam Walmsley says this is a common experience. “A lot of people come back from the States under the impression that their child may never have to wear orthotics ever again. But, in our experience of treating patients after SDR surgery, that expectation can be unrealistic and lead to disappointment. So, it’s better to reframe the goal – let’s reduce the spasticity and help the child become as independent as possible, even if it means the continued use of orthotics. That’s a far more holistic aim: it takes into account the individual child’s circumstances and adapts the treatment to help them reach their personal potential. For us, orthotics and physiotherapy play a very important part in a child’s rehabilitation.”
With that in mind, Sam referred Aran to internationally renowned physiotherapist Elaine Owen MBE. Elaine has spent her career in the NHS working with children with movement disorders, and for the past 20 years has used a gait laboratory to analyse children’s walking, optimise orthosis designs and set physiotherapy programmes. She has developed a comprehensive method of assessment, prescription and fine-tuning of lower limb orthoses, challenging conventional wisdom with evidence-based science and rewriting the textbooks. Her methods are now the gold standard for designing, aligning and fine-tuning lower limb orthoses.
LOC's Gait Lab technology illustrating how clinicians observe the pressures and forces involved during a walking exercise. These observations lead directly to the precise creation of bespoke orthotics designed to fit the patient's individual requirements.
Once a month Elaine runs a clinic at LOC, using its high-tech video vector Gait Laboratory. The lab works by using sophisticated cameras that synchronise with a highly sensitive force measurement plate. By measuring the force in three ways, a graphical representation of where pressure is applied through the foot and leg can be projected from the camera. This, then, helps LOC to fine-tune its orthotics. Although Aran had received two previous 3D gait assessments on the NHS, this data was not specifically generated to inform orthotic treatment, but rather was designed to collect more general clinical information on Aran’s case. In Kurda’s opinion, it was LOC’s ability to apply the data generated through the Gait Laboratory to fine-tune a bespoke solution for Aran that made the real difference to his post-operative progress.
For Aran, the result was dramatic: the day after he received his new ankle foot orthotic (AFO) he was able to walk unaided for the first time. It was Mother’s Day. “On the first video we made, all you can hear is me crying,” says Kurda. “After 10 years of daily physiotherapy and swimming, not to mention SDR, hamstring and tendon lengthening, we have finally achieved independent walking – it was a mother’s day gift that would take some beating.”
Aran has now managed to walk five metres unaided – that’s the equivalent of five hundred miles for a child who has never experienced such independence. “I think having something that fits so well and feels comfortable gave him the confidence to know that he was not going to fall,” says Kurda. “But he also faces a challenge in getting used to this progress and what it means for him. I think if you have spent all your life having to hold on to something, to then have that taken away must be very strange. He’s got the physical strength, it’s now about the psychological aspect of adapting to his newfound independence and building his progress from there.”
Nonetheless, Kurda is delighted with Aran’s progress and with her experience of working with LOC. “A pair of Aran’s AFOs got split and LOC simply replaced them without charge or questions. It’s that kind of thing that makes a massive difference. My advice to other parents is to talk to someone who has been through it, get the facts for yourself. The impact this has had on my child had been enormous.”
We have the following facilities and amenities at our Kingston Upon Thames location:
We also have the Gait Laboratory for orthotics patients and Onsite Manufacturing for speedy turnarounds and adjustments whilst you wait.
We have the following facilities and amenities at our Cambridge location:
For more information about The Beechwood Complementary Medical Practice, please visit The Beechwood Practice.
We have the following facilities and amenities at our Bristol location:
For more information, visit Litfield House Medical Centre.
We have the following facilities and amenities at our Romford location:
For more information about The Colin Dove Practice, please visti The Colin Dove Practice
LOC’s clinic is based in the University of Salford’s Podiatry Department and provides treatments for orthotics, scoliosis, pectus deformities, positional plagiocephaly and club foot.
It is also the base for LOC’s northern OSKAR clinic which is run by Sam Walmsley, clinical director of LOC, in conjunction with Elaine Owen MBE MSc SRP MCSP.
Due to COVID-19, we have had to temporarily close the Salford clinic and are operating out of another clinic in Bolton.
508 Blackburn Rd,
For more information, please visit The Good Health Centre
Clothing worn is dependent on which clinic you are attending. You will be sent a letter detailing what clothing to wear along with all other details prior to any appointment at the clinic.
Working with LOC and Elaine has been a great experience – they really take the time to look at your child and understand their individual challenges and needs. For parents who are in the same position that we were, I would say do your research – see what clinics are available near you and what the costs are, but my feeling is it’s worth every penny.
After 10 years of daily physiotherapy and swimming, not to mention SDR, hamstring and tendon lengthening, we have finally achieved independent walking – it was a mother’s day gift that would take some beating.
LOC’s video vector technology measures exactly where Austin’s weight is being distributed, how his hips are moving and how his legs are moving. It’s those insights that have made his new AFOs so effective. Even within a few days, LOC’s splints have had more impact on his independence of movement than anything else we have done.
Since his new orthoses, his change has been remarkable. He is more mobile and can walk independently. Jason is now walking indoors and outdoors and is unrestricted. He is now properly enjoying the summer sunshine for the first time in a few years with no complaints of pain.
It has been a breath of fresh air – LOC’s ability to accommodate Sophie’s circumstances and manufacture her orthotics so quickly has taken a huge amount of potential stress away. Alan talks to Sophie as well - she looks forward to seeing him. He has even been able to fulfil her request to have her SMOs decorated with unicorns! It makes her feel special and much happier about wearing them.
I can now go a mile without having to stop, so it is a lot better and I’m walking in a regular pattern now. The orthotic fits perfectly because LOC took proper mouldings and photographs; they were very thorough.
Amelia was always looking for something to hold on to, now she runs around. Sam really puts in that extra effort to make the clients happy. I’d recommend LOC because they have all the equipment and extremely professional staff who have been trained by world-renowned physiotherapist Elaine Owen.
Lilac just flits about now. Every day she's getting stronger and our expectation now. We are absolutely with The London Orthotics Consultancy for the long haul now. We’ve found a business that can provide what we need and who we trust, and it’s the trust that's the most important thing to us.
My left knee hyperextends and Sam felt he could improve that condition with a different design of brace and also improve my gait with some other adjustments. The brace was such a success that I used it solely after receiving it. I am most thankful to Sam and his colleagues for their dedication to my case and their prompt assistance, which changed a potential disaster into a great tourist visit.
Multidisciplinary teams in business will sit down together and discuss a project with all parties concerned, each adding their particular expertise and insight. This is what it is like at London Orthotic Consultancy (LOC) but on a more personal level: Teamwork is evident. The camaraderie and mutual respect are undeniable. The attention to the smallest achievement is uplifting.
The orthotics help support my foot. Not only that, they have endured daily use, training for the Marathon des Sables, the race itself and they are still going! I am amazed that they survived the MDS and they are still being used today.