31 August 2022
John Turner, who heads up our Greater Manchester clinic, first assessed Blake on 3 May. John has a great deal of experience in treating children who have cerebral palsy and Blake has a diagnosis of quadriplegic cerebral palsy, in his case, he is most seriously affected in his lower limbs.
He underwent SDR (selective dorsal rhizotomy) at Alder Hey in 2020 but continues to suffer with significant walking issues. Although LOC is totally supportive of this ground-breaking surgery, we think it is important that parents understand it is the first step on a long road of treatment. Properly prescribed bespoke orthotics play a vital part in the rehab process, careful attention must be paid to each child’s body alignment and gait patterns. At his initial assessment, John found that Blake toe-walked with hyperextension at his knees and his balance was incredibly suspect. Unfortunately, his NHS splints had proved to be a comprehensive failure.
Blake’s second appointment with John was in our Gait Laboratory where he was put through his paces both barefoot and in his current AFOs. By correctly tuning the current AFO’s, based upon the analysis only made possible by LOC’s Gait Lab, John was able to make some immediate radical improvements. Further fine-tuning resulted in some extra wedging being added. The result was that Blake’s knee hyperextension was corrected and he was much more balanced. Grace, Blake’s mum was pleased by the comprehensive service provided by John and his Gait Lab colleagues.
“We recently attended LOC’s gait lab with our 10-year-old son in Salford. After past lab experiences, we were prepared for the long haul! However, we were very impressed with how uncomplicated this seemed in comparison!
John and the gait lab technicians were able to gather the information needed with little discomfort and fatigue being caused to our son. I would say overall it was a positive experience. It was explained to us at each stage what was being done and why. Based on the results, we were able to make informed decisions about our next course of action.”
It is difficult to over-emphasise the advantage having access to our own gait laboratory gives LOC’s clinicians. We have had a video vector gait laboratory at our headquarters clinic in Kingston since January 2015, while we have had access to Salford University’s Gait Laboratory since we re-opened our clinic there earlier this year. We are now investing in one for our Cambridge clinic, which hopefully will be ‘up and running’ before Christmas. The objective of our work within our gait laboratories is to produce prescriptions that will:
Importantly the gait laboratories provide ongoing objective measurements of the effectiveness of our orthotic treatments. The benefits of the analysis provided by our gait labs apply to adults as much as children, for example, prescriptions for adults with lower limb conditions caused by Stroke, Post Polio Syndrome(PPS), or acquired brain injury can be made more accurately and the resulting bespoke orthotics fined tuned to the most minute detail at the fitting stage.
In July Blake was fitted with new bespoke AFOs manufactured by LOC’s own manufacturing team. The prescription for these aims to stabilise Blake’s ankles, be accommodative of his contractures and crucially are adapted with footwear to optimise his balance. Blake will need regular reviews as his walking improves, to ensure that his AFOs and footwear continue to be optimal.
If your child has cerebral palsy, whether or not they have undergone SDR surgery, and you want to find out if the combination of John’s expertise and the analysis provided by our Gait Laboratory can make a difference to your child’s gait, please contact us
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.
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.
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.
This depends on several factors; the position of the chest wall deformity, its severity, the flexibility of the chest, the kind of results wanting to be achieved and the age of the person undergoing treatment for pectus excavatum or pectus carinatum.
Early adolescence (roughly between the ages of 12-16 years old) – is an optimum age to start treatment, given that the chest is still maturing, and flexible, permanent correction is more easily achievable. Once bracing treatment is complete and a patient has stopped growing, the deformity will not return. For younger pectus patients, conservative bracing is used to keep a deformity from worsening and can help them to avoid surgery in later life.
For older pectus patients (between the ages of 20 to 30) results can be harder to achieve, as the costal cartilage hardens into the bone as a person matures. Over the years we have successfully treated many adults for both pectus excavatum and pectus carinatum and active adults with flexible chests can expect good results.
Again, this hugely depends on what a patient wants to achieve from treatment; whether that’s avoidance of surgery, improvement in the appearance of the chest shape, reduction in rib flaring etc. All these goals are taken into consideration during your first consultation. While there are no serious health risks of having pectus carinatum or excavatum – beyond the cosmetic – for many patients and parents, treatment outcomes involve improving confidence and self-esteem. During our 2018 Pectus Patient Survey, 92% of pectus carinatum patients surveyed said that treatment had a ‘major improvement’ or ‘an improvement’ on their social life.
You can read the results of our 2018 Pectus Patient Survey and quality of life questionnaire here.
If you are worried about your chest shape, or your child’s chest shape, then get in touch for a free Skype consultation with one of our pectus specialists who can assess their chest and discuss treatment options. We are always happy to communicate with local GPs, thoracic surgeons and consultants if a patient approaches us for bracing treatment after considering other options.