LOC has developed a reputation in the SDR community for its treatment and management of cerebral palsy patients who have undergone this ground-breaking surgery.
The National Institute for Health and Care Excellence (NICE) guidelines describe SDR surgery: "The aim of selective dorsal rhizotomy is to ease muscle spasticity and improve mobility in people with cerebral palsy. It involves cutting nerves in the lower spine that are responsible for muscle rigidity.” While SDR surgery is not a cure for cerebral palsy, a successful procedure can help a child’s physical state by reducing muscular stiffness and improving mobility.
We feel that SDR offers cerebral palsy patients an opportunity for rehabilitation. It is the first step on a long road of treatment. In our experience, the improvements can be dramatic. However, it is also clear that without continuing rehabilitation SDR patients will not get the maximum benefit from their surgery, and could potentially lose some of the initial improvements they make postoperatively.
Orthotics play a vital part in the rehab process. We feel that the alignment of the body needs special attention to allow the physiotherapy, personal training or just the child’s continued mobility to have a significant effect. Gait training and patterning is also essential. Learning patterns of movement at this stage can pay dividends in the future.
We believe that basic orthotic principles still apply, so we always design our orthotics to protect the developing bones of the child.
Tuned Ankle Foot Orthotics are especially good for this. However, at LOC, we also use innovative orthotics, such as DAFOs or Dorsiflexion Assist SMOs to improve alignment and gait. We also see good outcomes when we use Dynamic Lycra Garments to address postural problems and improve core stability.
All the time we aim to maximise function while maintaining alignment. We do not want to over support a joint – we want our patients to have to work their own musculature to maintain stability and posture. However, we also understand that they are often weak and have an underlying misalignment. Therefore, we want our orthotics to evolve with our patients – reducing support over time, which requires good communication with parents and other therapists.
Read Jude's story and about his treatment at LOC post-SDR surgery. Or read how LOC is helping the recovery of another SDR patient Aran from our blog.
In recognition of this, we have set up a specialist clinic within LOC called OSKAR. This stands for the Optimal Kinematic Alignment approach to Rehabilitation and is an orthotic method of treating children with lower limb neurological conditions. It was originally developed by Elaine Owen MBE MSc SRP MCSP, a world-renowned physiotherapist.
In the OSKAR clinic, we dedicate even more time to the initial consultation and utilise our video vector Gait Lab facility. This gives us highly accurate information about the forces that are exerted on a body during the gait cycle. It allows us to prescribe and fit more accurate and objectively measured orthotics.
Some parents who have struggled to fund rehabilitation treatment, as well as the original surgery, have been helped by the Tree of Hope charity.
Tree of Hope endeavours to provide assistance to families of sick and disabled children trying to raise money for specialist medical surgery, treatment, therapy and equipment. As a small charity, funds are limited, but they do everything they can to help parents achieve their fundraising goals. The process starts with a telephone or email application from the parent/carer/guardian of the child in need of assistance.
Your case will be assessed on a case-by-case basis. The Tree of Hope will get back to you and hopefully provide the hands-on help and support that is needed.
Just4Children is a recently launched charity whose objective is to provide support to families to help their sick and disabled children. Specifically, they will provide support so that families can access the quality of life-enhancing surgeries and treatments like Selective Dorsal Rhizotomy (SDR). They are currently helping Layla’s family raise £60,000 for the operation and subsequent aftercare. Layla is a 3-year-old from Wiltshire who has Spastic Diplegia Cerebral Palsy which affects the use of her legs and left arm.
To find out more: just4children.org
To get in touch:
Peterson’s Fund for Children’ is a registered local charity that supports children in Surrey who struggle with severe mental and physical disabilities. It has been in existence for 10 years and through extensive fundraising efforts has provided funding for much-needed therapy, bespoke and specialised equipment and often neglected respite care otherwise unavailable on the NHS. The aim of the charity is to help as many local children in need as possible therefore improving their quality of life and offering them opportunities to maximise their individual growth and potential.
Contact details: [email protected]
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.
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
An insole is a contoured orthotic device which alters the characteristics and biomechanics of the foot and ankle area. Biomechanics are concerned with mechanical laws and how they affect the living body, especially the musculoskeletal system.
They are removable devices, often made from plastic, that are designed to fit inside a shoe to provide additional support for your feet. As well as offering shock absorption, an insole can help distribute the weight of your body more effectively across the foot and can be made bespoke to cover a range of biomechanical conditions.
If you have symptoms in your feet, ankles, hips or your lower back that are intermittent or were not there to start with in early life, and have started to cause you pain over a period of time, bespoke orthotic insoles could be an excellent option.
If you have already tried rest, icing, compression and elevation and your feet have not recovered, we recommend a biomechanical assessment to consider the possibility of insoles. They are a non-invasive approach to treatment and in many cases, are a great option for symptoms that are not severe enough to warrant surgical intervention. Alternatively, they can be considered as an option prior to surgery.
We will send patients away when an insole is not appropriate, if a patient is suffering with iliotibial band syndrome for example, the problem can be helped with physiotherapy and a stretching programme. That’s what our biomechanical assessment is all about; determining whether there would be any benefit from altering the alignment of your feet.
Sofia’s AFOs Help Her to Stand and Walk During Lockdown
LOC’s gait lab has helped Lilac to move independently
Sam Walmsley to explain OSKAR Framework to Neuro Conference 2021 Delegates
Meet John Turner – our Manchester Orthotics Lead
LOC to launch OSKAR Framework to CMSUK 2020 Delegates
OSKAR Clinic AFOs and gait laboratory are game-changers for cerebral palsy patient Austin
Cerebral palsy patient, Sophie, maintains independence during lockdown with LOC’s help