The TheraTogs Lower Extremity System is designed to address several alignment and functional deviations of the knee joints, developing femurs, and hip joints in an independently ambulatory child, and in an ambulatory adult with no problems related to hip or trunk stability.
The Lower Extremity System is an effective intervention for the management of neuromotor, balance and gait disorders caused by a wide range of diagnoses, including:
- Cerebral palsy
- Ligament laxity
- Hemiplegia due to stroke or TBI
The Lower Extremity System can be effectively used to address a number of indications:
- Intoed gait in a child <7 years caused by excessive femoral torsion or excessive leg or foot rotation
- Excess anterior pelvic tilt caused by excessive femoral torsion or excessive leg or foot rotation
- Out-toed gait in a child <7 years caused by:
- Diminished femoral torsion
- Excessive lateral tibiofibular torsion
- Hip outward rotation bias
- Knee joint ligament laxity
- Knee hyperextension in a child age <7 years, or newly acquired knee hyperextension, caused by cerebral palsy, hypotonia, or ligament laxity
- Inadequate swing-phase knee extension in gait resulting in shortened step, caused by cerebral palsy, hemiplegia due to stroke, or traumatic brain injury
- Genu varum or genu valgum, caused by knee joint ligament laxity
- Persistent flexible foot pronation in hips/knees, caused by hypotonia or ligament laxity
- Excessive flexible foot supination, caused by ligament laxity
Working together, the client, clinician and caregiver can achieve these and similar outcomes with the Lower Extremity System:
- Supporting, assisting, and strengthening the lower abdominals
- Appropriate knee joint modeling in developing infants and children
- Improved step length
- Improve load-bearing alignment
- Assist quadriceps during late swing phase
- Use joint links to influence foot alignment and function by realigning the leg segments
- Defer or avoid the need for surgical long bone correction by using physiologic adaptation and skeletal modeling capacities in daily function.
NEW! Ehab Mohamed Abd El-Kafy (2014) The clinical impact of orthotic correction of lower limb rotational deformities in children with cerebral palsy: a randomized controlled trial. Clinical Rehabilitation 2014, Vol. 28(10) 1004-1014.
Ahl LE, Johansson E, Granat T, Carlberg EB. 2005. Functional therapy for children with cerebral palsy: an ecological approach. Dev Med Child Neurol. 47(9): 613-9.
Baquie P. 2002. Taping. General principles. Aust Fam Physician.. 31(2): 155-157.
Baquie P. 2002. Lower limb taping. Aust Fam Physician. 31(5): 451-452.
Bower E, McLellan DL. 1992. Effect of increased exposure to physiotherapy on skill acquisition of children with cerebral palsy. Dev Med Child Neurol. 1992 Jan;34(1): 25-39.
Brighton CT, Fisher RS, Levine SE, et al. 1996. The biochemical pathway mediating the proliferative response of bone cells to a mechanical stimulus. J Bone Joint Surg. 78-A(9): 1337-1347.
Brunner R, Krauspe R, Romkes J. 2000. [Torsion deformities in the lower extremities in patients with infantile cerebral palsy: pathogenesis and therapy] Orthopade. 29(9): 808-813. [Article in German]
Carter DR, Wong M, Orr TE. 1991. Musculoskeletal onotgeny, phylogeny, and functional adaption. J Biomech. 24(1):3-16.
Cusick B. 2005. Legs & Feet: A Review of Musculoskeletal Assessments, revised edition. Progressive GaitWays, LLC; Telluride, Colorado. www.gaitways.com. An instructional DVD.
Cusick B. 2000. Lower Extremity Musculoskeletal Development – Orthopedic Interventions for Pediatric Patients – Home Study Course Monograph #10.2.1. Wadsworth C, Editor. Published by the Orthopedic Section, American Physical Therapy Association. LaCrosse, Wisconsin. PH: (800) 444-3982.
Frost HM. 2004. A 2003 update of bone physiology and Wolff’s Law for clinicians. Angle Orthod. 74(1): 3-15.
Frost HM, Schoenau E. 2000. The “muscle-bone unit” in children and adolescents: a 2000 overview. J Pediatr Endocrinol Metab; 13(6): 571-590.
Gajdosik CG, Gajdosik RL. 2000. Musculoskeletal development and adaptation. In SK Campbell (Ed.): Physical Therapy for Children, 117-140. Philadelphia, PA: W.B. Saunders Company.
Ketelaar M, Vermeer A, Hart H, van Petegem-van Beek E, Helders PJ. 2001. Effects of a functional therapy program on motor abilities of children with cerebral palsy. Phys Ther. 81(9): 1534-45.
LeVeau BF, Bernhardt DB. 1984. Effect of forces on the growth, development, and maintenance of the human body. Phys Ther. 64(12): 1874‑1882.
McCullough NC. 1986. Orthotic management. In WW Lovell, RB Winter (eds): Pediatric Orthopaedics, Second edition, vol 2, 1031‑1060. Philadelphia, PA: JB Lippincott Company.
Poole JL. 1991. Application of motor learning principles in occupational therapy. Am J Occup Ther. 45(6): 531-537. Review
Rennie DJ, Attfield SF, Morton RE, Polak FJ, Nicholson J. 2000. An evaluation of lycra garments in the lower limb using 3-D gait analysis and functional assessment (PEDI). Gait Posture. 12(1): 1-6.
Stanger M. 1997. Use of orthoses in pediatrics. In Nawoczenski DA, Epler ME (eds.): Orthotics in Functional Rehabilitation Of The Lower Limb, 245-272. Philadelphia, PA: W.B. Saunders Co
Valmassy RL. 1996. Lower extremity treatment modalities for the pediatric patient. In RL Valmassy: Clinical Biomechanics of the Lower Extremities, 425-451. St. Louis, MO: Mosby.
Weseley MS, Barenfeld PA. 1971. Thoughts on in-toeing and out-toeing: pathogenesis and treatment. Bull Hosp Joint Dis. 32(2): 182-192.
The Lower Extremity System is available in the models and sizes shown below.
Note: In most cases, the Infant Lower Extremity System is appropriate only for larger infants with neuromotor issues requiring more hip and pelvis control than that which is provided by the Wunzi Infant System.
|GLE101||Infant: Boys/girls 15 to 25 lbs||GLE621||Large Female 170-200 lbs|
|GLE201||Preschool: Boys/girls 25-45 lbs||GLE701||Small Male 110-145 lbs|
|GLE301||Pediatric: Boys/girls 45-65 lbs||GLE711||Medium Male: 145-170 lbs|
|GLE401||Petite Adult: M/F 65-110 lbs||GLE721||Large Male: 170-190 lbs|
|GLE601||Small Female 110-140 lbs||GLE731||X-Large Male: 190-240 lbs|
|GLE611||Medium Female: 140-170 lbs|