Lower Extremity / Upper Extremity / Spinal Bracing / Pediatrics

Orthotic Devices for Lower Extremities

Lower limb orthoses are bracing devices used to manage orthopedic and neurologic effects on the otherwise intact extremities. Lower limb orthoses are used to provide support to a limb, improve alignment, improve function, control motion, reduce falls, provide pain relief, correct deformities, and reduce deformity progression.

Our orthotists specialize in adult and pediatric orthotic care. An orthotist’s main goal in creating an orthosis for a patient is to make an orthotic device that is lightweight, functional, and comfortable to help a patient restore function and improve quality of life. If you are actively working with a physical therapist, we will seek your permission to collaborate with them to ensure our design also meets the long term goals of the entire rehabilitation team (you, physician, physical therapist, caregivers, et al)

There are many conditions which may require treatment with a lower limb orthosis, some of these include:

• Stroke
• Cerebral Palsy
• Multiple Sclerosis
• Muscular Dystrophy
• Spina Bifida
• Osteoarthritis
• Joint Contractures
• Polio
• Trauma or Injury
• Various other neurological or musculoskeletal conditions

We have the capability to create any type of custom fabricated orthotic device needed to treat a patient. We also are able to provide custom fitted prefabricated orthoses when custom is not needed. Below is a list of some of the most common lower extremity orthotic devices we provide.

• SMO (supramalleolar orthosis)
• AFO (ankle-foot-orthosis)
• KAFO (knee-ankle-foot orthosis)
• HKAFO (hip-knee-ankle-foot orthosis)
• RGO (reciprocating-gait orthosis)
• Twister cables
• TAOS Orthotic Walker
• KO (knee orthosis: Ligament and Osteoarthritis)
• Stance control and microprocessor KAFOs
• Custom foot orthotics
• Sports bracing
• Fracture boots/Walking boot

Spinal Brace Orthoses

Spinal braces are a special kind of orthotic device. There are several reasons for a patient to need a spine brace, including post-operative care, acute injury, chronic pain, instability, degenerative disease or malformation of the spine. Spinal orthoses, which include neck and back braces, are used to support and stabilize and reduce pain through the various regions of the spine.

We custom fit a variety of custom and pre-fabricated spinal orthoses. Examples include:

• Scoliosis orthoses
• Lumbosacral orthotics (LSO)
• Thoraco-lumbosacral orthotics (TLSO)
• Halo
• Cervical Thoracic Orthosis (CTO)
• Cervical orthoses
• Back supports


April 19, 2017 started off like any other normal day for Chuck Cowart. As his day progressed he noticed his left arm fell asleep a few times, but he didn’t think much of it…

Chuck’s Story

Functional Electrical
Stimulation Devices

A functional electrical stimulator (FES) uses electrical current to activate nerves in extremities affected by upper motor neuron diseases. It is often used to help manage drop foot, knee instability, wrist drop, hemiplegia, and spasticity. FES is heavily researched and has many additional proven benefits.

Conditions such as foot drop, wrist drop or knee instability as a result of multiple sclerosis (MS), cerebral palsy (CP), cerebrovascular accident (CVA, otherwise known as a “stroke”), incomplete spinal cord injury (i-SCI), and/or traumatic brain injury (TBI) respond the best to FES management. Similar presentations associated with or caused by traumatic injuries are often not as successful in achieving a positive outcome with FES as the actual nerve pathway has been damaged, inhibiting the electrical impulse from properly delivering the stimulation.

At Westcoast we offer both upper and lower extremity functional electrical stimulation devices. If you are interested in learning more about this technology and whether it is right for you, please contact us to discuss or to schedule a consultation.

Conditions Treated

Foot drop is a condition where an individual is unable to lift the front portion of the foot off the ground when walking, resulting in dragging of the toe. A functional electrical stimulation device for foot drop is an alternative to an ankle foot orthosis (AFO). The device stimulates a nerve in the lower leg to lift the foot/ankle at the appropriate time during walking. The Bioness L300Go and WalkAide are both great devices for pediatric and adult patients who meet the criteria above.
Knee instability is a condition that can accompany foot drop in some people, exhibited by thigh weakness, causing instability of the knee, either hyper-extension or knee buckling.

The Bioness L300Go Plus system for Foot Drop and Knee Instability offers the dorsiflexion assist of the L300Go lower cuff with the addition of a thigh cuff to stimulate the flexors or the extensors of the knee. The Bioness L300Go Plus may improve walking, improve joint ROM and prevent atrophy of the leg muscles.

This Bioness L300Go Thigh Cuff is now also available for those who have knee instability and/or thigh weakness without foot drop, eliminating the lower cuff. This does however require use of a Foot Sensor for gait (walking).

Hand paralysis includes the loss of feeling, dexterity and function in one or more muscles groups of the hand and forearm – making it difficult to open and close the hand, reach or grasp. When a person experiences an upper motor neuron injury resulting in arm dysfunction, common activities of daily living become difficult to perform. People often compensate by performing these activities with one hand (unaffected side). The Bioness H200W is a wireless medical device that uses low-level electrical stimulation to activate the various muscle groups in the hand and forearm allowing you to open and close your hand. The H200W has a variety of functional and training modes and is an excellent addition to your rehabilitation program as well as for day to day functional gains.

Orthotic Devices for Upper Extremities

Upper extremity orthoses address pathologies of the wrists, elbows, shoulders, and more. Our team of skilled orthotists are experienced at helping patients deal with a wide range of clinical presentations. We begin by determining which type of upper extremity orthotic device is right for you. We offer everything from simple finger splints and resting hand splints to more complex high-tech devices.

Below are some of the most common upper extremity orthotic devices we provide.

• Custom hand/arm orthoses
• Flexion/extension wrist/hand/finger devices
• Joint stabilizers & restraints
• Shoulder immobilizers
• Wrist/hand splints
• Cock-up splints
• Functional electrical stimulation (for stroke, CP, MS, TBI, I-SCI)