Dynamic Bracing Solution
The Dynamic Bracing Solutions orthosis (brace) is based on the mechanical principles governing current prosthetic construction. This design may be the answer for persons with neurological/muscular damage to their lower limbs and who are experiencing the need for bracing in order to continue to live independent lives.
The DBS orthosis is not just a brace that the wearer has fitted and then goes home to live life as before. The process of fitting includes a combination of a careful and extensive evaluation of the structure and functionality of the affected limb, and then casting and constructing a brace fitted to the individual needs of the client. The construction of the orthosis often includes corrections for physical structural deformities. The construction phase is lengthy. Then, upon acquiring the brace, there is training over an extended period of time with limited use during the training. Included in the training is the opportunity for questions and feedback from the orthotist and modifications of the brace, if needed.
The initial evaluation is done by analyzing a videotape frame of the potential client, standing and walking, then designing the exact brace to fit the individual needs of the wearer. The training, which may be done individually using the materials supplied by the DBS orthotist and/or under the supervision of a physical therapist, not only changes how the wearer walks but also restructures old mindsets and habits.
The brace itself is made of light-weight carbon fiber graphite composite that has a combination of flexibility and rigidity. The composite is strong enough and rigid enough to provide stability to compromised limbs. Those same factors also make it safer to wear than braces made of traditional materials, reducing the incidence of breakage and limiting balance problems.
Also, incorporated into the design is a dynamic component that allows the wearer to more efficiently use body motion, and ground force resistance to improve gait and balance while walking, and to increase endurance and balance while standing. The mechanical principles that govern this design make it so effective that even some traditional KAFO (knee/ankle/foot orthotic or long leg brace) wearers, as well as those who use AFOs (ankle/foot orthotic or short leg brace), may be able to be fitted with an AFO, thus reducing the need for the long leg brace. A recent development for patients with painful ankle/foot that had been unsuccessfully treated by other means is the Unloader AFO.
Marmaduke Loke, CPO, and Jean-Paul Neilsen, CP, developed this system in the 1990s and have custom designed and custom engineered bracing for persons with polio/post-polio problems, spinal cord injuries, and other neuromuscular disorders.