Pediatric Orthotic Tuning

Northwestern Medicine Marianjoy Rehabilitation Hospital is one of only a few rehabilitation hospitals to offer orthotic tuning. Orthotic tuning is a specialized, comprehensive therapy technique. It can help improve posture, balance and gait efficiency in pediatric patients.

Children who may benefit from orthotic tuning include those with:

  • Neurological impairments that affect their gait (how they walk), such as stroke, traumatic brain injury and cerebral palsy
  • Orthopaedic impairments that affect joint, bone or muscle alignment

How does orthotic tuning work?

A multidisciplinary team, including a physician, physical therapist and orthotist, work together to use an advanced video assessment procedure, along with pressure-sensitive mat technology, to analyze your child's gait and to evaluate tuning techniques.

Therapists at Marianjoy Rehabilitation Hospital use the detailed information from this analysis to select or adjust devices that will help your child achieve optimal gait performance. This happens in several stages. To improve your child's gait or balance, their care team will customize orthotic devices for your child and change the support as they improve or grow.

Pediatric Tuned Ankle-Foot Orthosis Footwear Combination

At Marianjoy, tuning means something different than what you might expect in that it is not related to music or instruments. Instead, it is the process of selecting and adjusting the design features of the ankle-foot orthosis and footwear to achieve the best gait performance possible. The goals for this technique include maintaining arch integrity, as well as improving:

  • Tolerance of the ankle-foot orthosis and footwear
  • Standing balance
  • Alignment in gait
  • Efficiency in gait
  • Range of motion and strength over time

If a tuned ankle-foot orthosis footwear combination is recommended, there are several steps in this process. Those steps are outlined below.

Evaluation: Your child will be assessed by a care team, including a physiatrist, physical therapist and orthotist. Together, they will determine the appropriate angle and initial design features of the ankle-foot orthosis. The care team may then recommend additional changes to your child's ankle-foot orthosis to help improve gait. The assessment will include a video analysis of your child walking.

Fitting: Your child will be fitted with the ankle-foot orthosis in the orthotist's office or at Northwestern Medicine Prosthetic and Orthotic Center at Marianjoy. All tuned ankle-foot orthosis footwear combinations will have some wedging in the shoe or a heel on the ankle-foot orthosis. The orthotist may order shoes for your child, or they may guide you on the type of shoes you should bring with you to the appointment.

Follow-up visits: After your child has been fitted with the ankle-foot orthosis, follow-up appointments will be scheduled. The follow-up visits will help your child's care team assess the ankle-foot orthosis footwear combination, adjust the orthotic or footwear, and teach you and your child gait training and in-home activities. The care team will recommend changes to your child's ankle-foot orthosis or footwear to improve how your child walks.

All outpatient therapy and procedures require a physician referral. To learn more about the clinic, please call 630.909.7000. (TTY: 711)