[Place of orthotic devices in the neuromuscular diseases]

INTRODUCTION-AIM: If neuromuscular diseases differ by the age of the beginning, the mechanism, the topography and the evolution, they have in common to pull a deficit of the muscular force which establishes the main consequence of these diseases. The orthopedic devices is an essential constituent of the coverage. The purpose is to warn or to correct orthopaedic deformations, to protect, to facilitate or to supply a function, to assure a better comfort and to get for the patient the best quality of life. The purpose of this study is to emphasize the place of the orthopedic devices in the therapeutic protocol, the modalities of attributions but also the frequent difficulties.

retrospective inquiry with patients affected by neuromuscular diseases justifying an orthopedic devices assessed at the monthly multidisciplinary consultation of the service of physical and rehabilitation medicine of the National Institute of Orthopaedics M. Kassab from November, 2002 till April, 2003, the patients listed in the National Institute of Neurology and the patients seen at home.

30 cases of average age 16.7 years with extremes of 6 years and of 54 years. All the subjects of our study use an orthopaedic device which is either an orthosis, or a technical device. The most prescribed orthosis are those of the trunk. the posterior thigh-leg-foot thermo-formable night splints come at the head of list of the orthosis of lower limbs. The lack of satisfaction is reported especially for the orthosis of the trunk. Delivery periods are on average of five months.

the orthopedic device plays a fundamental role in the physiotherapy strategy. It is always prescribed in multidisciplinary way by taking into account deficits, environment and demand of the patient allowing so the purchase of an adapted and comfortable equipment. "Reproaches" and demands of the users are a delivery periods often long and an insufficient coverage notably for technical and organization of residence. We propose according to a review updated by the literature, the recommendations allowing a better prescription of an performing equipment.