The Often-Unmentioned Key Points of Orthotics-A Short Comment

Orthoses are a vital part of treating gait disorders, especially in children and adolescents with neurological and neuromuscular conditions. For proper walking, the supporting leg must be stable to allow the other leg to swing forward and take a step. Stability is also essential for motor development. This stability depends on the inclination of the tibia, which needs to be kept upright during mid-stance in both the sagittal and coronal planes. Controlling the load axis in all planes and the foot in the transverse plane helps maintain proper tibial control. More studies are now examining the effects different orthoses and designs. While much focus has been on the sagittal plane, there is much less information about how orthoses influence the coronal plane or foot control. As a result, there is limited guidance from the existing literature. Children who find it hard to express discomfort or negative effects may simply reject orthoses altogether. This paper explains how important proper tibia inclination and control on the load axis are in all planes and how they affect stability. The foot acts as a lever for the gastrosoleus muscle, which controls the tibia. In case of foot instability or deformity, the foot requires support that takes into account the changing load when walking. I also emphasize that these points are regularly considered when studies are reported.