Services
Around and About, Inc. is a full service orthotic and prosthetic facility which allows our patients to receive a custom fit almost immediately. In addition, we have a state of the art high tech suspension ceiling track that covers over 120 feet. This weight-bearing unloading system allows patients to be pain free during therapeutic training for prosthetics and braces, a system that is safer and more effective than parallel bars. We also have a mobile unit to accommodate patients needing Orthotics and Prosthetics that are homebound or unable to travel.
PROSTHETICS
Lower Extremity Prosthetics
Around and About, Inc. are the leaders in cutting-edge technology and provides the latest state of the art prosthetics for individuals who have upper and/or lower extremity amputations. We provide state of the art socket designs that fuse comfort with technology and function to provide the ultimate human experience.
Upper Extremity Prosthetics
Around and About, Inc.’s prosthetic team has worked with numerous patients over the years providing superior prosthetic care with patients that have loss their upper extremity. Our dedicated staff with decades of “hands on” clinical experience provides the most functional and natural applications to your design and intimate fit. Our clinicians are trained and certified in the most current technology for the upper extremity prosthetics including the i-Limb, BEBionic Hand, Michelangelo Hand, Steeper Hand, and other life-like bionic hands. We also are trained in the use of the Dynamic Elbow, Utah Elbows, Steeper Elbows, and more…
Custom Sports Prosthetics
In the world of sports prosthetics, there has been an explosion of innovations to enhance the sports experience. Most of these innovations have been from the design and technology coming from the military and baby boomer’s needs for adaptive and sports prosthetics to meet their athletic lifestyles. Sports prosthesis are needed for both upper and lower extremity amputees. Around and About, Inc. offers custom sports prosthetics for individuals with their specific lifestyle and athletic activities.
ORTHOTICS
Around and About, Inc. specializes in three different types of orthotic designs and interface. First and most popular, are the rigid designs such as custom laminated functional knee braces, hand splints, KFO’s (knee foot orthotics), scoliosis braces, and cranial helmets. Second, soft orthotics are generally used for children and our advanced age population. For example, a neoprene hand splint and splints utilized for patients that have experienced a stroke and need the support system that will aide in their return to their activities of daily living. Finally, the last category involves a combination of both the rigid, soft materials and/or custom designed fabrics for specific patient needs. These brace systems tend to accommodate the more competitive athletes and/or patients that require high levels of performance. In addition, specific materials and fabrics may incorporate special properties. For example, anti-bacterial, cooling capabilities, antiperspirants, water-proof, energy return, muscle facilitating/inhibiting are among the few specialized capabilities that are provided in our bracing systems.
KIDS AND TEENS
It’s very important to stress that kids and teens are just not “small adults.” These groups of patients have very unique and specific needs to be addressed with their orthotic and prosthetic interventions. Around and About, Inc. works closely with the patient’s physicians, physical and occupational therapists to provide the highest quality and standards of care.
Studies have shown that children fit with prosthetics at the age of 2 years old or earlier, have a better wearing pattern and skill set than patients that are fit at a later age. In addition, two-handed activity is typically observed at the time the infant is developing sitting balance, usually around 4-6 months of age. We call this the “fit to sit” criteria. Once your child demonstrates these sitting skills, this is usually the recommended time to fit your child with prosthetics. As a result, this early approach will aid in their development in achieving the targeted age-appropriate milestones for maximum success. Children that utilize a prosthesis early usually will mimic the normal movement and hand patterns of the non-involved side. This early fitting approach will allow for good proximal stabilization, better functional grasps of reaching and other coordination tasks that involve bi-manual activities. In general, the infant develops neuro-muscular control from head to toe Its paramount for the clinician to fit the infant early if an upper extremity prosthesis is indicated. Most children develop full grasp with good proximal stabilization of the upper shoulder girdle before the patient reaches one year.
PROSTHETICS
Studies have shown that children fit with prosthetics at the age of 2 years old or earlier, have a better wearing pattern and skill set than patients that are fit at a later age. In addition, two handed activity is typically observed at the time the infant is developing sitting balance, usually around 4-6 months of age. We call this the “fit to sit” criteria. Once your child demonstrates these sitting skills, this is usually the recommended time to fit your child with prosthetics. As a result, this early approach will aid in their development in achieving the targeted age appropriate milestones for maximum success. Children that utilize a prosthesis early usually will mimic the normal movement and hand patterns of the non-involved side. This early fitting approach will allow for good proximal stabilization, better functional grasps of reaching and other coordination task that involve bi-manual activities. In general, the infant develops neuro-muscular control from head to toe It’s paramount for the clinician to fit the infant early if an upper extremity prosthesis is indicated. Most children develop full grasp with good proximal stabilization of the upper shoulder girdle before the patient reaches one year.
CEREBRAL PALSY (CP)
Children with Cerebral Palsy (CP) are often limited in their activities because of primary and secondary impairments. In conjunction with other medical, surgical, and therapeutic interventions, orthoses play an important role in the physical management of children with CP. Orthoses are designed with one of two primary aims: either to affect the body structure or to assist function, although for children with CP, orthoses are frequently designed to achieve both of these aims. The aims of lower limb orthotic management of CP are to address the following:
- To correct and/or prevent deformity
- To Provide a base of support
- To Facilitate training in skills Improve the efficiency of gait
Early intervention has proven to be more effective to reach milestones, prevent contractures and associated deformities/abnormal tone.
CLUB FOOT
Fetal clubfoot is a congenital foot deformity in which the foot is curved toward the middle of the body. Treatment can be in utero or immediately after birth with approximately 4-10 sessions with serial casting to be followed with PT. Use of a brace after casting is recommended to prevent the deformity from coming back. In fact, recurrence is five times as likely in children who don’t consistently wear the brace as recommended. Research has shown that children who wear the brace as prescribed are less likely to need additional treatment.
Blount’s Disease
Blount’s disease is a growth disorder of the tibia (shin bone) that causes the lower leg to angle inward, resembling a bowleg. This idiopathic disease of the knees occurs in young children and adolescents (more common in boys and bilateral knees). Infantile Blount disease may resolve and respond to nonsurgical treatment involving bracing with children before the age of 3 years old with Stage I or II of the disease.
Idiopathic Scoliosis Bracing
Adolescent idiopathic scoliosis is characterized by a lateral curvature of the spine with a Cobb angle of more than 10 degrees and vertebral rotation with females demonstrating an increased prevalence than boys. Once detected, patients presenting a curvature between 25-40 degrees, will typically be provided a order treatment for rigid bracing (thoracolumbosacral orthosis). A small window of time for treatment opportunity is evident due to the rapid skeletal maturity. After one year, the patient is objectively monitored with the Riser’s sign which is the bone development over the top of the hip. Once the 4th position, usually less than a year of continue bracing indicated. This approach is the most common nonoperative treatment for the prevention of curve progression. There are many different brace designs, but with all of them, the objective is to restore the normal contours and alignment of the spine by means of external forces and, in some designs, the stimulation of active correction as the patient moves the spine away from pressures within the brace. Studies of bracing in adolescent idiopathic scoliosis have suggested that bracing decreases the risk of curve progression. Furthermore, studies have confirmed that conservative treatment with bracing is highly effective in treating juvenile idiopathic scoliosis, in particular most patients reaching a complete curve correction.
Idiopathic Kyphosis Bracing
Normal thoracic curvature of the spine is 20 to 45 degrees and is considered normal. Kyphosis is defined as a curvature of the spine measuring 45 degrees or greater on an X-ray and is a type of spinal deformity. There are different forms of kyphosis depending on the underlying factors. The types are classified into two general categories, postural and structural. Postural is caused by slouching or poor posture in your back whereas structural is caused by birth defects or from another spinal problem. Some of the types of kyphosis may include congenital, neuromuscular,
degenerative, Scheuermann’s disease, nutritional and postural kyphosis. There are different treatment options that vary from one patient to another depending upon their diagnosis and prognosis. Exercise, Bracing and Surgery are options. A brace is indicated in actively growing children with kyphosis curves greater than 65 degrees. The brace is typically prescribed to be worn 23 hours a day until the adolescent is done growing. Examples of orthopedic bracing that Around and About, Inc. uses is a Custom Supraclavicular Rigid Bracing system used nightly and a daytime brace utilizing the Catch Up Brace which incorporates rigid plates within a soft material to promote a more active patient. We also use the Milwaukee and Boston Brace
Pectus Carinatum “Pigeon Chest” and Pectus Excavatum
Pectus carinatum also called pigeon chest, is a malformation of the chest characterized by a protrusion of the sternum and ribs. It is distinct from the related malformation Pectus Excavatum.
Other bracing & speciality systems
Around and About, Inc. works with multiple patients that require different prescribed bracing systems. These may include SPINAL STENOSIS BRACING, SPONDYLIOTHESIS BRACING, and OSTEOPOROSIS BRACING which are among some of the most frequently observed.
Rehab and other services
Around and About, Inc. has onsite PHYSICAL THERAPY with experienced physical therapists that have worked with numerous patients with a myriad of disorders and pathologies involving orthopedic, neurological, pediatric, gait disorders, amputations, congenital, developmental delays, and other diagnoses. There are multiple advantages patients are able to experience at Around and About, Inc. The practitioners have multiple licenses that provide a unique perspective in treating the “whole patient.” In addition, the full functioning lab allows our prosthetic patients to be seen for physical therapy while their prosthesis is adjusted if needed, allowing a more time efficient and productive session.
In addition, to Physical Therapy, Around and About, Inc. provides support groups and outside resources to address the needs of our patients. Furthermore, we provide neuromuscular devices including the Bioness and the WalkAide for patients with specific lower and upper extremity diagnoses. Functional training, Biomechanics for the work place and an abundance of Home Exercise Programs to allow the patient to continually succeed in their daily and nightly activities.
Time is of the Essence
Our highly educated and experienced clinicians will educate and guide you with the vital timelines to promote optimum success for the patient’s overall performance. This is crucial to provide the proper brace and/or prosthesis at the appropriate time. Below are examples of how bracing/prosthesis require careful monitoring with age, development, and progression as your child reaches these timeframes.
