🦽 Chapter 755 · Upper & Lower Extremity Assistive Devices

Nelson Textbook of Pediatrics 22nd Edition | Assistive devices: orthoses (AFO, KAFO, SMO, resting hand, wrist cock-up, supramalleolar), prostheses (myoelectric, body-powered), mobility aids (walkers, crutches, gait trainers), wheelchairs (manual/power), robotic exoskeletons. Matching device to child's functional level, growth, and environment.

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📋 30 Clinical Scenarios — Assistive Devices

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Need for Assistive Devices

Select a patient presentation to review appropriate assistive device prescription (Nelson Ch 755).

📋 Stepwise Approach to Assistive Device Prescription

🔑 Key Principles — Chapter 755
• Orthoses: Static (immobilize) vs dynamic (assist movement). AFO for foot drop/plantarflexor tone; solid AFO reduces hypertonicity; hinged AFO allows dorsiflexion.
• Prostheses: Lower limb first at pull-to-stand age; upper limb myoelectric after age 3-4 years; body-powered for younger children.
• Mobility devices: Reverse walker for CP (wide base, erect posture); gait trainer for poor trunk control; wheelchair when ambulation not feasible.
• Wheelchair seating: Custom seating orthosis for head/trunk control, pressure relief cushions for insensate skin.

    ⚡ Reflex Prompts — Assistive Device Decisions

    📖 Summary: Assistive Devices (Nelson 755)