Orfit Blog

10 tips to comfortably position and immobilize children or adults with anxieties

26 March, 2015 | | Categorised in:

When positioning and immobilizing a patient for a radiation therapy treatment, anxieties like claustrophobia can occur when the immobilization is performed with a thermoplastic mask. Here are a couple of measures you can take to prevent this from happening and to make the patient feel as comfortable as possible.

10tipstomimmobilize

1) Prepare your patient

Obtaining a good result starts with a good preparation. Your patient needs to know exactly what he or she can expect and why the mask is so important: It will help keep them in the same position each time for each treatment session. You can show them a moulded mask as an example and you can show the different moulding steps on a poster. If they know in detail what will happen, it will be less likely they are frightened. Gaining trust and allowing them to ask questions are crucial steps before applying the mask.

2) Help them relax

Talk them through the mask moulding process by helping them to breathe in a relaxed manner. You have to assure them that they can keep on breathing through their nose even with the mask on their face.

The mask feels like a hot wet towel similar to what you receive during a facial treatment in a spa. This can be given as an example so they feel more at ease and know what to expect.

For some patients it helps to meditate or do relaxation exercises. For inspiration, we recommend this article: http://whatisradiationtherapy.com/simulation-details/

3) The Orfit Open Face Hybrid Mask 

The Orfit Open Face Mask may become the standard in radiotherapy as it leaves most of the face uncovered, thereby reducing the discomfort and high anxiety experienced by claustrophobic (and other) patients undergoing head and neck Radiation Therapy.

Open Face Mask Radiation Oncology

If treating all patients with an Open Face Mask is not yet an option for your Radiation Oncology Department, remember that Orfit Industries offers different versions of almost all masks, leaving either eyes, mouth and/or nose free.

4) Choose the right head support

Orfit has different sizes of head supports available. Choose the one that fits nicely around the patient’s head and neck. If necessary you can use blocks and wedges for additional support. You want to avoid having pressure points at the back of the head or somewhere in the neck.

The more comfortable the patient is feeling, the less he or she will move.

head supports2 Continue reading

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Splint in the Spotlight – the Dorsal Wrist Cock-up Orthosis

18 March, 2015 | | Categorised in:

 

Splint-in-the-Spotlight

Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Dorsal Based Wrist Cock-Up Orthosis

Objectives of the Splint: Immobilization of the wrist joint for restriction of motion, pain relief, joint alignment, functional support, and/ or positioning for healing.

dorsal-wrist-cock-up-splint

Pathologies

Many of the same wrist pathologies treated with a custom fabricated volar based wrist cock-up orthosis can be treated with a dorsal based orthosis as well. The most common pathologies of the wrist that benefit from this orthosis include:

  • Fractures
  • Nerve compressions (Carpal tunnel syndrome)
  • Wrist sprains
  • Post-surgical conditions
  • Spasticity
  • Cerebral palsy

Some distinct advantages of the dorsal design are that it leaves the volar palm free for sensory input, and it acts as a strong lever to help lift a spastic flexed wrist into a more functional and beneficial position. The dorsal design allows for functional activities to be performed easily without interference of the orthosis.

Product Recommendations

The dorsal wrist cock up orthosis should be fabricated from a thermoplastic material that has a moderate to high degree of conformability to ensure a close fit, yet is strong enough to support the desired wrist position. Orfit Industries offers the following thermoplastic materials with high conformability which ensures that they fit comfortably on the dorsal forearm and allow for molding around bony prominences. They are available with perforations or in solid sheets.

Continue reading

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Join the ‘Orfit Patient Immobilization & Positioning Group’ on Facebook

9 March, 2015 | | Categorised in:

Test3

Orfit Industries recently launched the Orfit Patient Immobilization & Positioning Group on Facebook. This group provides a platform for professionals in Radiation Oncology who use Orfit Patient Immobilization and Positioning Solutions.

https://www.facebook.com/groups/Orfit.Radiotherapy/

We invite Radiation Therapists, Physicians, Medical Physicists, Mould Room Technicians, Nurses and selected industrial partners to join the group and stay informed, share ideas, discuss and ask questions about positioning and immobilizing patients who receive radiotherapy treatments. The group will also be a platform where you can learn more about the broad range of solutions that Orfit Industries offers.

We look forward to receiving many contributions to make this an interesting and informative place!

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Splint in the Spotlight – the Volar Wrist Cock-up Orthosis

4 March, 2015 | Tags: , , | Categorised in:

Splint-in-the-Spotlight

Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Volar Based Wrist Cock-Up Orthosis

Objectives of the Splint: Immobilization of the wrist joint for restriction of motion, pain relief, joint alignment, functional support, and/ or positioning for healing.

knipsel

Pathologies

Many pathologies of the wrist are treated with a custom fabricated volar based wrist cock-up orthosis. The most common pathologies of the wrist that benefit from this orthosis include:

  • Fractures
  • Nerve compressions (Carpal tunnel syndrome)
  • Wrist sprains
  • Tendonitis
  • Ganglion cysts
  • Arthritis
  • Post-surgical conditions

Positioning of the wrist varies according to the diagnosis; however, the wrist is usually maintained in either neutral or slight extension. This allows the patient to comfortably perform functional activities with the wrist fully supported and properly positioned.

Product Recommendations

The volar wrist cock-up orthosis should be fabricated from a thermoplastic material that has a high degree of conformability to ensure a close fit.  Orfit Industries offers the following thermoplastic materials with high drape and excellent conformability, perfect for a well-fitting and comfortable volar wrist cock-up splint. They are available with perforations or in solid sheets. Continue reading

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Choosing the most suitable Orfit masks for head and neck

2 March, 2015 | Tags: , | Categorised in:

Orfit Industries has a wide range of thermoplastic immobilization masks, both for head and neck and for extra cranial immobilization. The complete range of masks can be found on the Orfit website.

The below information is a guideline to help you find the most suitable head and neck mask that fits your needs.

various-masks

How to choose the most suitable Orfit masks for head and neck?

Step 1: Which kind of base plate do you have in your department?

  1. Orfit HP base plate: The Orfit HP base plates have slots that accept our L-shaped profiles.
    32110
  2. Push-pin base plate: This base plate is compatible with masks with push-pin profiles.
    32148
  3. S-Type base plate: this base plate accepts the Orfit DUON masks.
    INT-3
  4. U-Frame base plate: This base plate accepts the Orfit UON masks.
    32097

Step 2: Now that you have determined the type of base plate you have in your department,
and the type of profile(s) the mask should have, you can continue your search in a certain mask range: Continue reading

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How to use the Orfit SBRT Solution with a short baseplate: an instructional video

17 February, 2015 | Tags: , , | Categorised in:

The Orfit SBRT (Stereotactic Body Radiation Therapy) Solution allows for the treatment of lung and abdominal tumors while keeping control over the breathing movement of the patient. It provides the stability and reproducibility needed for high dose and high precision treatments.

The SBRT solution comes with a long or a short baseplate. The advantage of the long base plate is that it can be combined with various All-In-One cushions and extra cranial masks. The advantage of the short base plate is that it is easy to handle thanks to its smaller size.

We have two instructional movies available for viewing. One for the SBRT solution with long base plate (watch it here) and one for the SBRT solution with short baseplate. Watch the video below to learn how to use the short base plate in combination with a mechanical pressure system or a pneumatic pressure belt, while combining it with either an AIO arm set-up or a MammoRX Arm set-up.

The mechanical pressure system consists of an arch, a compression plate and a screw that pushes down the compression plate to create the desired abdominal pressure. The pneumatic pressure belt is strapped around the patient’s waist. An inflatable bag is attached to this belt and inflation with a manual pump will create pressure on the abdomen.

Two positioning devices are available for arms and hands. The first one is a cushion and grip poles system, similar to the AIO Breast- and Lungboard. The second one are the MammoRx arm and hand supports.

More information can be found on our website. If you have questions, you may get your local Orfit distributor or ask your question in our Orfit Patient Immobilization & Positioning Group on Facebook!

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Orthotic fabrication for kids

1 December, 2014 | Tags: , | Categorised in:

By: Debby Schwartz, OTD, OTR/L, CHT and Orfit Product Specialist

How do you get kids to cooperate with orthotic wear? How do you make sure the orthosis will stay put on their extremity? And how do you make an orthosis on a child that can’t sit still?

Orthotic fabrication for children can be quite challenging for all parties involved. Here are some guidelines to make the process easier for you and your young client.

When fabricating orthoses for young patients, you must always consider the age and developmental level of your client. The clinical setting in general may frighten younger children. Prepare a quiet area for splint fabrication without distractions and noise. Let them play quietly or eat a snack while you prepare the pattern and heat up the thermoplastic material. Always explain to the parents and caregivers what you are doing so they are calm as well.

Give a small piece of the activated thermoplastic material to the child and parents to handle while you fabricate the orthosis. Let them feel it and play with it. Make an orthosis on their doll or toy so that they have a buddy going through the same process!

Enlist the young client’s cooperation with the orthotic wearing schedule by using your knowledge of what appeals to each age group. Everyone is attracted to the bright colors now available in thermoplastic materials and strapping materials. Younger children might like their orthoses to resemble animals, so try giving the splint an actual face! Older teenagers might be tempted by cool bright colors that match their favorite teams or school colors. And everyone likes stickers or jewelry to liven up and individualize their orthosis!

Some additional strategies to increase compliance with orthotic wear are as follows:

  • Develop the schedule of orthotic wear with the child and family so everyone is well informed.
  • Provide written, verbal and pictorial instructions of the wearing schedule.
  • Create a chart and use stickers as a reward for following the schedule.
  • Label each orthosis clearly when issuing more than one, and make sure to show the child and caregivers how to don and doff each correctly. Numbering straps or color-coding an assortment of orthoses may be helpful.
  • Demonstrate the proper method of orthosis application to the child and family. Take a cell phone picture or a video of this so that there is a record!
  • Give the child a choice in color of materials and/or strappings so that they have a say in the design of the orthosis.
  • Allow the child to do a favorite activity while wearing the orthosis.

Increasing the likelihood that the younger child will not remove straps or the orthosis requires knowledge of child development and creativity! For very young children, use secure strapping that requires two hands to open, such as buckles, buttons, zippers, etc. Place these on the dorsal surface, which makes it difficult for the child to remove by himself. Some additional creative strapping solutions to keep orthoses on young patients are as follows:

  • Cover the orthosis with a shirt sleeve, stockinet sleeve or a tube sock/
  • Wrap an Ace bandage or Coban® wrap over the orthosis
  • Use shoelaces to tie the orthosis closed on the dorsal surface
  • Use devices typically manufactured for keeping shoelaces tied (Bow Biters).
  • All children grow quickly, so you must monitor the fit of the orthosis frequently.
  • Remember also that all children have unique hands that require custom designs and individualized intervention plans.

These guidelines can also be handy when treating patients with mental and/or physical disabilities.

More information on orthotic fabrication for kids can be found in the chapter “Orthoses for the Pediatric Population” in a soon- to- be released book on orthotic fabrication, entitled Introduction to Orthotics: A Clinical Reasoning & Problem-Solving Approach, 4th Edition. (Expected release date is December 10, 2014.)  The chapter is interspersed with multiple photos of orthoses for children, most of them fabricated using Orfit Industries’ low temperature thermoplastic materials!

Introduction to Orthotics is an excellent and practical resource for all occupational therapy practitioners and splint fabricators in clinical or educational settings. It features up-to date references, evidence-based research tables, orthotic patterns and how –to videos on orthotic fabrication. It is available for pre-order on popular websites like  www.amazon.com.

Here are some photos illustrating colorful orthoses for children, many fabricated with  Orfit Colors NS thermoplastic materials.  Orfit Colors NS is an elastic based thermoplastic material with excellent memory and stretch. This product comes in 8 brilliant colors and will appeal to everyone!  Two thicknesses (3.2 mm or 1/8” and 2.0 mm or 1/12”) and two perforation patterns help make this product incredibly versatile and appropriate for a wide range of pediatric orthoses.  In addition, Orfit Industries offers several orthotic designs in colorful precuts, making orthotic fabrication simple and easy.  And of course Orfit Industries has beautiful  strapping materials in multiple colors as well.”

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Report: MR in radiotherapy – an important step towards personalized treatment

20 November, 2014 | Tags: | Categorised in:

The Swedish Radiation Safety Authority has recently published a report regarding the use of MR scanning in radiation therapy. The report with the title ‘MR in radiotherapy – an important step towards personalized treatment?’ can be found  via this link (PDF).

The important role of imaging in radiation therapy is outlined in this document. The authors describe the use of MR scanning in radiation therapy together with the difficulties and possibilities. One of the topics is immobilization of a patient. Immobilizing a patient in an MR scanner can be challenging due to the size of the bore and the use of coils, especially for head and neck patients. “A common problem in in connection to RT is that patients need to be investigated in their treatment position in immobilization devices, which hampers the use of optimal MR-coil configurations.”

Immobilisation System MRI Siemens

Orfit Industries has developed an MR compatible immobilization device for the Siemens Magnetom MR scanners. This system allows to immobilize a head and neck patient in the same position on the CT, Linac and MR scanner with the same head support and thermoplastic mask. In addition it offers a solution to place the Flex coils closely to the head in order to have a good image quality. More information can be found on our website.

Immobilization devices for other MR scanners in the market are currently being developed.

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Choosing the Proper Splinting Material for your Orthoses

19 November, 2014 | Tags: , | Categorised in:

Answers to the most frequently-asked questions about our splinting materials

The following is a question and answer based article geared towards understanding the many different types of thermoplastic materials available for orthotic fabrication. It is important to understand the ways in which thermoplastic materials behave when activated in order to make them work properly and effectively for each and every orthotic design. Selecting the appropriate thermoplastic material may not be as clear cut as it seems, because there are so many choices available and so many slight nuances and differences among the products.

We hope this format will answer most of your questions about thermoplastic materials and help you select the best product for your patients’ needs.

1) “Why do we need so many choices in low temperature thermoplastic materials?”
“If you could choose just one splinting material to cover all your splinting needs in the clinic, which one would it be?”

We get asked these type of questions all of the time. We are fortunate to have so many choices in splinting materials today because one material will simply not cover all of our splinting needs. We make rigid and strong anti-spasticity orthoses, as well as lightweight thumb supports. We fabricate long arm orthoses with materials possessing maximum resistance to stretch. We also make dorsally based hand and finger orthoses from very conforming materials. There is no splinting material which will satisfy every requirement we have. So we need to understand the properties, characteristics, and qualities of these low temperature thermoplastic materials in order to make the best choices in our orthotic fabrication.

2) “What are Low Temperature Thermoplastic Materials (LTTPs)?”

The splinting materials we use to fabricate orthoses today are referred to as low temperature thermoplastics (LTTPs) because we activate them using relatively low heat (water between 60-70°C or 140°-170°F) as compared to other high temperature thermoplastics which require higher activation temperatures ( greater than 100°C or 210°F). We can also place these LTTPs directly on our patients while we are molding the orthoses, unlike the previous generations of therapists who used higher temperature products and had to create molds of their patient’s arms.

There are so many types and varieties of LTTP splinting materials available today.  It is just as important to know and understand the correct orthotic design for your patient’s needs as it is to select a proper LTTP for the orthosis. This ensures that your custom made fabricated orthosis is not only procedurally correct, but also supportive, durable, and comfortable as well.  Patients will tend to be more compliant with a comfortable and proper fitting orthosis.

3) “How did we get so many types of LTTPs?”

LTTPs became available in the 1960’s. The first LTTPs were made from rubber products and therapists working with these had good control of the material as they formed splints.  But the material itself had minimal stretch and very little conformability (see glossary in question 4). It was hard to mold around bony prominences. Plastic LTTPs were introduced in the 1970’s. Plastic LTTPs are highly conforming materials, but challenging to control. So, the manufacturers of these products tried combinations of plastic and rubber together. These LTTPs created well molded orthoses and offered a good amount of control.  Newer concepts in polymer production and design greatly improved the strength and rigidity as well as the elasticity of the LTTPs. As technology improves, we will continue to see improvements in our LTTPs.

4) “What are some of the basic characteristics of low temperature thermoplastic materials?” Continue reading

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