A custom Supra-Malleolar Orthotic (SMO) device with a high heel raise and forefoot lock for a 8 year old patient with sensory toe walking due to global development delay. The SMO has an extension to the toes to block flexion at the forefoot to an extent to prevent toe walking and the high heel raise will encourage heel contact. The heel raise and forefoot extension will be reduced periodically until the patient develops a heel to toe walking pattern.
SMOs are closely fitted custom orthoses made from thin and flexible thermoplastic that encompasses the foot and hugs the ankle. SMOs are a little difficult to fit into some shoes, so shoes that have some depth or a high top shoe are preferred.
They are recommended for:
- Significant forefoot, mid-foot, and subtalar instability.
- Global foot delay deviations due to low or high tone.
- Control supinated or pronated foot.
- Foot deviations that interfere with stance and balance.
- Young children with significant foot instability that need free dorsiflexion and plantarflexion for crawling, pulling to stand, and squatting.
- Allows movement in the sagittal plane (dorsiflexion/plantarflexion).
Not recommended for:
- Knee flexion or extension instability.
- Persistent toe walking.