- - - - - - - - - - - - - The purpose of this site is to be generally informational. There is  difficult material in these pages. Specific application must be with the help of a professional as there is more information omitted than given.   Use the content of this site as a starting point for asking  questions of your own doctor, therapist, orthotist or specialized nurse.  - - - - - - - - - -


PO Home = Website base (w popular links in boxes).
The web site has 3 main divisions

    1. The Practice = some basics about us.

    2. Topics about Interventions = more limited discussions that concentrate on kinds of treatments & how they differ. Nuts & bolts surgery, first aid etc.

    3. Topics - More general with some inclusion of treatment but not centered on treatment. Basic science, anatomy, skills training for diagnostics etc.

    Each subject is usually represented two to three times, but in different style. Linear historical, gestalt (sketch generality then fill in detail), and format driven by topic related Q&A are the most common.

We do not pander to grade school. The use of highlighted text (hypertext) allows you jump to more advanced & technical material.

Notice: Artwork and original graphic layouts were originally designed and executed on
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About those buttons:
Some topics are just plain complicated as there are so many vantages to consider. Knowing a good sequence where to begin, then -what next- helps a lot.

Button arrangements change. They are set up to allow better NEXT choices. Example sequence especially suited to this web site:

Explain? OK.

In SACH we follow the pioneering work of Inman whose interest was prosthetics for soldiers coming back from war.  A backward reconsideration of that work tells us you do not need feet to walk. You need something that behaves like a foot. So a deformed foot that does not behave like a foot is not as good as a rubber or wood + plastic or carbon thing that does do the job expected of a foot. Inman revealed WHAT a foot does. What legs do.[in a lab]. By the way - nice & straight - isn't in the list. With a prosthetics edge, Inman's list (determinants) were incomplete and loaded toward stance phase. His study subjects were missing parts but neurologically intact.

Working from a neurologic impairment vantage, this author's studies sought to fill in Inman's blanks. In neurologic disorders (if you follow the above buttons), problems will be seen to come more from swing phase abnormality (something not on the floor) than from most of Inman's determinants - important as they are - normally. NORMALLY. Having the ability to adjust to change. But stuck with ABnormal controls?

He did not uncover that EXPECTATIO N (which we add to his list) is the most important determinant of  them all. Much of what we do is coming from a control stream issued with certain expectations alert to sense deviation. The sensory side has to update expectation on the fly to adjust that instruction stream. Many injuries come directly from a mismatch of expectation to actuality. Unanticipated ice. An unexpected additional step down - or up. Softer ground than thought, an unseen protrusion on the floor or steeper incline than realized... The fun house. Even wrong visual cues. Drive a car with the windows covered in tin foil. Text while you drive? Redundant? Sorry.

So if a foot is hopeless at its job? Use a fake one that gets it right. Prosthetic or an AFO (not much different).  And yes hinges will allow the foot to keep making the very mistakes you want to avert! So SACH (fine tune a prosthetic) has its twin in SAWCH (orthotics). Same mechanics, Prosthesis, orthosis, and even a cast if made by knowing hands. Well, we solved the foot. The rest of the leg? The list... do the list.

So if you see an odd list of buttons, that is why. Also button clusters are breadcrumbs, to help you navigate back reflecting the way you came. Expect duplication. Button sets have different objectives.

NOF 4.5 - NOF 15