The Soft Boston Orthosis: An Orthotic Alternative for the Management of Spinal Instability


0ver the past three years the Rehabilitation Centre for Children has utilized the Boston Soft Body Jacket for the management of spinal instability in patients afflicted with neuromuscular conditions that cause low muscle tone or imbalance, progressive atrophy, involuntary spasticity, or impaired sensation. These disabilities present the orthotist with some rather difficult problems when attempting to comfortably fit and maintain these patients in a conventional, rigid type of orthosis. The Soft Boston Orthosis, developed by O & P Systems through Children's Hospital in Boston, is a flexible, anterior opening, velcro closure, thoraco-lumbo-sacral orthosis constructed with two layers of aliplast, between which are "sandwiched" strips of rigid thermoplastic that are strategically placed to achieve the desired rigidity and support for each specific patient. Positive attributes of the Soft Boston Orthosis have been: stabilization or improvement of scoliosis, improvement of postural positioning, head control and comfort, as well as improved support for seating, requiring less elaborate wheelchair seating systems. This paper will discuss various aspects of the construction of the orthosis, fitting procedures, and trouble-shooting some of the problems which have arisen with this orthosis.

Rehabilitation Centre for Children, 633 Wellington Crescent, Winnipeg, Manitoba, Canada R3M OA8.