Purpose/Method: A 70-year-old engineer, suffering from drop foot, designed
and produced a strange orthosis. Although on ambulation the orthotic device
elevated his foot, an abnormally strange walking pattern was required. Of
his own volition the patient attended an orthotic clinic requesting that a
local manufacturer produce a replica of the orthosis. The patient received
an explanation pertaining to the range of regular orthotics available and i
n what way they would improve his functional ability.
Results/Conclusion: The patient saw all the options available and physicall
y tried several. The patient was afforded the opportunity of fi ee choice a
nd chose his own, self-designed orthotic. From a professional point of view
this was the most inappropriate option. The rehabilitation team erred in i
ts psychological management of the case, for it overlooked the question of
the patient's motivation and commitment to change.