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Clinical Solutions in Practice

Can A New Brace Offer Relief For PTTD?

March 2010

   When it comes to ankle support for posterior tibial tendon dysfunction (PTTD), a specially designed foot brace may offer quick relief.

   The Aircast AirLift PTTD Brace may help with the treatment of PTTD and early signs of adult-acquired flatfoot, according to DJO Global, the manufacturer of the device. The brace uses the Airlift integrated aircell in collaboration with a semi-rigid shell. DJO Global says the shell provides more support and alignment for the ankle.

   Jeff Houck, PT, PhD, has been recommending the brace for about three years.

    “Patients generally note some immediate improvement after wearing the brace,” notes Dr. Houck. “It allows for dorsiflexion-plantarflexion range of motion, which may be important to prevent atrophy of the calf and function during walking.”

   Dr. Houck often prescribes the brace to patients. “As long as the deformity is not too severe, this brace works well for us,” says Dr. Houck, an Associate Professor in the Department of Physical Therapy at Ithaca College-Rochester in Rochester, N.Y.

   Lew Schon, MD, recommends the Aircast AirLift PTTD Brace for many of his patients.

    “It (Aircast AirLift PTTD Brace) has changed the lives of about 80 percent of my patients. It has saved them from buying a $500 to $1,000 custom brace and is much more effective,” says Dr. Schon, the Director of Foot and Ankle Services at Union Memorial Hospital in Baltimore.

   Dr. Schon, who designed the brace, says the Aircast AirLift PTTD brace is especially supportive of the arch with the air bladder technology and the straps that secure the arch and ankle.

Addressing The Importance Of Exercise And A Good Fit

   Dr. Houck recently completed a randomized controlled trial with the Airlift brace. In the trial, Dr. Houck and his colleagues compared bracing and stretching to bracing, stretching and strengthening exercises in patients with PTTD. They found that patients in the brace and stretching group did “fairly well” as they demonstrated significant improvements in pain reduction and function. However, when it came to the more severe patients, Dr. Houck says the combination of strengthening exercise and bracing was more effective.

   Drs. Houck and Schon both emphasize the importance of ensuring a good brace fit for the patient’s foot.

    “Although many patients like the expensive custom braces, they can still have issues with the fit, especially if they have swelling or changing foot shape due to their deformity. They find the other braces bulky and too restrictive,” explains Dr. Schon. “About 25 to 45 percent of my patients are reporting that they did not find the custom braces comfortable or effective, but loved the Airlift.”

   Dr. Houck says the Aircast Airlift device is inexpensive and easy to use once patients learn the proper inflation technique. Dr. Schon says the Aircast Airlift brace is the only brace that uses an air bladder under the arch. Dr. Houck notes this inflation is beneficial for most patients but there are some patients for whom custom orthotics are more effective. He also notes that the Aircast Airlift brace lasts about two to three months before it wears out.

   Dr. Schon says that even though the Aircast Airlift brace can wear out at times, most of his patients “sing its praises and are very thankful.”

Editor’s note: Dr. Schon is a designer and co-inventor of the Aircast Airlift brace, and has received a small royalty for the device. Dr. Schon adds that he is not a paid consultant of DJO Global.

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