Residents of Sault Ste. Marie and Algoma District with mobility challenges now have a full-time certified orthotist to turn to for clinical evaluations, fittings and adjustments.

Debbie MacKay, who began practicing in May from a clinic located at Motion Specialties on Great Northern Road, worked as a certified orthotist for approximately 25 years in Halifax, Ottawa and, most recently, at the Queen Elizabeth Hospital in Charlottetown.

The move to the Sault is a homecoming for MacKay, who graduated from high school in the city, and for her husband, who was born and raised there.

Residents of the city and district are currently served by several orthotists from out of town who travel to Sault Ste. Marie for assessments and fittings. Having access to a full-time orthotist in the city will be more convenient for patients, especially if adjustments are required, said MacKay.

“Once I have the device, I can make any further modifications immediately, right here onsite. That’s probably the main thing that makes this service appealing.”

MacKay suspects there are a lot of people in Algoma District who could benefit from orthotics, but haven’t been assessed or fitted. The orthotics clinic at Queen Elizabeth Hospital in Charlottetown has a six-month wait list, she noted.

“In Algoma District, the population is very similar to Prince Edward Island, and there’s no reason to believe that the demand is any less. The challenge is that when the service is offered through a private clinic, there’s more of a financial concern.”

In southern Ontario and other provinces, orthotics services are often available through hospital rehabilitation programs, so the labour component of the service is looked after.

Orthotics services are covered by private health insurance plans, the Workplace Safety and Insurance Board and Non-Insured Health Benefits for First Nations. Partial coverage is also available through the Ontario Assistive Device Program and Easter Seals.

Orthotic devices are used to assist patients with mobility challenges caused by muscle weakness, spasticity, uncoordinated muscle movements, skeletal deformity and trauma.

People with muscular dystrophy, multiple sclerosis, ALS, and cerebral palsy commonly require them, as do people who have had strokes.

MacKay recently designed a custom ankle-foot orthosis (AFO) for a patient in Elliot Lake who had nerve injury complications as a result of hip surgery. The nerve damage resulted in muscle weakness that prevented the patient from being able to control his leg from the knee down.

“The ankle-foot orthosis is completely changing the level of progress for his rehabilitation because of the function the brace provides,” said MacKay.

“Without the brace, the patient would be susceptible to falling and causing further damage to his hip.”

Fall prevention

Preventing falls and hip injuries is especially important for seniors, she said, because if they injure their hip, they’re bed-ridden for a long period of time and that leads to further complications.

“I couldn’t put him in a brace that totally locked up the leg and ankle and provided a 90 degree positioning of the foot because we know the muscle strength is going to come back and we didn’t want to interfere with the muscle development. Instead, we put him in a jointed brace that allows motion and assists the dorsiflexion, so he can use his muscles and gain strength. The design allows for swapping out the ankle joint that he currently has for a weaker set once we get to that plateau where it’s time to push his leg a little bit more and ask more of those muscles. It’s all designed around anticipated progress.”

MacKay also assisted another patient with a customized lumbo-sacral corset.

“This patient was suffering from a hernia and wasn’t a candidate for surgery. When she stood up, it extended more than 12 inches. That’s extreme. It’s the most extreme situation I have seen.

“A lot of abdominal hernias result from abnormal weakness of the abdominal wall and it’s not something patients can recover from on their own. We made some special modifications for her to use along with the corset and she went from not being able to do very much to literally dancing down the hall after being fitted with it.”

There are other places patients can go to purchase a lumbo-sacral corset in Sault Ste. Marie, but none with the knowledge and expertise to customize them, said MacKay.
“It’s not just about fitting someone with a small, medium or large. Sometimes, that’s all that’s required, but there are other times when we have to provide customization that matches the abilities of the patient.

“For example, if they don’t have the strength in their hands to be able to pull the Velcro open, we’ll customize the straps in order to allow them to be independent. We don’t want to set them up with something if they need someone else to help them climb out of it.”

MacKay graduated from Guelph University with a BSc in Human Kinetics and earned a diploma in Clinical Methods in Prosthetics and Orthotics from George Brown College in Toronto.