A therapist usually tries to delay recommending a permanent brace for the feet or legs until the end of therapy. The reason this is done is because the client's strength may change. When selecting a brace, one must feel fairly confident that the current strength of the area being braced has reached a plateau or will not be making any immediate dramatic changes. The treatment plan is different for each client. The plan is developed based on the initial evaluation of the client's abilities.
Strength is a major factor in determining what types of treatments are appropriate.
Strength is classified on a scale of 0-5. Zero meaning that there is no palpable or visual contraction of a muscle and five meaning that the therapist cannot break the client's contraction of the muscle. In between, one through four, are various intensities of muscle contractions. The treatments may initially start with teaching strategies for basic self-care and daily living needs. For example, learning to roll over in bed, sit up, transfer from the bed to a chair, sit to stand, transfer for bathing and toileting, etc.