Find answers to some of the questions we hear most often from our PBO Group clients.

Prosthetics FAQs

The cost of a prostheses is extremely variable. An estimate can only be provided once the device design is complete following a full assessment. However, we will always provide these estimates so that you are aware well ahead of time what the costs will be.

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To learn more about our warranties for PBO Group devices, click here.

The Assistive Devices Program (ADP) is the Ontario Ministry of Health payer for prosthetic devices and will provide coverage for a portion of the cost but not the entire amount. PBO Group staff can provide information on additional available funding sources.

A mild soap and water solution that you would use on your own body is the best approach for cleaning your device. Do not use harsh chemicals like window cleaner, bleach wipes, etc., as they can cause skin irritation.

Some prostheses are made specifically to allow you to wear them in the shower (sometimes called a shower leg). In some cases, a waterproof cast cover can be used to protect the device. Generally speaking, we recommend removing the device and using a shower seat for stability.

Contact your prosthetist. If you are experiencing skin irritation or extreme discomfort, ulcers, blisters, or skin breakdown, stop wearing the device until you can be reassessed.

We don’t recommend wearing your prosthetic device while sleeping because it is good for your residual limb to have some time each day to have a break from the pressure and the humidity associated with wearing a socket.

Three different approaches can be taken regarding the appearance of your prosthetic arm or leg. In some cases, clients opt for no cosmetic cover, so the device’s inner workings can be seen. In other cases, a cosmetic cover with synthetic skin is chosen to make the device look as lifelike as possible. In other cases, a limb-shaped cover is designed with a pattern or image that reflects the wearer’s personal style. We work with you to determine the approach that best meets your physical needs and personal style.

To some degree, any prosthesis can be used for a variety of activities, however, we can also incorporate design features in your prosthesis for specific recreational pursuits such as running, swimming, skating, hockey, golf, music, fishing, hunting, etc.

We strive to make your prosthetic as light as possible, balancing this with the need for it to be structurally sound for your weight and activity level.

Phantom pain can be a common complaint following amputation, and there are various treatment options, including prosthetic adjustment, mirror therapy, and/or medication. Your prosthetist and/or medical team can provide guidance based on your specific situation. Phantom limb sensation is the experience of feeling the amputated limb but is not painful. This does not need to be treated and should not be confused with phantom limb pain.

Yes, and PBO Group staff can help you learn more about potential financial support for your prosthesis from a variety of funding sources, including The War Amps, Rotary Club, Lions Club, Ontario Federation for Cerebral Palsy, MS Society, March of Dimes, ACSD, ODSP, Ontario Works, Veterans Affairs, NIHB, Kiwanis, and more.

Bracing FAQs

We offer a wide range of both custom and off-the-shelf bracing options.  These include, but are not limited to:
-cranial remolding or protective helmets
-braces for the upper and lower spine
-braces for the upper extremity including finger, wrist, elbow and shoulder
-braces for the lower extremity including ankle, knee, hip, foot orthoses or a combination thereof.

The cost of bracing can vary widely.  For off-the-shelf bracing solutions, we will be able to give you a better sense of potential costs at your initial assessment. For custom bracing, an estimate is provided once the design of the brace is complete. We will always provide these estimates so that you are aware well ahead of time what the costs will be.

The time it takes can vary depending on our ability to secure funding, procure the parts that might be needed and fabricate the device.  Generally speaking, most patients can be fit within 1-4 weeks from their initial appointment.

An SMO (supra-malleolar orthosis) is designed to support the foot only and typically extends just over the ankle bones.  An AFO (ankle-foot orthosis) is designed for greater support of the foot-ankle complex as well as sometimes the knee.  It generally is larger and will extend to the height of the upper calf.

To learn more about the warranties for PBO Group products, click here.

The Assistive Devices Program (ADP) is the Ontario Ministry of Health payer for bracing devices and will contribute a portion of the cost but not the entire amount. PBO Group staff can provide advice on additional funding sources.

Custom braces are tailored to your specific needs, body type, and activity level in a way that off-the-shelf braces are not. Custom brace sizing can also be customized to your exact body dimensions. In some cases, an off-the-shelf or pre-made brace or splint is a great choice, often for conditions like strains, sprains, tendonitis, carpal tunnel, and ACL injury. Our Certified Orthotists can also recommend, fit, or modify off-the-shelf bracing.

We have helped many clients with bracing to address arthritis of the knee and hip.

Read our blog posts about bracing to prevent hip surgery and bracing to prevent knee surgery to learn more.

PBO Group regularly supports clients with bracing solutions who are stroke survivors and/or living with conditions such as MS, CP, ALS, Arthritis, Muscular Dystrophy, Scoliosis, Osteoarthritis and more.

While every brace is different, with proper maintenance, we generally see braces lasting at least two years and often longer.

While an ankle or foot brace can limit your shoe choices, there are a variety of great options that your specialist can recommend at local shoe providers.

It can be hard to know if a brace is the right solution for your unique situation until we know a little bit more about you. We offer free initial consultations, so there is no upfront cost to determine if a brace could help.

If you experience things like discomfort, skin irritation, mechanical failure or broken straps, please schedule an appointment for brace maintenance. In cases where the brace no longer fits, something cannot be repaired, or the cost to repair the brace exceeds the cost of replacement, replacement is recommended.

While there are some devices specifically designed for sleeping (e.g. scoliosis, carpal tunnel, range of motion stretching), in most cases, braces are removed for sleeping.

Some braces are made specifically to allow you to wear them in the shower. In some cases, a waterproof cast cover can be used to protect the device. Generally speaking, we recommend removing the brace and using a shower seat for stability.

A mild soap and water solution that you would use on your own body is the best approach for cleaning your brace. Do not use harsh chemicals like window cleaner, bleach wipes, etc., as they can cause skin irritation.

PBO Group works with a variety of excellent bracing suppliers, including Donjoy, Breg, Ossur, Ottobock, Bauerfeind, and Aircast.

Yes, and PBO Group staff can help you learn more about potential financial support for your prosthesis from a variety of funding sources, including The War AmpsRotary ClubLions ClubOntario Federation for Cerebral PalsyMS SocietyMarch of DimesACSDODSPOntario WorksVeterans AffairsNIHBKiwanis, and more.

Orthotics FAQs

The cost of custom foot orthotics varies from $450 to $650 depending on the type of the device designed and created to meet your unique needs.

Foot orthotics can get wet without harm, however it is advised that moisture be kept to a minimum and that they be left to air dry (no heat) if they do become wet.

It may be necessary to increase the length or width of your shoes by a half size depending on the shoe style however, that is not always the case. Your Orthotist will be able to advise you on your shoe selection.

Your foot orthotics can be moved between shoes as long as the shoes are of an appropriate style to function well with your devices. Your Orthotist will be able to advise you on your shoe selection.

Foot orthotics will last anywhere between two to five years depending on the amount of use and environment.

There is no need to maintain your foot orthotics in any way other than cleaning them. You can clean them using warm water and a mild soap with a soft cloth to wipe all surfaces. Once clean they should be left to air dry. Do not heat your orthotics to dry them.

To learn more about our warranties for PBO Group products, click here.

There are many factors that set custom orthotics apart from pre-made and off-the-shelf orthotics. Read this blog post to learn more.

No, orthotics are not covered by OHIP / ADP but are often covered by private insurance programs and WSIB.

Orthotics can help with a wide variety of conditions, including Plantar Fasciitis, tendonitis, metatarsalgia, arthritis, flat feet, ankle pain, knee pain, back pain, bunions, heel spurs, diabetic ulcers, and both osteoarthritis and rheumatoid arthritis.

Yes, all foot orthotics provided by PBO Group are custom-made by our talented in-house team.

Osseointegration FAQs

As with most major medical procedures, Osseointegration surgery does carry potential risks. As the amputee’s implant protrudes through the skin to connect directly to the prosthesis, it is possible for bacteria to track up the metal implant to the femur. Diligent skincare at the exit point of the implant is critical in order to prevent potential skin complications and infection.

Low bone density can also lead to other complications if the bone is not strong enough to withstand a significant increase in force following the surgery. Potential risks related to low bone density include bone fracture at the top of the implant, splitting of the bone at the implant or lack of bone integration with the implant.

Until 2018, Canadian amputees had to travel to hospitals in Australia and Europe in order to undergo Osseointegration surgery. In 2018, the first Canadian Osseointegration surgery was performed in Montreal by Dr. Robert Turcotte. Two PBO Group clients have already undergone procedures there.

From our experiences with Ontario Osseointegration candidates, we have seen costs for services related to pre-surgery, surgery and post-surgery care be quite variable and cover a very dramatic range. Like most medical procedures, there are a variety of factors that can influence cost. Some of the factors that can impact the costs associated with Osseointegration include:

  • Length of residual limb
  • Level of amputation
  • Prosthetic requirements
  • Funding model and supplementary contributors
  • Travel expenses
  • Duration of rehabilitation
  • Potential post-surgical complications

As a result, we strongly recommend connecting with a Prosthetist at one of our locations to better understand your exact situation and determine a range of costs that will be narrower and more accurate.

Yes, while it’s not happening in Canada yet, osseointegration is being performed on arms in other parts of the world.

As of 2022, the PBO Group team has provided pre- and post-surgery support to 10 amputees who have already undergone osseointegration. We have been engaged in osseointegration since 2017 and continue to update our practices and procedures with respect to delivering professional care for our OI clients.

Compression Therapy FAQs

The benefits of having custom-fit compression therapy solutions include a tailored fit based on your specific measurements, medical-grade levels of compression, better solutions for sensitive skin and helpful advice and support that can make for easier wear and care.

No. The assistive devices plan contributes to funding of compression garments for the diagnosis of lymphedema.  We are registered vendors for prosthetics and orthotics only.  If you have lymphedema and would like to pursue funding through ADP, you will have to find a registered vendor and authorizer within your area.  A list of vendors can be found at: https://www.ontario.ca/page/garments-pumps-and-braces

The most common condition managed with compression stockings is venous stasis or venous insufficiency.  However, they can also be used for chronic lower extremity swelling, for tired or achy legs, for preventative reasons in persons who stand for extended periods of time or for pregnant women.

Cranial Remolding FAQs

Most importantly, get assessed your child assessed in a timely manner. Treatment of flat head syndrome is time sensitive. Our clinics do not charge for initial assessments and we do not require a referral to see your child. Once assessment is complete, we can better decide on the next steps. If a helmet is indicated, a prescription is required for us to fit your child.

Our clinical staff will do a standard physical assessment.  A digital image will be taken using a 3D scanner.  This scanner is harmless and uses light to take pictures of your baby’s head.  This scan is incredibly accurate and can then be used to take precise measurements of the symmetry of the head.

Costs for cranial remolding helmets vary, but are generally in the $3000 range.

All adjustments to cranial remolding helmets are without charge.

We are proud to say that our helmets are some of the lightest on the market.  As they are custom-made to fit your child’s head, the weight can vary slightly from helmet to helmet.  A typical helmet weight is 7 ounces.

Every case varies, but the typical range of time that cranial remolding helmets are worn by infants is usually between nine and sixteen weeks.

Early intervention is important, whether that is the use of a helmet, which is typically started when a baby is between five and six months old, or the use of conservative repositioning therapy, which can be started at a very young age. Having your baby assessed at a very young age will help ensure the best treatment plan can be developed for the best outcomes.

No, but most major insurance companies do cover the costs or a portion of the costs of cranial remolding helmets.

At PBO Group, we offer both helmet models because they each offer unique advantages. After assessing your baby’s skull, we’ll help you make the best choice for your baby’s specific needs. This blog post provides more details on some of the factors that we take into consideration.

We recommend that helmets get removed for swimming.  The time in the pool can be counted towards your child’s hour off of helmet wear during the day.

Plagiocephaly is the most common cranial anomaly and presents as a parallelogram-shaped head. Plagiocephaly results in either the right or left side of the back of the head being flat. The asymmetries on the back of the head result in varying degrees of mal-alignment of the ears, forehead, eyes, nose, mouth and chin. Children with Plagiocephaly commonly have or are susceptible Torticollis, which is a tightening of the sternocleidomastoid muscle.

Brachycephaly can be divided into two separate categories. Symmetrical Brachycephaly is a disproportionate head shape where the entire back of the head is flat. This results in a head shape that is wider than it is long. Asymmetrical Brachycephaly is an asymmetrical head shape that is a combination of Plagiocephaly and Brachycephaly. Both categories are a result of prolonged positions on the baby’s back within the early years of development. Prolonged pressure on the back of the head causes the head to grow into areas that are not under the contact of the foreign object (i.e. car seat). This results in the head growing upwards, outwards and sometimes forward.

Scaphocephaly is the least common of the cranial anomalies and results in a head shape that is very narrow and long. It is commonly seen when the child has what is called Craniosynostosis, which is a premature fusion of the cranial sutures. Craniosynostosis needs to be ruled out prior to helmet therapy by your medical physician.

Torticollis is a condition where the sternocleidomastoid muscle (a muscle on the side of the neck) is tight. This inhibits the child’s ability to turn in the opposite direction. Eighty to ninety percent of children with Torticollis will develop varying degrees of Plagiocephaly. Therefore, it is important to communicate with your family doctor if you notice that your child has a tendency to tilt their head to one side or is unable to turn their head to one side. Stretching and passive ROM are the forms of treatment for Torticollis, which can be provided by a physiotherapist or chiropractor trained in pediatrics. By treating Torticollis at an early age, the chance of the child’s Plagiocephaly developing or progressing will be decreased.

Repositioning therapy, or tummy time, is a treatment modality for babies less than three- to five months of age that are starting to exhibit characteristics of cranial flattening. Children that are greater than 5 months of age will continue repositioning therapy if their CVAI measurement is less than 6.25 and their oblique difference is less than 10 mm. If the child is higher than these values at 5 months of age, then a remolding helmet is considered. You can find recommended tummy time exercises in this blog post.

To learn more about our warranties for PBO products, click here.

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