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3) P&O > 1) Intro Lecture/Vocab & LE Orthosis > Flashcards

1) Intro Lecture/Vocab & LE Orthosis Flashcards

1
Q

What is an orthotic?

A

A static or dynamic externally applied device used to improve pt fxn

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2
Q

What are all of the things that orthotics do?

A
  • Prevent & correct deformity
  • Support segment for WB (unload)
  • Assist, facilitate, or limit movement
  • Decr pain or discomfort
  • Improve posture/alignment
  • Immobilize
  • Provide feedback
  • Improve cosmesis
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3
Q

What are the indications for orthotics?

A

Impaired:

  • Posture
  • Muscle performance
  • Jt mobility or integrity
  • Motor fxn
  • Sensation
  • Peripheral nerve integrity
  • Integumentary integrity
  • Acute conditions (post-trauma or surgery)
  • Chronic conditions (neuro & msk)
  • Prophylactic
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4
Q

Are there age or practice setting limitations for orthotics?

A

No

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5
Q

Who does the team approach encompass?

A
  • Pt & caregiver
  • PT
  • OT
  • Orthotist
  • Physician (Physiatrist)
  • Social Worker
  • Vocational Counselor
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6
Q

What are the two types of orthoses?

A

Brace & Splint

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7
Q

What is a brace?

A

Designed to resist or direct force long term or permanently

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8
Q

What is a splint?

A

Designed to maintain or attain a position on a temporary basis

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9
Q

What terms are used for orthotic nomenclature?

A
  • Body part/jt
  • Function terms
  • Special characteristics or hardware
  • Trademark names
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10
Q

How do you name orthoses?

A

Based on what jt’s they cross

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11
Q

FO

A

Foot Orthotic

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12
Q

AO

A

Ankle Orthotic

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13
Q

KO

A

Knee Orthotic

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14
Q

HpO

A

Hip Orthotic

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15
Q

AFO

A

Ankle Foot Orthotic

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16
Q

KAFO

A

Knee Ankle Foot Orthotic

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17
Q

HKAFO

A

Hip-Knee-Ankle-Foot Orthotic

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18
Q

LSHKAFO

A

Lumbo-Sacral-Hip-Knee-Ankle-Foot Orthotic

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19
Q

SIO

A

Sacro-Illiac Orthotic

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20
Q

CO

A

Cervical Orthotic

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21
Q

CTO

A

Cervical-Thoracic Orthotic

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22
Q

LSO

A

Lumbo-Sacral Orthotic

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23
Q

TSLO

A

Thoracic-Lumbo-Sacral Orthotic

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24
Q

CTLSO

A

Cervical-Thoracic-Lumbo-Sacral Orthotic

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25
Q

HCTO

A

Head-Cervical-Thoracic Orthotic

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26
Q

HO

A

Hand Orthotic

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27
Q

EO

A

Elbow Orthotic

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28
Q

SO

A

Shoulder Orthotic

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29
Q

WHO

A

Wrist-Hand Orthotic

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30
Q

EWO

A

Elbow-Wrist Orthotic

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31
Q

SEO

A

Shoulder-Elbow Orthotic

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32
Q

SEWO

A

Shoulder-Elbow-Wrist Orthotic

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33
Q

SEWHO

A

Shoulder-Elbow-Wrist-Hand Orthotic

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34
Q

What is a pre-fabricated orthotic?

A

Custom-fit aka “off the shelf”

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35
Q

What are the indications for prefab orthotics?

A
  • Mild-mod jt involvement
  • Temporary use
  • To figure out if a custom-made orthotic would be effective
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36
Q

What are the indications for custom-made orthotics?

A
  • Mod-severe jt involvement
  • Extended/permanent use
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37
Q

Which orthotic fits and fxn’s better: Prefab or custom-made?

A

Custom-made

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38
Q

What are the different materials that orthotics can be made out of?

A
  • Thermoplastic
  • Metals (Steel, aluminum, titanium)
  • Carbon fiber
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39
Q

What is the benefit of using metal to make an orthotic?

A

It’s strong

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40
Q

What do metal orthotics lack, who can this benefit, and why?

A

Lacks metal

Good for pt’s w/conditions such as lymphedema bc it leaves space for swelling

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41
Q

What are the cons of using a metal orthotic?

A
  • Can be heavy and bulky
  • Requires maintenance-oil jt’s
  • Limited footwear options
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42
Q

What is good about carbon fiber orthotics?

A
  • Greater elasticity → Allows for energy return
  • Lighter
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43
Q

What are the benefits of thermoplastic orthotics?

A
  • Light
  • Easy to clean
  • Total contact
  • Can wear a variety of shoes
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44
Q

What does the material an orthotic is made of effect?

A

Fxn of the device

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45
Q

What does total contact mean in regards to an orthotic?

A

Pressure will be distributed over a large area

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46
Q

In a pt w/strong PF & inv hypertonicity, which AFO would exert the largest edge pressure?

A

*

47
Q

Which AFO would best control PF Hypertonicity?

A

*

48
Q

Explain ground reaction force

A

*

49
Q

Explain example of controlling degrees of freedom

A

Can put an orthotic on legs bilaterally to allow pt to focus on spine movement

50
Q

In a 3 point pressure system, how are the points distributed?

A

1 point on the convexity, 2 points on the concavity

51
Q

Give an example of when a 4-point pressure system could be used and why

A
  • Used to control knee flexion
  • 4th point prevents pressure on the patella
52
Q

What things need to be taken into consideration for designing an orthotic?

A
  • Pressure distribution
  • Force arm
  • GRF
  • Pressure System
  • Control of DoF’s
53
Q

What type of orthotic could be used for genu recurvatum?

A

Swedish Knee Cage

54
Q

Where would the points go on a 3-point system?

*

A

*

55
Q

How would you set up a wheelchair w/a 3-point pressure system to reverse decorticate posturing?

A

Tilt w/c in space and use gravity as the point of pressure on the convexity

56
Q

Foot Lift

A

Used to correct limb length discrepancies, SIJ dysfxn. or in conjunction w/KAFO

57
Q

What is this?

A

Foot Lift

58
Q

Heel Lift

A

Used to reduce achilles tendon stres

59
Q

What is this?

A

Heel Lift

60
Q

Heel Cup

A

Redistributes fat pad to improve shock absorption, especially in cases of heel spurs or chronic plantar fasciitis

61
Q

What is this?

A

Heel Cup

62
Q

What do rigid & semi-rigid corrective foot orthotics do?

A

Normalize abn subtalar & TMT mechanics

63
Q

What FO would you use for a pt w/achilles tendinitis?

A

Heel Lift

64
Q

What FO would you use for pt w/plantar fasciitis?

A

Heel cup

65
Q

What FO would you use for a pt w/ a 1/4” limb length discrepancy?

A

Foot Lift

66
Q

What does an aircast do & which pt’s are commonly given this?

A
  • Controls talo-crural jt
  • Pt’s w/inversion sprains
67
Q

True or False: An aircast accomodates for swelling?

A

True

68
Q

What is one limitation of AFO’s?

A

They limit proprioception

69
Q

What is this?

A

SwedeO

70
Q

What is this?

A

Surestep

71
Q

What does a surestep do?

A

Controls inv/ev

72
Q

What is this?

*

A

Langer Total Control

73
Q

What is a langer total control AFO used for?

A

Instability

74
Q

What does a CAM walker do?

A

Immobilizes the ankle

75
Q

True or False: CAM walkers do not unload distal structures?

A

True

76
Q

How do patellar tendon weight-bearing AFO’s work?

A

They reduce WB through the metatarsals, TCJ, & STJ by putting pressure through the patellar tendon via a lip

77
Q

What is this?

A

Patellar Tendon Weight-Bearing AFO

78
Q

What would you use an articulated/jointed AFO for?

A

To normalize a pt’s gait

79
Q

Because articulated/jointed AFO’s normalize gait mechanics, what else does it do?

A

Decr energy cost of ambulation

80
Q

What does Ground Reaction/Floor Reaction AFO do?

A
  • Controls tibial advancement → Helps maintain knee extension during midstance
  • Compensates for weak PF’s
  • Controls the knee through the ankle
81
Q

What is the problem w/knee immobilizers?

A

The numbers on the flexion/extension stop are never accurate so you need to use a goni & teach pt about alignment for donning

82
Q

What do KO’s limit?

A
  • Genu recurvatum
  • Anterior tibial translation
  • Varus/Valgus Forces
  • Rotation
  • Enhance proprioception
83
Q

What are knee unloading braces used for?

A

OA

  • Buys the pt a little bit of time before needing a knee replacement
84
Q

What pt population are knee unloading braces not too effective for?

A

Active pt’s

85
Q

What type of pressure system do knee unloading braces use?

A

3 point

86
Q

What does a T-strap orthosis do?

A

Alters patellar tracking

87
Q

What do infrapatellar straps do?

A

Decr strain on patellar tendon by decr patella-patellar tendon angle

88
Q

What can ratcheting lock KAFO’s be used for

A
  • Hamstring spasticity
  • Low-load, long duration stretch
89
Q

What do weightbearing KAFO’s do & how?

A

Unloads the proximal tibia & femoral condyles by having pt wb through their isch tubes (there’s a lip on the device that the pt kind of sits on)

90
Q

What does extension assist KAFO do?

A

Controls heel rise in midstance and increases knee extension in terminal swing

91
Q

Why do stance control KAFO’s get tiring to use?

A

Bc they restrict knee flexion

92
Q

What sequelae of CVA would contraindicate a stance control AFO & why?

A

Synergy → Pt won’t be able to PF enough to extend knee

93
Q

How do stance control AFO’s work?

A

1) PF produces an extension force at the knee

2) DF releases extension force during swing

94
Q

What are HpO’s used for?

A

Congenital hip issues → Keeps the pt in abdution

95
Q

What do LSHO’s do?

A

Limit adduction. flexion, & IR

96
Q

What is the difference between a post-op hip abduction orthosis & a spika?

A

Post-op hip abduction orthosis cues & Spika maintains

97
Q

What conditions can RGO’s be helpful for & what do they do?

A

SCI & CP → Facilitates gait

98
Q

RGO

A

Reciprocal Gait Orthotic

99
Q

What is a pavlik harness used for & how does it work?

A

To tx reducible developmental hip dysplasia in kids <6mo by drawing the femur into flexion & abduction

100
Q

What is a pavlik harness not appropriate for?

A

Fixed teratologic hip dislocations

101
Q

What does a Scottish Rite brace do?

A

Facilitates WB in abduction for pt’s w/Perthe’s Disease

102
Q

Explain serial casting?

A

Cast stretch in 1 position, leave it on for a few days, take it off & recast again in new range

103
Q

How does an RCAI passive adjustable splint work?

A

Set an angle & it holds the pt there

104
Q

Is a dynasplint passive or active?

A

Active

105
Q

Is an RCAI splint passive or active?

A

Passive Adjustable

106
Q

What is a multi-podus boot?

A

For pt’s who were in one position for an extended period of time

107
Q

Is a multipodus boot active or passive?

A

Passive

108
Q

What is a wedge shoe?

A

Eliminates forefoot WB (aka unweights the met heads)

109
Q

Who are wedge shoes good for?

A

Pt’s w/DM

110
Q

Process for evaluating a pt for an LE orthosis

A
  • Eval standing w/out external support as appropriate
  • Look at at least the feet, knees, and ankles
    • Iliac crests & L/S is also helpful
  • View from all angles
  • MMT & ROM for K ext, PF, & DF
  • Sensation (Protective, Proprioceptive, Kinesthesia, & Balance)
111
Q

After giving a pt an LE orthosis, what needs to be checked?

A
  • Alignment & slippage
  • Donning/doffing
  • Pressure areas & skin care
  • Pt ed
  • Monitor for weight loss/gain
  • ROM
112
Q
A
113
Q

After giving a pt an orthosis, if you notice some skin redness should you go crazy & why?

A

Not necessarily → Sometimes it takes some time for a pt’s skin to get used to the device

114
Q
A

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