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ORTHOTIC AND PROSTHETIC MOCK EXAMS > AFO Types and Considerations > Flashcards

AFO Types and Considerations Flashcards

1
Q

Solid or Rigid

A

Provides rigid support of ankle in desired position that has implications for knee control

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2
Q

Solid or Rigid Benefits

A
  1. Increased Dorsiflexion swing
  2. Adjustability of stiffness by changing trimlines
  3. Increased stance phase; knee flexion or extension by restricting ankle motion
  4. Decreased equinovarus in stance
  5. Possible ankle control with PF spasticity
  6. Increased static balance
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3
Q

Solid or rigid: considerations that may limit success

A
  1. Desire to allow volitional muscle activation
  2. Decrease PROM
    3 Bulk and weight of AFO
  3. Desire for allowing ankle DF during functional mobility
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4
Q

Solid or rigid: Key AFO design considerations

A
  1. Material strength provides increased motion restriction and ankle control
  2. Increased AFO stiffness may lead to increased knee flexion at IC
  3. Anterior trimlines increased ankle control
  4. AFO rigidity AFO set in DF leads to knee flexion in stance
  5. AFO set in PF leads to knee extension in stance
  6. Increased AFO stiffness may increase knee flexion at IC
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5
Q

Solid AFO Example

A
  1. Anterior trimlines
  2. Thicker materials
  3. Fixed at ankle in slight PF, neutral, or DF based on control needed
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6
Q

Ground Reaction

A

Provides knee stability through a posteriorly directed force on the proximal tibia

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7
Q

Ground Reaction: Benefits

A
  1. Increased DF in swing
  2. Strong stance phase knee flexion control
  3. Possible increased gait speed if a soft heel or rocker sole is added to the shoe
  4. Increased static balance
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8
Q

Ground Reaction: Considerations that may limit success

A
  1. Genu recurvatum
  2. Strong hyperextension thrust in stance
  3. Quadriceps spasticity
  4. bulk and weight of AFO
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9
Q

Ground Reaction: Key AFO design considerations

A
  1. Anterior proximal contact of AFO leads to stance phase knee extension
  2. Increased AFO stiffness may increased knee flexion at IC
  3. AFO set in PF leads to knee extension in stance
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10
Q

Ground Reaction AFO Example

A
  1. Fixed at ankle in slight PF
  2. Anterior shell for added tibial control
  3. Carbon or plastic options
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11
Q

Semirigid

A

Provides varying degrees of rigidity based on design and materials used

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12
Q

Semirigid: Benefits

A
  1. Increased DF in swing
  2. Adjustability of stiffness by changing trimlines
  3. Increased stance phase knee flexion or extension by limiting ankle motion
  4. Increased gait speed if AFO has fewer restrictions to movement
  5. May increased dynamic balance based on design
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13
Q

Semirigid: Considerations that may limit success

A
  1. PF spasticity (great or equal to MAS 3)
  2. Decreased strength or control of the ankle or knee muscles
  3. Equinovarus
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14
Q

Semirigid: Key AFO considerations

A
  1. Material roperty choices restrict or allow motion
  2. AFO set in DF leads to knee flexion in stance
  3. AFO set in PF leads to knee extension in stance
  4. Anterior trimlines increase ankle control and AFO rigidity
  5. Posterior trimlines decrease ankle control and AFO rigidity
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15
Q

Semirigid AFO Example

A
  1. More posterior trimlines
  2. Ankle in slight PF, neutral, or DF based on control needed
  3. Some ankle motion allowed based on material thickness and flexibility
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16
Q

Flexible/Posterior Leaf Spring

A

Provides varying degrees of flexibility based on design and materials used

17
Q

Flexible/Posterior Leaf Spring: Benefits

A
  1. Increased DF in swing
  2. Lightweight
  3. Pre-fabricated options
  4. Increased gait speed
18
Q

Flexible/Posterior Leaf Spring: Considerations that may limit success

A
  1. PF spasticity (great or equal to MAS 3)
  2. Decreased strength or control of the ankle or knee muscles
  3. Decreased dynamic balnace
19
Q

Flexible/Posterior Leaf Spring: Key AFO Design Considerations

A
  1. Material properties allow motion
  2. Posterior trimlines decrease ankle control and AFO rigidity
20
Q

Posterior Leaf Spring AFO Example

A
  1. Most posterior trimline
  2. More ankle motion allowed due to material flexibility
  3. Minimal to no mediolateral ankle support
  4. Minimal to no effect at the knee
21
Q

Articulating

A

Provides varying degrees of motion at the ankle through hinges with optional stops to limit ROM if desired

22
Q

Articulating: Benefits

A
  1. Increased DF in swing
  2. Adjustable as patient’s needs change
  3. Allows for volitional muscle activation
  4. Increased stance phase knee flexion or extension by allowing or restricting ankle motion
  5. Decreased equinovarus in stance with design that encompasses more of the ankle
  6. Increased gait speed if AFO has less motion restrictions
  7. Increased static balance if AFO has more motion restrictions
23
Q

Articulating: Considerations that may limit success

A
  1. PF spasticity (great or equal to MAS 3)
  2. Decreased ankle PROM
  3. Bulk and weight of AFO
  4. Decreased medial/lateral ankle stability
24
Q

Articulating: Key AFO Design Considerations

A
  1. Hinges allow motion
  2. Stops restrict motion
  3. AFO set in more DF leads to increased knee flexion in stance
  4. AFO set in more PF leads to increased knee extension in stance
25
Q

Articulating AFO Example

A

Double Metal Upright AFO:
1. DF and PF stops set by adjusting screws/bars in each channel
2. Springs can be added for DF assist
3. Good option with edema and to allow modifications with recovery

Articulating Plastic AFO:
1. Many options for hinge types
2. DF and PF stops achieved by straps, hinge types, and/or materials abutting
3. Good option to allow modifications with recovery

26
Q

Dynamic

A

Enhances or resists ankle motion while allowing some motion and/or energy storage

27
Q

Dynamic: Benefits

A
  1. Increased DF in swing
  2. Increased push-off force
  3. Allows for volitional muscle activation
  4. Possible increased stance phase knee flexion or extension by supporting sagittal plane ankle motion
  5. Possible decrease equinovarus in stance with design that encompasses more of the ankle
  6. Increased gait speed
28
Q

Dynamic: Considerations that may limit success

A
  1. PF spasticity (great or equal to MAS 3)
  2. Equinovarus
  3. Knee buckling
  4. Genu recurvatum
  5. Decreased ankle PROM
29
Q

Dynamic: Key AFO Design Considerations

A
  1. Material property and/or spring choices assist, restrict or allow motion
  2. AFO set in DF leads to knee flexion in stance
  3. AFO set in PF leads to knee extension in stance
30
Q

Dynamic AFO Example

A

Carbon Fiber AFO:
1. Stores and releases force for push-off
2. Minimal medial/lateral support at ankle
3. Minimal to no adjustability

Articulating AFO, DF Assist:
1. Free DF with some DF assist from this hinge
2. PF stop created by contact of shells posteriorly
3. Pin or longer shells can be used posteriorly for more PF restriction

ORTHOTIC AND PROSTHETIC MOCK EXAMS (21 decks)

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