Ankle Foot Orthotics

Question 1

what are precautioons/contraindications of AFOs

Answer 1

precaution: sensation impairment or edema
contraindication: open wound or fixed deformity of the ankle

Question 2

what are trim lines

Answer 2

they are the borders of an orthosis that determine the amount of containment and control of the tibia

Question 3

what is the height and reasoning of the trim lines

Answer 3

it is one inch inferior to the fibular head; a longer lever arm is needed for more control

Question 4

how is the design of a full foot plate significiant

Answer 4

controls the knee

also used for pt. with hypertonicity

Question 5

what is an articulated or hinged joint

Answer 5

a free joint that allows for full ankle DF/PF but limits medial/lateral motion

Question 6

where are postings placed on an orthotic

Answer 6

added to the external plantar surface of the hindfoot to provide extra support for any abnormal alignment or accommodated fixed deformities

Question 7

what are AFOs most commonly used for

Answer 7

drop foot

Question 8

what is a patellar tendon bearing shell indicated for

Answer 8

heel ulcers
calcanectomy
severe foot trauma
chronic ankle pain
****this custom AFO is used to take WB off the bottom foot

Question 9

what are pre-fab AFOs best for

Answer 9

best for short term used or trials

best for patients with good sensation and no edema

Question 10

what is the top choice pre-fab AFO

Answer 10

carbon fiber because it has energy storing benefits and is light weight

Question 11

what patient would be using a carbon fiber AFO

Answer 11

pt. with MS or post-polio would benefit from the light weight mold due to their impairments involving fatigue and decreased strength

Question 12

when would we choose to use a conventional AFO

Answer 12

when it is hard to fit a custom orthotic because of poor skin integrity
for someone with edema, severe bony deformity or poor sensation

Question 13

what is the name of a foot orthosis with trim lines above the malleoli and surrounding the foot

Answer 13

a supramalleolar orthotic

Question 14

when is a SMO indicated

Answer 14

for someone who needs medial/lateral control but has DF/PF control

Question 15

characteristics of the posterior leaf spring

Answer 15

pre-fabricated
trim lines are posterior to the malleoli
provides DF assist
gives support during swing but no control during stance

Question 16

how can a solid AFO counteract genu recurvatum

Answer 16

it is set at 2-3 degrees of DF which minimizes the excessive extension moment while preserving the knee joint

Question 17

how is knee extension moment promoted

Answer 17

by ankle plantar flexion

Question 18

how is knee flexion moment promoted

Answer 18

by ankle dorsiflexion

Question 19

what type of ankle joint provides only mediolateral stability

Answer 19

the free joint

Question 20

when is a PF joint stop used

Answer 20

used in someone with dorsiflexion weakness

Question 21

when is a dorsiflexion joint stop used

Answer 21

used in quad weakness; because if you are unable to get full extension in the knee your leg will keep buckling therefore creating too much dorsiflexion

Question 22

when is a dorsiflexion assist spring joint contraindicated

Answer 22

with someone who has hypertonicity

Question 23

what is the purpose of a ground or floor reaction AFO

Answer 23

limits forward progression of the tibia during stance phase which produces a knee ext moment because it sets the leg in slight plantarflexion

Question 24

when is a ground reaction AFO indicated

Answer 24

used for someone with excessive knee flexion and dorisflexion

Question 25

what does the spiral AFO control

Answer 25

controls eversion/inversion

has little control over DF/PF

Question 26

How is the toe off AFO considered a dynamic response orthoses

Answer 26

it stores and returns energy which can reduce the energy cost of walking
the anterior design provides DF resistance which assists PF and propulsion at toe off

Question 27

which AFO is indicated for Charcot Marie Tooth deformity and why

Answer 27

the unloading neuropathic AFO because it transfers weight from the foot into the orthotic and is designed to off load wound sites