Ankle Orthoses Flashcards
true or false: AFO Can affect mechanics @ knee
true
How does AFO differ from an FO?
- Improved tibial control
- Improved foot control
- Can affect mechanics @ knee il
Superior trim line usually ___’’ distal to fibula head
1-1/2
avoid nerve pressure
a pt is wearing an AFO with foot straps, what may the patient have?
spasticity
a pt is wearing a hinged AFO with a dorsiflexion stop, what ankle mm are weak?
Mostly with weak plantarflexor muscles: think stance
a pt is wearing a hinged AFO with a plantarflexion stop, what ankle mm are weak?
Mostly with weak dorsiflexor muscles: think swing
Goals of AFO During SWING
- Foot clearance: safety
- Reduces need for inefficient gait compensations
- Set up for proper foot positioning at IC
If excessive flexion during MST → Positioning AFO in
plantarflexion encourages knee extension
If excessive extension during MST → Positioning AFO in
slight DF encourages knee flex
**quad strength to control flexion**
If excessive flexion during MST → Positioning AFO in
plantarflexion to encourage knee extension
Solid/Locked AFO indications
- Ankle weakness/instability
- Increased PF tone
- Mild knee hyperextension or buckling (flexion)
SAFO drawbacks
- Sit to stand, stairs, inclines
- Alter motion during gait
- produces compensations
Anterior band AFO AKA
Floor reaction AFO or Ground Reaction AFO
Anterior Band AFO (Floor/ground reaction AFO) during IC/LR prevents any
anterior translation of the tibia
for knee extension weakness
Hinged AFO (HAFO) indications
- M/L instability
- DF/PF ROM is available
- DF/PF weakness
- (amount of motion is customized)
HAFO with DF assist indications
weak DF
true or false: HAFO with DF assists controls loading response preventing foot slap on a patient with weak tibialis anterior
true in theory, but false in clinic
HAFO with PF stop indications
- Absent or weak ankle DF
- Increased PF muscle tone
HAFO with PF stop prevents what during the swing phase?
prevents toe drag
does a HAFO with PF stop allows tibia to translate forward during stance?
yes
HAFO with DF stop indications
- Absent or weak ankle PF
- Intact DF strength
- Mild knee extensor weakness
pop: which device is not appropriate for pt with absent ankle IV/EV with weak DF/PF
a. HAFO - free motion
b. HAFO - DF stop at 3 deg. with assist and PF stop at 0 deg.
c. SMO
d. KAFO
a and c
Posterior Leaf Spring (PLS) indications
-
Good for DF weakness
- Usually used post CVA
- Pt may present with foot slap or toe drag
- Not first choice if no or minimal DF strength
Posterior Leaf Spring (PLS) is not good for the person with
mod to max PF weakness or increased PF tone
the premise behind Posterior Leaf Spring (PLS) is that motion occurs becasue
material bends & recoils P
Supramalleolar Orthoses (SMO) indications/function
Increased m/I stability while allowing DF/PF
Controlled Ankle Motion (CAM) indications
- Post-surgical or with fractures
- Rocker bottom
Positional Orthoses
- Prevent PF contractures from forming
- Prevent heel ulcers from forming
- Not for ambulation
Contracture-reducing
- Applies force (low load, prolonged) to bring foot into DF
- Tension is adjustable
- Not for gait 1.
Arizona brace
posterior tibialis tendon rupture
Stirrup orthoses
- Air casts or splints
- Provide support and mainly resist inversion
Elastic Supports used for
- prevention
- Minimal support
- Minimal edema control?
- Proprioception
