Braces, supports, and taping Flashcards
How are scoliosis braces often named?
By the region that they support
What is a TLSO?
Thoracolumbarsacral orthosis
What is a CTLSO?
Cervical-thoraco-lumbo-sacral orthosis
What kind of brace is a boston brace? What is it AKA?
A TLSO. Under arm brace
T/F
A boston brace is worn over clothing for atleast 21 hours a day
False,
Under clothing, worn at least 23 hours a day.
What kind of brace is a milwaukee brace and what is it for?
A CTLSO? Worn for curves of the thoracic spine.
How is the milwaukee brace similar to the boston brace? How is it different?
it’s worn 23 hours/day.
It’s different because it includes a neck ring held in place by vertical bars attached to the body of the brace
T/F
A charleston brace is worn for most of the day
False, it’s a night time brace only used during sleep hours.
How is a milwaukee brace fitted?
Molded to patient while they are in side flexion, to give added pressure
What are the 3 types of bracing for spinal fractures?
Voigt-bahler brace
TLSO
Extension (hyper-extension)
What are the 4 ancillary braces mentioned?
Knight-Taylor
Knight spinal brace
Lennox-Hill brace
Williams brace
What do trochanteric/sacroiliac belts do and who are they mainly for?
Support the SI joints and pelvis (force closure).
Pregnant and post-partum females with SI joint pain.
What happens to the SI joints if the belt is worn over the trochanters?
Gapping of the SI joint
T/F
There is strong evidence from research that lumbar supports have great effect for for low back injuries in preventing reinjury
False
There is weak evidence that low back injuries may
benefit from supports by reducing the risk of re-injury
What are some downsides of wearing a lumbar support if you’re a patient who has never been injured?
Those who have never been injured:
– No protection and may have even more severe injury
– Increase intra-abdominal pressure (and blood
pressure) without reducing compression on the spine
• May allow people to lift more or give the
impression that they can (risky)
• Effect of supports is variable some people lift
with better mechanics, some with worse
• Higher blood pressure and heart rate = cardiac risk
What is a recommended lumbar support?
Back belt
T/F
Back belts are to be worn consistently and continuously
False,
they are made for temporary use
What should be considered in fitting a back belt for a patient?
Screen for cardiovascular risk
Educate patient on how to not rely on the belt, and how to strengthen core and stabalizer muscles
Studies of patients wearing knee braces for ACL tears demonstrated that….
– Patients report subjectively feel more stable – Does not improve stability objectively – May not protect from injury – Bracing slows hamstring reflexes
T/F
Studies show that knee bracing enhances the hamstring reflex
False,
Elastic taping does this
What kind of injury does knee bracing best protect from?
injuries sustained from lateral blows
What is the function of neoprene sleeves?
To keep joints warm.
T/F
Neoprene sleeves do not protect against injury
True
What is a common noted benefit between neoprene sleeves and knee braces?
Possible improved proprioception in patients with deficits
Where on the body is a Cho-pat utilized?
Knee (Osgood-schlatter’s disease)
Elbow (epicondylitis)
Are walking boots weight bearing?
Yes
What movements are facilitated and inhibited by an ankle stirrup?
Flexion/extension allowed
Prevents inversion/eversion
What kind of orthopedic device be used for fractured toes?
Orthopedic (fracture) shoe.
There hasn’t been much research one on cervical pillows, but out of what has been demonstrated, what showed positive results and what showed mixed results
Positive results for pain management
Mixed results on disability
What movements should the patient refrain from when using a cervical pillow?
Flexion, extension
What are the features of a philadelphia collar?
- Rigid
- Prevents motion
- Stabilization
- Slight distraction
What are the features of a soft cervical collar?
• “Reminder” • Limit cervical motion • Not rotation • Following sprain/strain injuries
What are the characteristics of a wrist splint?
• Cock up splint, neutral, or flexion
– Depends on “Spoon”
What are the indications of a wrist splint?
Sprains, carpal tunnel
What is ropiness associated with?
Deep tonicity
Indictations for a cervical orthosis:
Dislocation/subluxation
Some fractures
Compression
flexion injury (compression)
What are the landmarks for a cervical orthosis?
Occiput
Mandible
Sternal notch
Trapezius
What are the 4 kinds of support systems?
- Compressive
- 3 Point
- 4 Point
- Double 3 Point
In fitting a cervical orthosis, if the patient is able to tuck his chin into the brace what does this suggest?
It’s not the right size
What does a lumbosacral belt do?
• Help Stabilize the interverebral joints
• Increase motion of adjacent joints
• Transfer part of the vertical load from the spine
to other structures
• Increase intra-abdominal pressure
• Decrease intradiscal pressure
• Decrease venous return from the lower
extremities
• Control lordosis
• Support arthritis, herniated discs, minor
fractures, spondylitis and protruding abdomen
• Provide an awareness of correct posture
• Decrease abdominal and/or spinal muscular
activity
When checking the fitting of a lumbosacral brace should a patient be standing or sitting?
Sitting
What is the best way of sitting a lumbosacral brace?
Patient laying down with knees bent.
How do SI belts stabalize the joint?
By squeezing the ilia and the sacrum together
What direction is the cervical orthosis supposed to be fitted from?
Anterior
What are the 4 criteria in selecting the right support?
Breatheability
Compression
Flexion
Stability
T/F
Where you apply the external straps (with a lumbosacral device) can have an effect on the location of compression.
True
What is another function of an SI belt related to the trochanters and pain?
stabilizes the trochanters and helps
relieve sciatica pain and scoliosis caused by
pelvic instability.
When is an SI belt best used?
After an injury, with hyper mobility
of the sacroiliac joints or after a pregnancy.
What are the sacroiliac belt landmarks?
ASIS
Distal sacrum or sacrococcygeal joint (very top crease of buttocks)
Symphysis pubis
Greater trochanter (for full hip measurement)
Where are SI belts measured for fit?
From the side in sitting position
What part of the anatomy are measurements for an SI belt taken?
Fullest part of the buttocks
What is the best position the patient can assume for fitting an SI belt?
Best secure fitting is with patient lying down, knees bent
Trachanteric belts are very similar to SI belts except…
Similar function to sacroiliac belt but less bulk. • Goal is immobilization supporting the pelvic and sacrum. • Useful in reducing inflammation
What is the purpose of a rib belt?
• Stabilizes rib and sternum
fracture.
• Provides supporting pressure
following surgical incisions.
What are the landmarks for a rib belt?
- Xiphoid Process
- Costal Flair
- Inferior Scapula
- Scapular Spine
Whats the purpose of an abdominal support?
Supplements musculature weakened by loss of muscle tone. • Reduces strain on muscles, ligaments and joints of lumbar and spine. • Help restore normal distribution of body weight. • Improves posture and overal body physiology. • Helps after surgery by preventing abdomen from straining abdominal incisions.
Where are measurements taken for an upper extremity brace?
Just below elbow at widest
part of forearm depending
on support needed.
With epicondylitis where should pad placement be?
Closest to area of pain
How is brace for epicondylitis applied?
In supination
What are the measurements for wrist supports?
Circumference of wrist.
How is a wrist support fitted?
When patient is in supination
T/F
When fitting a wrist support, straps closets to fingers are fitted first?
True
What is a great risk associated with immobilization in wearing an upper extremity support?
Frozen shoulder
To prevent injuries from prolonged immobilization, upper extremity supports should be worn constantly for no longer than how long?
3-4 days & work
with a therapist or doctor
With an upper extremity support, too much tension or pressure on the Brachial Plexus region can happen and the nerve or blood supply can be cut off, which can result in what?
Arm flail
What should rigid “gunslinger” braces have to offset their rigidty?
Weight on the ilium.
What are knee sleeves best for?
Legs that are symmetrical
What are open-closure knee braces best for?
Legs that are not symmetrical
What are the benefits of braces with adjustable straps
Help control patella posture and creates environment for rehab.
T/F
Ankle supports encourage ambulation
True
What are the indications of an ankle support?
- Edema reduction
- Retain proprioception
- Retain strength
- Knee issues
- Plantar Fasciitis
What’s the most common type of ankle sprain and what percentage incidence does it claim?
Inversion ankle sprain. 80% of ankle sprains.
What kind of motion do ankle braces support and limit?
Limits abnormal motion but allows
biomechanically appropriate pathways of
motion.
How should ankle supports be applied directionally?
Should be applied from bottom up with
laces or straps.
What are the benefits of an air-gel ankle support?
• Good for early
Ambulation.
• Limits motions that led
to injuries.
What are the benefits of plastic inserts?
Help limit motions
that led to injuries.
What is lace design ankle supports good for
Great for post injury and provides
excellent compression & medial/lateral support.
What does kinesio tape treat?
treatment of muscular
disorders and lymphedema reduction
What are the acute benefits of kinesio tape?
Helps prevent overuse and facilitates lymph flow
What 4 things is kinesio tape used to help treat?
- Carpal Tunnel Syndrome
- Patellar Pain
- Neck Pain
- Low Back Pain
What kind of taping should be done for an acute ankle sprain?
Closed basket weave with stirrups and heel lock.
What conditions of the foot does kinesio tape treat well?
Plantar fasciitis
