Case Study Part 2

Question 1

List what problems will definitely be addressed with a solid ankle thermoplastic AFO without a tibial strap (5 things)

Answer 1

1. Knee weakness
2. Ankle weakness
3. Stance phase stability
4. Toe clearance
5. Pre-positioning

Question 2

What problems may be addressed with a solid ankle thermoplastic AFO without a tibial strap

Answer 2

1. Hip weakness

2. Crouch gait (but only mildly because he needs the tibial strap to really make a difference)

Question 3

What gait deviations will be impaired with a solid ankle thermoplastic AFO without a tibial strap

Answer 3

Decreased ankle strategies
Decreased surface accommodations
Decreased push off

Question 4

How are the rockers of gait being impacted with a solid ankle thermoplastic AFO without a tibial strap

Answer 4

Heel: absent
Ankle: decreased
Toe: normal

Question 5

What planes of motions are being controlled with a solid ankle thermoplastic AFO without a tibial strap

Answer 5

Sagittal plane motions are controlling the TCJ and knee and ankle mod to max
Frontal plane motions are controlling the STJ and midtarsal joint maximally

Question 6

List what problems will definitely be addressed with a carbon posterior shell AFO with a custom molded SMO (5 things)

Answer 6

1. Ankle weakness
2. Stance phase stability
3. Toe clearance
4. Pre positioning
5. Increased step length

Question 7

What problems may be addressed with a carbon posterior shell AFO with a custom molded SMO

Answer 7

1. Knee weakness

2. Genu varus/valgus

Question 8

What gait deviations will be impaired with a carbon posterior shell AFO with a custom molded SMO

Answer 8

Decreased accommodation to uneven surfaces

Decreased ankle strategies (carbon AFO)

Question 9

How are the rockers of gait being impacted with a carbon posterior shell AFO with a custom molded SMO

Answer 9

Heel: decreased
Ankle: decreased
Toe: normal

Question 10

What planes of motion are being controlled with a carbon posterior shell AFO with a custom molded SMO

Answer 10

Sagittal plane motion is being controlled moderately with the carbon posterior shell AFO
Frontal plane is being controlled maximally with the SMO

Question 11

Why is a posterior leaf splint not appropriate for Griffin (4 reasons)

Answer 11

No frontal plane control because of the trim lines
Only minimal control over the TCJ in swing/toe clearance
Won’t help in stance phase stability
Won’t help genu recurvatum

Question 12

Why is a carbon anterior shell/ground floor reaction AFO no appropriate for Griffin (4 reasons)

Answer 12

No frontal plane control and only minimal sagittal plane control
Will INCREASE genu recurvatum
Doesn’t help with genu varus/valgus
Will make functional activities like walking uphill hard

Question 13

Once Griffin is given an appropriate orthotic to help him with gait, what functional activities should be easier for him to accomplish

Answer 13

Running on uneven surfaces, walking uphill/up a ramp, jumping, kick a ball with the left foot

Question 14

What are some therapeutic exercises to work on with Griffin once he get an appropriate orthotic

Answer 14

Strengthening of the LE, balance exercises, single leg stance, orthotic management