Ch 6 - Prosthetic and Orthotics: Assistive Devices and Shoes Flashcards
What can canes provide?
– Inc base of support
– Dec loading/demand on LE
– Provide sensory feedback
– Assist acceleration/ deceleration during locomotion
For what disabilities should canes be prescribed?
– Improve balance – Dec pain – Red WB on injured structures – Compensate for weak muscles – Scan the immediate environment
Difference between Crutch and a Cane?
- Cane has 1 point of contact with the body
* Crutch has 2 points of contact with the body
Where should cane height be adjusted on a patient?
20° to 30° elbow flexion or height of greater trochanters for cane height
What are indications for walkers?
- B/L weakness and/or incoordination
- ↑ balance
- Partial or full WB relief of LE
- Unilateral weakness or amputation of LE
- General support to aid mobility
What does a shoe consist of?
Upper
Sole
Added heel
What are the parts of an Upper oxford style shoe?
Vamp Quarters High Quarter Tongue Throat Toe box
What is a Thomas heel?
Flat with medial extension to support weak foot arch
What is a Military heel?
Slightly narrower base, measures 1.25 to 1.375 inches
What is a Cuban heel?
Still narrower base, higher heel
What is a Spring heel?
Placed under outer sole, eliminates breast, only 0.125 inches
What do athletic shoes eliminate?
Heel because one can run faster this way.
What is a Blucher-style opening?
Front-laced shoe in which the quarters are not attached distally to the vamp and remain loose and fully open, thus leaving more room for the entering foot
What is a Bal or Balmoral-style opening?
Front-laced shoe in which the lace stays (containing the eyelets) meet in front and are stitched to the vamp
What does a medial internal heel wedge promote?
Hindfoot inversion
What does a lateral internal heel wedge promote?
Hindfoot eversion
Relieve pressure on the cuboid
What is the University of California Biomechanics Lab (UCBL) orthosis?
Custom-molded orthosis used to control flexible calcaneal deformities (rearfoot valgus or varus), and transverse plane deformities of the midtarsal joints (forefoot abduction or adduction)
What is a Plastazote full-contact insole?
Custom molded
Accommodates many foot problems/deformities
Provides almost immediate comfort for plantar pain
What is a Rocker bar?
Convex strip placed across the sole just posterior to the metatarsal heads
What is a Rocker bar used for?
Relieve metatarsal pain
Quicken the gait cycle
Assist dorsiflexion
Decrease demand on weak plantar flexors
What does a Lateral sole wedge promote?
forefoot eversion
What does a Medial sole wedge promote?
forefoot inversion
What does a Lateral toe wedge promote?
Assist the foot to toe out
What does a Medial toe wedge promote?
Assist the foot to toe in
What does a Lateral heel wedge promote?
Rotate hindfoot into eversion
What does a Medial heel wedge promote?
Rotate hindfoot into inversion
What does a Lateral heel flare promote?
Resist hindfoot inversion
What does a Medial heel flare promote?
Resist hindfoot eversion
What is a Thomas heel?
Project anteriorly medially
Provides support to the medial longitudinal arch
What is a Reverse Thomas heel?
Project anteriorly laterally
Provides support to the lateral longitudinal arch
What is a heel lift used for?
Fixed pes equinus deformity
Leg length discrepancy >1/4 to 1/2 inch (or if symptomatic)
What is the Most common biomechanical problem with runners?
Pronated foot
What is a pronated foot associated with?
– Tibial stress syndrome – Patellofemoral syndrome – Posterior tibial tendinitis – Achilles tendinitis – Plantar fasciitis
