Chapter 26: Lower Limb Orthoses Flashcards
What are the three categories of foot orthotics?
Accommodative or soft devices
Intermediate or semirigid devices
Corrective or rigid devices.
Accommodative FOs are used to what?
Cradle and protect rigidly deformed, insensate, or dysvascular feet.
When can intermediate or semirigid foot orthotics be used?
Mild problems such as metatarsalgia without ulceration
Corrective foot orthotics are used when?
for slight flexible biomechanical deformities
When are metal orthoses used?
A previous wearer of the AFO
Unusally large or heavy individuals
Need for minimal contact (Edema, heat-sensativity, can’t tolerate contours)
The floor reaction AFO does what?
The extended rigid forefoot section accentuates the knee extension moment at midstance and prevents tibial collapse from absent or weak gastrocnemius.
Which patient population is indicated for a floor reaction AFO?
Patient has paralyed ankle/foo complex but good or better quadriceps and balance.
Myelodysplasia
Spinal cord injury
Peripheral nerve injury
Poliomyelitis
Gastrocnemius-soleus trauma or dysfunction.
What is a common lower limb deficit?
Flaccid equinus
Flaccid equinus can result from what?
Charcot-marie-Tooth disease,
Cerebrovascular accidents with mild residual symptoms
Muscular dystrophy
Peroneal palsies
What are the orthotic options to compensate for pretibial compartment weakness or paralysis?
Bilateral 2-in heel lifts Piano wire AFO Metal Alloy dorsiflexion assist AFO Flexible plastic AFO Peroneal NMES
What is the justification of a KAFO?
Need to control the knee complex in addition to a need for suspension or control of the ankle and foot.
What are the coronal plane, and sagittal plane controls of the single axis knee joint?
coronal plane: stabilizes Genu varum/valgum
Sagittal plane: Free flexion and extenion
Slight hyperextension stop.
What are the clinical applications of a single axis knee joint?
Mild to moderate genu varum or valgum
What are the coronal plane and sagittal plane controls of an offset knee joint?
Coronal: Stabilizes genu varum/valgum
Sagittal: free flexion/extension
integral hyperextension stop
What are the clinical applications of an offset knee joint?
Moderate to severe genu recurvatum and varus and valgum
