Commonly Prescribed Lower Extremity Orthoses Flashcards
UCBL Orthosis
-Category: Static
-Actions: Stabilize subtalar and tarsal joints in stance
-Indications:
*Rearfoot valgus/varus. *Flexible pes planus
-Contraindications: Rigid foot deformity
-Options: Thermoplastic, Gillette modifications
DAFO
-Category: Dynamic
-Actions: Stabilize subtalar and tarsal joints in stance
-Indications:
*Flexible pes planus.
*Mild to moderate spastic diplegic or hemiplegic CP.
*Hypotonic CP
-Contraindications: Rigid foot deformity
-Options: Thermoplastic
Supramalleolar Orthosis (SMO)
-Category: dynamic
-Actions:
*Stabilize subtalar and tarsal joints in stance. *Preposition foot for IC by heel
-Indications:
*Flexible pes planus.
*Mild to moderate spastic diplegic or hemiplegic CP. *Hypotonic CP
-Contraindications: *Significant equinovarus hypertonicity
-Options: Thermoplastic
Posterior Leaf Spring
-Category: Dynamic
-Actions:
*Assist limb clearance in swing.
*Preposition foot for IC by heel.
-Indications: Dorsiflexion weakness, impaired motor control, LMN flaccid paralysis of dorsiflexion
-Contraindications: Moderate to severe hypertonicity
-Options: Thermoplastic
Carbon Graphite AFO
-Category: Dynamic
-Actions: Assist limb clearance in swing; pre-position foot for IC by heel
-Indications: Paralysis or impaired muscle performance of dorsiflexors
-Contraindications: Moderate to severe hypertonicity
-Options: Custom or prefabricated
Neuro-orthoses
-Category: Dynamic
-Actions:
*Assist limb clearance in swing
*Preposition foot for IC by heel
-Indications: Dorsiflexion weakness or low tone
-Contraindications:
*Flaccid paralysis
*Patient intolerance of electrical stimulation
-Options: Functional electrical stimulation
Articulating Ankle AFO
-Category: Dynamic
-Actions
*Assist limb clearance in swing
*Preposition foot for IC by heel
*permit advancement of tibia (2nd rocker) in stance
-Indications:
*Impaired motor control of ankle musculature
*Potential for recovery of neuromotor function
-Contraindications: LMN paralysis (flaccidity) or hypotonicity as primary problem
-Options:
*Thermoplastic or metal double-upright
*Dorsiflexion assist
*Plantarflexion stop
*Adjustable range into dorsiflexion can be incorporated
*Often requires shoe with cushion heel
Solid AFO
-Category: Static
-Actions:
*Control ankle position throughout stance
*Provide stance phase stability via ankle-knee coupling
*Assist limb clearance in swing
*Pre-position foot for IC by heel
*Distal trim line behind metatarsal heads or extended toe-plate
-Indications: Significant hypertonicity with seriously impaired motor control at ankle and knee
-Contraindications: LMN paralysis (flaccidity) or hypotonicity as primary problem
-Options:
*Thermoplastic
*Basis for KAFO and HKAFO
*Requires cushion heel and rocker bottom shoe
Tone-inhibiting AFO
-Category: Static
-Actions:
*Control ankle position throughout stance
*Provide stance phase stability via ankle-knee coupling
*Typically extended toeplate
-Indications: Significant hypertonicity with seriously impaired motor control
-Contraindications: LMN paralysis (flaccidity) or hypotonicity as primary problem
-Options:
*Thermoplastic, Basis for KAFO and HKAFO
*Requires cushion heel and rocker bottom shoe
Anterior floor reaction AFO
-Category: Static
-Actions:
*Provide stability in stance via ankle-knee coupling
*Control ankle position throughout stance
-Indications: Weakness or impaired motor control at knee and ankle
-Contraindications:
*Ligamentous insufficiency at the knee
*Genu recurvatum
-Options:
*Thermoplastic or carbon composite
*Custom-made or custom-fit
Weight-Relieving AFO
-Category: Static
-Actions: Protect lower leg and foot during stance by reducing weight bearing forces
-Indications: Protect lower leg and foot during stance by reducing weight bearing forces
-Contraindications:
*Mechanical instability of the knee, or injury to proximal tibia
*Patient intolerance of PTB weight-bearing forces (rare)
-Options:
*Thermoplastic and metal hybrid
*Custom or prefabricated
