Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Orthotics > Foot Orthotics > Flashcards

Foot Orthotics Flashcards

1
Q

What is a foot orthotic?

A

 A device that is placed in a person’s shoe to reduce or eliminate pathological stresses to the foot or other portions of the lower kinetic chain.
 A device used to support the foot, improve function, and improve the alignment of the foot and/or lower extremity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Function of the foot during gait

A

Provide base of support
Mobile adaptor
Shock attenuation
Accommodation of transverse plane
motion
Provide rigid support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Talocrural joint axis

A

Through malleoli
 Lateral malleolus is inferior & posterior to medial malleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Talocrural joint PF

A

with adduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

talocrural joint DF

A

with abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Subtalar joint OKC pronation

A

Calcaneus
 Everts
 Abducts
 DFs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Subtalar joint OKC supination

A

Calcaneus
 Inverts
 Adducts
 PFs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CKC Pronation

A

o Calcaneus everts
o Talus adducts and PF’s
o Leg internally rotates
o Knee flexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CKC Supination

A

o Calcaneus inverts
o Talus abducts and
dorsiflexes
o Leg externally rotates
o Knee extends

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mid-Tarsal Joint Axes

A

Longitudinal Axis:
- Pronation/Supination (Eversion/Inverson)
Oblique Axis
- PF/DF
** In WB’ing, MTJ follows the STJ (Oblique axis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tarsometatarsal Joints

A

 Keep MT heads on the
ground
 STJ Pronation
 MTJ Pronates with STJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TMT Joint - Supination Twist

A

 1-2nd MT DF 2° GRF
 4-5th MT PF 2° flexor mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stance phase includes:

A

– Initial Contact
– Loading Response
– Mid-stance
– Terminal Stance
– Toe-off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Swing phase includes:

A

 Initial Swing
 Mid-Swing
 Terminal Swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 Functional Goals of the Foot

A
  1. Get both calcaneal condyles on the ground
  2. Get MT heads on the ground
  3. Provide rigid level for toe off
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What position is the STJ in at heel strike?

A

supination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

initial contact is with…

A

the lateral condyle of calcaneus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What occurs after initial contact?

A

STJ pronation to get medial condyle of calcaneus on ground

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you get metatarsal heads on the ground?

A

STJ pronates, giving forefoot mobility to adapt
to surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Provide rigid lever for toe off - mid stance:

A

STJ moves toward neutral, increasing the
stability of the forefoot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

provide rigid level for toe off - terminal stance/toe off:

A

STJ is supinated to provide rigid foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when does maximum supination occur?

A

just prior to toe off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

motion during gait cycle

A

 Foot is in supination prior to loading response
 STJ pronation occurs until 50% of gait cycle
 Re-supination initiated during mid-stance, by 60% of gait
 Supination (max stability) just prior to toe off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is subtalar joint neutral

A

Point at which the talus is neither pronated nor
supinated, relative to the navicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
reliability of subtalar joint neutral
Intrarater – Fair – Interrater – Poor – Both can improve with training/experience
26
Usefulness of subtalar joint neutral
– Consistent starting point – Intrinsic foot deformities – Neutral position of the joint
27
What is "functional" neutral position (resting standing foot position)
– Knees extended – Arms at sides – Feet 6 inches apart – Comfortable amount of toe-out
28
What does "functional" neutral position do?
More closely approximates the position of the subtalar joint during gait
29
Compensations
A change in the structure, position, or function of one part to neutralize an abnormal force or a deviation in structure, position, or function of another part
30
Functions of a foot orthotic
 Distribute WB forces evenly on the plantar surfaces of the foot  Reduce excessive stresses to the proximal structures from pronation/supination  Reduce the magnitude and rate of excessive pronation  Balance intrinsic foot deformities
31
Indications for Foot orthotics
- LE/Spine symptoms - PT goals achieved or pt plateaus - Course of therapy completed
32
Intrinsic abnormalities require
more controlling orthotic
33
extrinsic abnormalities require
more accommodative orthotic
34
Foot orthotic requirements
 Conforms to the contours of the foot  Rigid enough to control pronation, but flexible enough to allow normal motion  Capable of being adjusted with precision  Durable  Comfortable  Does no harm  Cost-effective  Lightweight
35
normative angle of inclination values
Newborn: 150 Adult: 125 Geriatric: 120
36
"Normal" subtalar joint neutral
Rearfoot: 0-3° varus Forefoot: calcaneus perpendicular to MT line
37
Osseous Deformity
rotation within the calcaneus
38
Shell
"frame of the eye glasses"
39
posts
"lens" Intrinsic Extrinsic
40
Shell - Soft
– Goal: pressure relief, shock attenuation – Material: soft foams – Extrinsic posts – Indications: DM, hyposensitivity, pes cavus, supinatory foot
41
Semi Rigid Shell
– Goal: Motion control, shock absorption – Material: cork, leather, low-temp plastics – Posts: intrinsic or extrinsic – Indications: motion control
42
Rigid Shell
– Goal: CONTROL – Material: heat-moldable plastics – Casting required – Posting: intrinsic – Indications: control of excessive pronation
43
Posting Functions
 Control motion, bring ground to the foot  Maintain abnormal joint relationships  Prevent compensation/reduce abnormal motion  Enhance muscle activity
44
Intrinsic Posting
 Within the shell of the orthotic  Forefoot posting is almost always intrinsic  ↓’d bulk so better fit in shoe  have to be conservative (50%) difficult to adjust  $$$ custom made
45
Extrinsic Posting
 Most orthotics have extrinsic rearfoot posting  Stronger  Easier to adjust  Less arch pressure  More bulk in shoe
46
Varus Post
on medial side of foot
47
forefoot posting - varus post
on medial side of foot
48
forefoot posting - valgus post
on lateral side of foot ** forefoot only
49
0 degree post
extrinsic post without angulation (LIFT) – Large FF varus, no RF abnormality
50
Bar post
runs straight, flat across – Usually extrinsic – Rigid plantarflexed 1st ray  Bar post under rays 2-4
51
Posting determination - rear foot
– Approximately 50% of varus – Maximum 6º
52
posting determination - forefoot
- approximately 40% - maximum 8 degrees
53
posting determination - age
more conservation with increasing age
54
posting determination - weight
more aggressive with increasing weight
55
last thing that determines posting
activities
56
Accommodative orthotic (soft shell)
 Allows significant amount of flexibility  Supinatory foot type  Improve shock absorption  Distribute forces t/o foot  “Bias” – controls motion and lets foot come to ground more easily
57
What are accommodative orthotics used for?
 Congenital malformations  ROM problems  Insensate feet  Diabetic/Rheumatoid feet  Illness, old age, unhealthy feet  rigid PF'd 1st ray
58
Biomechanics Orthotic (Rigid/semi- rigid)
 Increased rigidity of shell  Semi-rigid or Rigid  Durometer – indication of flexibility/rigidity – Higher number = more rigid -- weight, activity, desired control
59
what are biomechanics orthotics used for?
- anything else - pronatory foot problems
60
Biomechanics orthotic requirements
– Conform exactly to contours of the foot – Sufficiently rigid to maintain contours with use – Control abnormal motion – Allow normal motion to occur in proper sequence – Stand up to stress and wear – Capable of being adjusted with precision
61
Dual Density
 Usually semi-rigid shell  Provides control of excessive pronation  Softer, accommodating material on top  Allows shock attenuation  Best of both worlds  Easier for patients to break in  Top cover can be replaced
62
considerations for selection
 Patient condition: Acute/chronic  Pronatory v. supinatory  Intrinsic/extrinsic deformities  Patient's footwear  Type of stress you are trying to reduce  Type of material  Customized v. over-the- counter  Cost  Fabrication time
63
Patient information
 Bring shoes in  Goals and limitations of orthotics  Not likely an immediate cure  may need adjustments
64
break in period
 Break-in period may vary  Day 1 - 1-2 hrs  Increase total wear time by 1-2 hours/ day  Break-in period will depend on type of orthotic  More rigidity = longer break-in periord  Tolerate ~ 6-8 hrs/ day prior to wearing for sports  Sports: begin 1/3 of time and increase by 1/3’s  Stop if symptoms increase or new sx arise
65
Longevity
 Depends on usage, body weight, and material  Long-term use - evaluate ~ 1-4 years  Semi-rigid ~ 1-2 years  Soft orthotics 6 months to one year (max)
66
Purchasing new shoes
 Wait until they have orthotic  Don’t show it to the clerk  Find an appropriate shoe/fit  Then place orthotic in shoe to determine if a larger size is needed
67
Dress shoes
 Difficult to wear orthosisbecause of narrow shank and shallow heel  Dress orthotics are available  As heel height increases, function of the orthotic decreases  Maximum heel height = 2 in
68
Diabetes - typical changes
 Intrinsic Muscle Weakness  Toe deformities (hammer/claw toes)  Prominent MT heads  Fat pad atrophy
69
Diabetes - Shoe Considerations
- Wide toe box - Good plantar contact - Straight last
70
Orthotic considerations for diabetes
 Decrease plantar pressures – Total contact 1st & 5th MT heads Talus Navicular ** Usually accommodative or dual-density
71
RA shoewear
 Probably straight last  Good heel counter  Wide toe box
72
RA - Hallux rigidus
- rocker-bottom shoe or MT bar
73
Trouble shooting - primary cause
shoe gear
74
trouble shooting - sudden recurrence of complaints
– Worn post – Orthotic fatigue – Gouging of shoe insole by post – Physiological changes in the patient
75
trouble shooting - medial foot callus
– Not fully controlling foot – pronating against orthotic – Excessively high post
76
trouble shooting - lateral foot callus
– It’s a good thing – Actually keeping foot in appropriate position
77
trouble shooting - postural complaints
– Usually due to not following break-in schedule – Decrease wearing time – If symptoms aren’t elimated over time, re-evaluate your patient and/or orthotic

Orthotics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions