Footwear Modification Quiz - Chapter 7 Flashcards
A ____ serves as the foundation for LE orthotics and prosthetics
shoe
A good fitting shoe
minimizes _____,
Provides ______,
and absorbs shock of ____ ____ _____
stress, support, ground reaction forces
What are the four basic parts of a shoe
sole, upper, last, and heel
Which basic part of the shoe protects the plantar surface of the foot
sole
Which basic part of the shoe covers the dorsum of the foot
upper
Which basic part of the shoe is the base of the shoe that determines the shape of the shoe
last
Which basic part of the shoe is beneath the outsole under the anatomical heel
heel
What are the subparts of the sole
outsole, midsole, insole, welt, and shank
Which part of the sole is the material that contacts the ground
outsole
Which part of the sole is between the insole and outsole
midsole
The midsole is typically a ____ ____ for shock absorption and stability
foam polymer
The foam polymer that makes up the midsole provides _____ and ____
absorption and support
Which part of the sole comes into contact with the foot
insole
Which part of the sole is a strip of leather or plastic that attaches the upper and insole to the sole of the shoe
welt
Which part of the sole is a longitudinal reinforcement of the mid portion of a non athletic shoe
shank
True or False:
The shank is a part of the sole of an athletic shoe
false
What are the subparts of the upper part of the shoe
counter, vamp, closure, toe box
Which part of the upper stabilizes the heel
counter
Which part of the sole covers the midfoot and shaft
vamp
Which part of the sole has multiple styles
closure
Which part of the sole encloses the forefoot
toe box
What is a shoe last
a model of a foot that a shoe is constructed over
What is the purpose of a shoe last
serves as the base of the shoe and determines its size and shape and simulates the normal weight bearing foot
What are the 5 different types of lasts
conventional last, straight last, medial last, inflare, and outflare
which type of shoe last has the toe box slightly lateral to midline
conventional
What is another term for a conventional last
reverse last
which type of shoe last has little or no curvature making symmetrical halves
straight last
which type of shoe last has a shoe box that is slightly medial to midline
medial last
what is the most common type of shoe last
medial last
which type of shoe last has curves even more medially from the heel than a medial last
inflare
which type of shoe last has curves more laterally than the conventional last, from just distal to the heel all the way to the toe
outflare
which type of shoe last looks like you’re wearing your shoe backwards
outflare
Variance of which characteristics of the heel greatly impact function and support
height, size, and compressibility
The height of the heel influences the ____ required for the ankle rocker
ROM
The ____ of the heel influences the ROM required for the ankle rocker
height
The height of the heel influences the ROM required for the ____ ___
ankle rocker
Heels greater than ____ inches, exponentially increases weight bearing on the metatarsal heads
1 1/2
Is shoe sized determined more by arch length or overall foot length
arch length
The first metatarsal should be positioned at the (skinniest/widest) point of the shoe
widest
The widest part of the shoe should be wide enough for normal _____ in weight bearing
spray/spread of toes
It is recommended that the shoe should be ____ longer than the longest toe
1/2 inch
What are the potential effects of a poorly fitted shoe that might be too narrow
hallux valgus, bunions, or metatarsalgia
How might hallux valgus, bunions, or metatarsalgia be developed
poorly fitted shoes that might be too narrow
What are the potential effects that age has on influencing foot contour
increased splay, increased forefoot height due to toe deformities
How does increased splay, increased forefoot height due to toe deformities relate to foot contour
age effects
How might pregnancy influence foot contour
increased laxity, forward COM, and increased load on the midfoot
How does increased laxity, forward COM, and increased load on the midfoot relate to foot contour
pregnancy effects
How might obesity/edema influence foot contour
excessive stress on the midfoot, fluctuations in circumference
How does excessive stress on the midfoot, fluctuations in circumference relate to foot contour
obesity/edema effects
Repetitive ____ can influence affects of foot contour
stress
(correction/accommodation) The change in shape of the foot by placing forces on the foot to correct soft tissue which influences body modeling or alignment
correction
(correction/accommodation) Supports the foot in its current or preferred position if the patient cannot tolerate correction
accommodation
Correction of foot shape is appropriate for (flexible/rigid) deformities and is commonly seen more in (younger/older) patients
flexible; younger
Accommodation is appropriate for (flexible/rigid) deformities and for when you are trying to reduce ____ or _____ to a particular region of the foot
rigid; pain and irritation
What are the three types of prescriptive footwear that accommodates deformity, redistribute weight, facilitate normal gait, and reduce risk of neuropathic ulcer
Moldable leather, plastazote shoes, and custom molded shoes
Moldable leather, plastazote shoes, and custom molded shoes are prescriptive footwear that aids in accommodating what 4 foot impairments
Deformity
redistribute weight
facilitate gait
reduce risk of neuropathic ulcer
Metatarsus adductus, in-toeing, out-toeing, and toe- walking are conditions appropriate for shoe modifications in the _____ population
pediatric
What are the 4 conditions in the pediatric population that are appropriate for show modification
metatarsus adductus
in-toeing
out-toeing
toe-walking
What pediatric condition can be corrected by a straight or reverse last
metatarsus adductus
What pediatric condition can be corrected by a reverse last
in-toeing
What pediatric condition does not response to a shoe modification
out-toeing
What pediatric condition has literature that says varied corrections can be used to fix this problem
toe-walking
List the major conditions that can compromise foot function that relate to aging
diabetes, arthritis, CHF, charcot foot degeneration
What is Charcot foot degenerative condition
Destruction of the tarsometatarsal or MTP joints
Charcot foot degenerative condition is sometimes a secondary effect of ______
diabetes
What are the 4 diagnosis-related considerations for the foot
arthritis, gout, diabetes, peripheral vascular disease
If a patient has pain in their feet due to arthritis, how would a PT help fix the problem
limit abnormal motion, accommodate the deformity, and reduce loading impact
If a patient has pain in their feet due to gout, how would a PT help fix the problem
limit abnormal motion, accommodate deformity, and reduce loading impact
If a patient has pain in their feet due to diabetes, how would a PT help fix the problem
protect the plantar surface, distribute weight bearing pressures
If a patient has pain in their feet due to peripheral vascular disease, how would a PT help fix the problem
prevent skin breakdown and cushion impact secondary to hypersensitivity
What are the three regions of the foot
forefoot, midfoot, and hind foot
What part of the foot makes up the forefoot
metatarsals and phalanges
What part of the foot makes up the midfoot
cuneiforms, navicular, and cuboid
What part of the foot makes up the hindfoot
talus and calcaneus
Which joints are found in the forefoot
tarsometatarsal joints
Which joints are found in the midfoot
talonavicular and calcanealcuboid joints
Which joint are found in the hind foot
subtalar joint
Metatarsalgia, seasmoiditis, and Morton’s syndrome/Neuroma are (forefoot/midfoot/hindfoot) conditions
forefoot
Which forefoot condition can be described as pain around the metatarsal heads due to compression of the plantar digital nerve or the 5th MTP
metatarsalgia
Which forefoot condition can be described as inflammation of sesmoid bones
seasmoiditis
Which forefoot condition can be described as repetitive irritation of the plantar digital nerve between the 1st and 2nd metatarsal head or between other digits
morton’s syndrome/neuroma
Hallux Rigidus, Hallux Valgus, Hammertoes, Claw toes, and Mallet toes are all (forefoot/hindfoot) conditions
forefoot
Which forefoot condition can be described as DJD of the 1st MTP joint and results in a loss of extension
Hallux Rigidus
Which forefoot condition can be described as a bony formation on the medial aspect of 1st MTP which results in a laterally deviated hallux
Hallux Valgus
Hallux Rigidus results in pain at the end of ____ phase of gait.
Stance
What are the two forefoot shoe modifications discussed in the lecture
Metatarsal bars and toe rockers
Why would a metatarsal bar be a forefoot modifications
because it unloads the metatarsal heads and redistributes weight to the metatarsal shafts
Explain how a metatarsal bar is a good forefoot shoe modification
It accommodates for forefoot rigidity
It facilitates push off
It follow the angle of the met heads
If a patient has metatarsalgia or Morton’s Neuroma, what shoe modification recommendation would you make
Metatarsal bar
Why would a toe rocker be a forefoot modification
because it provides a mechanical substitute for an ineffective forefoot and toe rocker
Explain how a toe rocker is a good forefoot shoe modification
It adds a layer the hind and midfoot that is tapered off at the forefoot to provide the mechanical substitute of a toe rocker
True or False:
A toe rocker has a sole that is grinded proximally to the metatarsal heads
False, it is distal to the met heads so the shoe does the work and doesn’t load the met heads as much
Pes Cavus, Pes Planus, Pes Equinus, and Plantar Fascitis are all (forefoot/midfoot/hindfoot) conitions
midfoot
What are the four midfoot conditions
Pes Cavus, Pes Planus, Pes Equinus, Plantar Fasciitis
Which midfoot condition can be described as an exaggerated longitudinal arch
pes cavus
Which midfoot condition can be described as pronation without supination at midstance when the foot is fixed or flexible
pes planus
Which midfoot condition can be described as high arch
pes cavus
Which midfoot condition can be described as flat foot
pes planus
Which midfoot condition can be described as limited ankle dorsiflexion in either a fixed or flexible position
pes equinus
Which midfoot condition can be described as inflammation of the plantar fascia with pain at its insertion of the medial calcanues
plantar fasciitis
If a patient has pain with a midfoot condition, we want to restrict the joint from reaching ____ ____ to avoid pain. This does NOT mean we restrict total ROM
end range
Typical midfoot accommodations involved providing addition support to the (forefoot/midfoot/hindfoot). To do this we reinforce the _____ to increase rigidity of the shoe and also reinforce the ____ to prevent collapse of the foot.
midfoot; shank; vamp
Typical midfoot accommodations involved providing addition support to the (forefoot/midfoot/hindfoot). To do this we reinforce the shank to increase ____ of the shoe and also reinforce the vamp to prevent _____ of the foot.
midfoot; rigidity; collapse
If a PT wants to reinforce the vamp of a shoe to prevent collapse of the midfoot, what type of shoe modification would be added to the shoe
a buttress
A _____ provides additional medial or lateral support to the midfoot
buttress
When should a buttress be used
When a heel and forefoot wedge is not adequate to control frontal plane collapse.
In the lecture, a buttress is described as aggressive ___foot and ___foot (sagittal/frontal/transverse) plane control
midfoot and rearfoot frontal plane control
Arthrodesis, Achilles Tendonitis, Bursitis and Haglund’s Deformity, Sever’s disease, calcaneovalgus and calcaneovarus are all (forefoot/midfoot/hindfoot) conditions
hindfoot
Which hindfoot condition can be described as the fusion of a joint in the foot/ankle which is a treatment of severe arthritis
arthrodesis
Which hindfoot condition can be described as pump bumb
Haglund’s deformity
Which hindfoot condition can be described as calcaneal apophysitis
sever’s disease
What are the rearfoot and heel modifications
shoe lifts, honey combs, rocker bottoms, and SACH (solid ankle cushioned heel)
If a patient had a leg length discrepancy, what shoe modification would you recommend
shoe lifts
A ____ reduces weight of a shoe lift
honeycomb
When using an internal shoe lift, you can accommodated up to ___ inches. When using an external show lift, you must use ___ inch or greater to accommodate for the discrepanc
3/8; 1/2
What type of shoe modification facilitates functional rockers and tibial progression
rocker bottoms
A SACH functions as a (toe/ankle/heel) rocker
heel
A (positive/negative) heel is angled anteriorly in relation to the heel counter
negative
If the sole at the heel is lower than the sole at the foot then it is considered a (positive/negative) heel
negative
A (positive/negative) is angled posteriorly in relation to the heel counter
positive
If the heel is taller than the sole at the forefoot you have a (positive/negative) heel
positive
A negative heel moves the GRF in an ____ direction which means there is (less/more) force exerted on the joint at initial contact
anterior; less
Compare loading time and tibial progression speed between a positive and negative heel
A negative heel will prolong heel loading and slow down tibial progression while a positive heel will speed up heel loading and also speed up tibial progression.
Would a negative heel speed up or slow down the heel rocker
slow down
Would a positive heel speed up or slow down the heel rocker
speed up
A positive heel moves the GRF in a _____ direction which means there is (less/more) force exerted on the joint at initial contact
posterior; more
Would a positive heel increase or decrease the muscle activity of the pre-tibials
increase
Would a negative heel increase or decrease the msucle activity of the pre-tibials
decrease
If a patient has a fixed equinus deformity, what shoe modification would you recommend
heel wedge
A heel wedge allows for (sagittal/frontal/transverse) control
sagittal
If a patient has pain due to Sever’s disease or from pronation, which shoe modification would you recommend
A heel wedge
A ___ ___ paired with an AFO can control tibial floor to shaft angle
heel wedge
A heel wedge paired with an ____ can control tibial floor shaft angle
AFO
A heel wedge paired with an AFO can control ___ floor with ____ angle
tibial; shaft
If a patient has hindfoot varus or valgus, what shoe modification would you recommend
a heel wedge
If a patient has poor frontal plane alignment, where would you extend a heel wedge to?
The forefoot
A heel wedge is used to address (forefoot/midfoot/hindfoot)
hindfoot or rearfoot
