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Prosthetics & Orthotics > FOs + AFOs > Flashcards

FOs + AFOs Flashcards

1
Q

select appropriate device and materials, design/fabricate/fit orthoses & protheses, and demonstrate how to use the device. These are all responsibilities of ??

A

certified orthotist/prosthetist

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2
Q

what kind of education does a CPO need?

A

Bachelor’s Degree or higher in O&P from an accredited program
OR
a degree with a post-graduate O&P certificate program from an accredited program AND clinical residency

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3
Q

how many hours of continuing education must a licensed orthotist or prosthetist complete annually in TN?

A

15 hours
– no more than 5 hours should be completed via delivery methods using some sort of at home/online platform

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4
Q

if a person is licensed in more than 1 profession (i.e., orthotist AND prosthetist), how many hours of continuing education must they complete annually in TN?

A

20 hours
– 6 hours shall pertain to each profession they are licensed in

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5
Q

practice under guidance of CPO, assist with O&P procedures and tasks related to patient management, fabricate/repair/maintenance of devices. these are all responsibilities of ???

A

O&P assistant

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6
Q

assists CPO by providing technical support. this is responsibility of ???

A

O&P technician

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7
Q

what are the requirements to become an orthotic fitter?

A

high school diploma, GED or college education
pre-certification education course
500-1000 hours of supervised patient care
license in related allied health profession, includes PT

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8
Q

what is the scope of practice for an orthotic fitter?

A

prefabricated orthoses
evaluation of patient needs
formulate and implement treatment plan

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9
Q

what is PTs role in O&P?

A

assessment for identified purposes
preparation for use
evaluation of fit
education on fit and training
gait training, transfer training, high level training
assessment and quantification of functional benefits and uses

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10
Q

what are the 4 rockers AND the phases of gait each fall into?

A
  1. heel rocker - initial contact to loading response
  2. ankle rocker - loading response to midstance
  3. forefoot rocker - terminal stance
  4. toe rocker - pre swing
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11
Q

foot orthoses aka ____
what are the purposes? (6)

A

insert
- alignment correction
- deformity accommodation
- facilitate supination/pronation
- pain relief
- improve foot and/or proximal alignment
- relieve weight bearing stresses

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12
Q

what should we recommend if our patient is going to use a foot orthosis?

A

progressive increase in wear time

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13
Q

what is a fixed deformity?
flexible/dynamic deformity?

A
  • cannot be passively corrected
  • can be corrected. possible causes: irregular muscle activity, muscle length, ligamentous deficit
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14
Q

prefabricated orthoses are good for ____ term use specifically helps with ____, _____, _______

A

short term
healing, function/training aid, contracture prevention

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15
Q

custom/definitive orthotics can be used for ____ term use

A

short or long term

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16
Q

what does the evidence say about prefabricated vs custom foot orthoses?

A

one is not better than another

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17
Q

3/4 length FO extends to:
sulcus length FO extends to:
full length FO extends to:

A

– met heads
– proximal to toes
– extends to toes

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18
Q

soft foot orthoses:
– provides _____
– absorbs ____
– may redistribute _____ pressures

A

– cushioning
– shock
– plantar

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19
Q

semi-rigid foot orthoses:
– provides some ___ and ____ absorption
– provides _____

A

– flexibility ; shock
– control of the foot

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20
Q

rigid foot orthoses:
– _____ deformities
– controls ______
– provides ______

A

– stabilizes
– abnormal motion
– support

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21
Q

what 3 things should you include in your documentation of a foot orthoses?

A

length (3/4, sulcus, full)
fabrication method (custom, off the shelf)
flexibility (soft, rigid, semi-rigid)

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22
Q

what two foot deformities resulting in abnormal medial longitudinal arch indicate use of a FO?

A
  1. pes planus (flat foot) – posterior tibialis supports arch
  2. pes cavus (high arch) – support deformity w/ high arch support
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23
Q

which abnormal medial longitudinal arch deformity can be corrected with FO?

A

pes planus - if flexible can be corrected

24
Q

______ inch indicates normal leg length discrepancy
______ inch difference will result in gait abnormalities
– what kind of FO would you use for leg length discrepancy?

A

3/5
1 & 2/3
– external shoe modification, heel lift/wedge

25
Q

what two rearfoot malalignment deformities indicate FO use?
– what kind of FO would you use for each?

A
  1. rearfoot varus
    – medial wedge to accommodate ; decreases hyperpronation
  2. rearfoot valgus
    – lateral wedge to accommodate ; decreases supination
    – medial wedge to correct
26
Q

AFO types (2) & materials (3):

A

types: pre-fabricated or custom
materials: plastic (polypropylene), carbon fiber, or metal

27
Q

uses for indication of AFO: (6)

A

provide ankle stability
correct malalignment
control foot drop
enhance mobility
deformity prevention
regulate or reduce muscle tone

28
Q

traditional custom fabrication method for AFOs:
– ____ time
– ____ reliability

3D scanning custom fabrication method for AFOs:
– _____ time
– ____ reliability

A

more
poor

faster
poor

29
Q

a patient comes to you without an AFO and can walk without one although exhibits impaired gait. why would you choose to recommend an AFO for this patient?

A

safer and more efficient

30
Q

when prescribing orthotic devices what three things do you need to consider?

A
  1. where in the gait cycle is the deviation
  2. factors that compromise the abnormal phases of gait (muscle, ROM, spasticity)
  3. identify specific orthotic interventions would benefit
31
Q

how do AFOs help during the swing phase?

A
  • provides external support for foot clearance
  • optimize limb position for initial contact in preparation for stance stability
32
Q

how do AFOs help during the stance phase?

A
  • provide external support for stance stability
  • facilitate forward progression
  • influence proximal alignment
  • optimize position of the ankle/foot
33
Q

solid or fixed AFO:
– provides ____ stability and ___-____ support
– accelerated _____ _____
– loss of _____ and ____ rocker
– assists with _______
– position foot for ____
– ideal position:

A

– stance and medial-lateral
– heel rocker
– ankle and forefoot
– foot clearance
– initial contact
– foot in plantigrade, neutral ankle and subtalar joint

34
Q

where should the calf band of a solid AFO sit?

A

below fibula head to prevent impingement of peroneal nerve

35
Q

Solid AFOs are utilized for a patient with _____

A

knee hyperextension –> pushes tibia anterior

36
Q

an AFO in 5 deg PF produces ____
an AFO in 5 deg DF produces ____

A

knee extension
knee flexion

37
Q

hinged/articulating AFOs:
– _____ ankle ROM
– provides _____ stability
– can have _____
– aids in ______
– some _____ are preserved

A

– limited
– medial-lateral
– DF/PF assist/stop
– foot clearance
– rockers

38
Q

what is the most common hinged AFO combo?

A

DF assist, PF stop

39
Q

Posterior leaf spring AFO:
– control PF from ____ to _____
– allows DF during ____ phase
– support foot during _____ phase
– pt needs good M/L stability. Why?

A

– initial contact to loading response
– stance
– swing
– trimlines of AFO are posterior to malleoli (doesn’t provide much M/L support)

40
Q

anterior floor reaction AFOs:
– maintains ____
– compensates for ______ muscles
– facilitate _____ couple
– anterior shell controls _____

A

– proper ankle alignment
– weak or absent gastroc-soleus
– PF knee extension
– forward tibial progression

41
Q

anterior floor reaction AFOs are not appropriate for individuals with:

A

knee ligamentous instability or genu recurvatum

42
Q

energy return or dynamic response AFOs:
– assist limb clearance in ____
– positions _____ for initial contact
– assists with ____

A

– swing
– heel
– forward propulsion

43
Q

energy return or dynamic response AFOs are not appropriate for individuals with:

A

moderate to severe hypertonicity

44
Q

tone inhibiting AFOs:
– controls ____ position
– provides ____ stability
– inhibits _____ induced by tactile stimulation
– controls ____ _____
– indicated for patients with ____

A

– ankle position
– stance
– reflexes
– muscle length
– hypertonicity with significantly impaired motor control (fixed ankle)

45
Q

what are some alternate options for an AFO?

A

FES - rely on stimulating the common peroneal nerve (anterior tib)
Ossur foot up
DF assist with Ace wrap

46
Q

in the objective portion of your note, be sure to document the following gait deviations:

A

magnitude (timing, related to ROM)
side (left/right)
joint
direction/motion (flex/ext)
phases of gait

47
Q

“excessive R hip flexion mid to terminal stance” should be documented in which section of your note?

A

objective

48
Q

in the assessment portion of your note, include the possible ____ of the gait deviation such as:

A

etiology -
impaired motor control
abnormal joint ROM
impaired sensation
pain

49
Q

in the assessment portion of your note, you should include the etiology AND _____ on functional tasks, such as:

A

impact/significance
– weight acceptance
single limb support
swing limb advancement

50
Q

in acute stroke, it is best practice to provide an AFO to improve _____

A

quality of life

51
Q

in acute stroke AND chronic stroke, you should NOT provide an AFO for someone with ___

A

spasticity

52
Q

in chronic stroke, you SHOULD provide an AFO to improve ______ whereas in an acute stroke, you MAY provide an AFO

A

endurance

53
Q

in an acute stroke, it is best practice to provide FES to improve (4)

A

quality of life
dynamic balance
muscle activation
gait kinematics

54
Q

in chronic stroke, you SHOULD perform FES to improve ______ & _____ whereas in an acute stroke, you MAY perform FES

A

endurance and muscle activation

55
Q

in people with DF paresis, they may benefit from ____ and ____ orthoses

A

circular and elastic
(not as much dorsal orthoses)

56
Q

in children with CP, if they ambulate with an AFO they have:
– decreased ____ __ during walking
– improved _____
– increased ______

A

– energy expenditure
– ankle position
– walking velocity, stride and step length, single support time

Prosthetics & Orthotics (17 decks)

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