Gait and Orthoses

Question 1

Orthosis

Answer 1

• external device worn to restrict or assist motion or to transfer load from one area to another
• Orthosis (noun)
• Orthotic (adjective)

Question 2

Orthotist

Answer 2

-member of the health care team who designs and fabricates orthotic devices, and evaluates patients for devices

Question 3

Essential Task Requirements of Gait

Answer 3

• Progression (moving in desired direction)
• Stability (postural control)
• Adaptability (meet environmental/task demands

Question 4

AFO

Answer 4

• Primary Aim: control foot motion in SAGITTAL plane
• 2* aim: control med/lat foot motion, control knee
• plastic/metal
• shelf/custom

Question 5

Plastic Orthosis

Answer 5

• upright shell with calf band

- polyethylene/polypropylene

Question 6

Benefits of Plastic Orthoses

Answer 6

• Interchangeable with different shoes
• relatively lightweight
• good motion control

Question 7

Limitations of Plastic Orthoses

Answer 7

• Hot

- Take up space in shoe

Question 8

Metal Upright Orthosis

Answer 8

-Consists of shoe, stirrup, calf band

Question 9

Benefits of Metal Upright Orthoses

Answer 9

• Accommodate changing limb volume

- cooler

Question 10

Limitations of Metal Upright Orthoses

Answer 10

-Patient restricted to one pair of shoes

Question 11

Posterior Leaf Spring

Answer 11

• (PLS)
• Thin narrow shell that allows some motion at ankle
• Stance: calf shel moves forward over footplate
• Swing: calf shell springs back to facilitate foot clearance

Question 12

Articulating AFO

Answer 12

• joint allows for some motion
• Better adaptability for pt
• wider, heavier

Question 13

Articulating AFO’s can control movement by:

Answer 13

• Blocking motions with stops

- Assisting motion with springs

Question 14

Non-articulating AFO

Answer 14

• limits motion at ankle

- for ankle and knee weakness

Question 15

Controlling the knee with an AFO

Answer 15

• Floor reaction AFO

- Traditional AFO

Question 16

Floor Reaction AFO

Answer 16

• Set in PF
• Anterior shell/band (prox tibia) helps push back tibia
• Good for quad weakness to decrease knee buckling

Question 17

Tone Reducing AFO

Answer 17

• often for children with CP and adults with spasticity
• foot plate and upright designed to put pressure on PF and ankle invertors to reduce tone
• may have extended footplate to control toes

Question 18

KAFO

Answer 18

• control knee, blocking knee flexion in stance
• can help correct genu varus/valgus
• can be unblocked for sitting

Question 19

KAFO Limitations

Answer 19

-bulky, heavy, less variability of movement, can’t respond to perturbations, vault/hip hike/circumduct to clear foot

Question 20

HKAFO

Answer 20

• blocks knee and hip movements

- Limitations: heavy, large, no balance strategies, expensive, not functional walkers (except kids)

Question 21

Reciprocating Gait Orthosis

Answer 21

• RGO
• allows for unilateral stepping
• for kids
• post + lat weight shift on one side advances opposite LE

Question 22

T1-T3 Lesion

Answer 22

• HKAFO

- “Drag to” Gait

Question 23

T4-T6 Lesion

Answer 23

• HKAFO

- “drag to” gait

Question 24

T6-T8 Lesion

Answer 24

-“swing to” gait

Question 25

T9-T12 Lesion

Answer 25

- HKAFO - KAFO at lower levels - "swing through" gait

Question 26

L2-L4 Lesion

Answer 26

- KAFO - Loftstrand Crutches - 4 Point Gait

Question 27

L4-L5 Lesion

Answer 27

- AFO - Crutches/Cane - 2/4 point gait