Gait and Orthoses Flashcards
Orthosis
- external device worn to restrict or assist motion or to transfer load from one area to another
- Orthosis (noun)
- Orthotic (adjective)
Orthotist
-member of the health care team who designs and fabricates orthotic devices, and evaluates patients for devices
Essential Task Requirements of Gait
- Progression (moving in desired direction)
- Stability (postural control)
- Adaptability (meet environmental/task demands
AFO
- Primary Aim: control foot motion in SAGITTAL plane
- 2* aim: control med/lat foot motion, control knee
- plastic/metal
- shelf/custom
Plastic Orthosis
- upright shell with calf band
- polyethylene/polypropylene
Benefits of Plastic Orthoses
- Interchangeable with different shoes
- relatively lightweight
- good motion control
Limitations of Plastic Orthoses
- Hot
- Take up space in shoe
Metal Upright Orthosis
-Consists of shoe, stirrup, calf band
Benefits of Metal Upright Orthoses
- Accommodate changing limb volume
- cooler
Limitations of Metal Upright Orthoses
-Patient restricted to one pair of shoes
Posterior Leaf Spring
- (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
Articulating AFO
- joint allows for some motion
- Better adaptability for pt
- wider, heavier
Articulating AFO’s can control movement by:
- Blocking motions with stops
- Assisting motion with springs
Non-articulating AFO
- limits motion at ankle
- for ankle and knee weakness
Controlling the knee with an AFO
- Floor reaction AFO
- Traditional AFO
Floor Reaction AFO
- Set in PF
- Anterior shell/band (prox tibia) helps push back tibia
- Good for quad weakness to decrease knee buckling
Tone Reducing AFO
- 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
KAFO
- control knee, blocking knee flexion in stance
- can help correct genu varus/valgus
- can be unblocked for sitting
KAFO Limitations
-bulky, heavy, less variability of movement, can’t respond to perturbations, vault/hip hike/circumduct to clear foot
HKAFO
- blocks knee and hip movements
- Limitations: heavy, large, no balance strategies, expensive, not functional walkers (except kids)
Reciprocating Gait Orthosis
- RGO
- allows for unilateral stepping
- for kids
- post + lat weight shift on one side advances opposite LE
T1-T3 Lesion
- HKAFO
- “Drag to” Gait
T4-T6 Lesion
- HKAFO
- “drag to” gait
T6-T8 Lesion
-“swing to” gait
T9-T12 Lesion
- HKAFO
- KAFO at lower levels
- “swing through” gait
L2-L4 Lesion
- KAFO
- Loftstrand Crutches
- 4 Point Gait
L4-L5 Lesion
- AFO
- Crutches/Cane
- 2/4 point gait
