Indications/Contraindications for orthosis

Question 1

Actions of UCBL orthosis:

Answer 1

Stabilize subtalar and tarsal joints in stance

Question 2

Indications of UCBL:

Answer 2

Rearfoot valgus/varus
Flexible pes planus
Pronation control, flexible pes planus, OA of the hindfoot, posterior tib dysfunction, tarsal coalition, rearfoot valgus/varus

Question 3

Contraindications of UCBL:

Answer 3

Rigid foot deformity

Toe walker, mod-high tone, ankle arthritis (rigid foot deformities)

Question 4

Actions of DAFO:

Answer 4

Stabilize subtalar and tarsal joints in stance

Question 5

Indications of DAFO:

Answer 5

Flexible pes planus
Mild-mod spastic diplegia or hemiplegia CP
Hypotonic CP

Question 6

Contraindications of DAFO:

Answer 6

Rigid foot deformity

Question 7

Actions of supramalleloar (SMO):

Answer 7

Stabilize subtalar and tarsal joints in stance

Preposition foot for IC by heel

Question 8

Indications of SMO:

Answer 8

Flexible pes planus
Mild-mod spastic diplegia or hemiplegic CP
Hypotonic CP
Severe Pes Planus, Mild ankle instability, low (hypo) tone, Intermittent toe walkers, mild to moderate CP, tarsal coalition, post tib dysfunction

Question 9

Contraindications of SMO:

Answer 9

Significant equinovarus
hypertonicity
high tone (hypertonicity) , sagittal plane, weakness deformity, dominate toe walkers,  equinovarus/valgus

Question 10

Actions of Posterior Leaf Spring:

Answer 10

Assist limb clearance in swing

Preposition foot for IC by heel

Question 11

Indications of posterior leaf spring:

Answer 11

DF weakness, impaired motor control, LMN flaccid paralysis of DF

Question 12

Contraindications of posterior leaf spring:

Answer 12

Mod-severe hypertonicity
moderate to severe spasticity, coronal plane ankle instability, ankle dorsiflexion limitations/fused joint, severe knee instability

Question 13

Action of carbon graphite AFO:

Answer 13

Assist limb clearance in swing

Preposition foot for IC by heel

Question 14

Indications of carbon graphite AFO:

Answer 14

Paralysis or impaired muscle performance of DF

Question 15

Contraindications of carbon graphite AFO:

Answer 15

Mod-severe hypertonicity

Question 16

Action of neuro-orthoses:

Answer 16

Assist limb clearance in swing

Preposition foot for IC by heel

Question 17

Indications of neuro-orthoses:

Answer 17

DF weakness or low tone

Question 18

Contraindications of neuro-orthoses:

Answer 18

Flaccid paralysis

Pt intolerance of e-stim

Question 19

Actions of articulating ankle:

Answer 19

Assist limb clearance in swing
Preposition foot for IC by heel
Permit advancement of tibia in stance

Question 20

Indications of articulating ankle:

Answer 20

Impaired motor control of ankle muscles

Potential for recovery of neuromotor function

Question 21

Contraindications of articulating ankle:

Answer 21

LMN paralysis (flaccidity) or hypotonicity as primary problem

Question 22

Solid ankle AFO actions:

Answer 22

Control ankle position throughout stance
Provide stance phase stability via ankle-knee coupling
Assist limb clearance in swing
Preposition foot for IC by heel
Distal trim line behind metatarsal heads or extended toe-plate

Question 23

Solid ankle AFO indications:

Answer 23

Significant hypertonicity with seriously impaired motor control at ankle and knee
Ankle instability/weakness in more than one plane
Equino varus
Moderate-severe pes plano valgus
Mild-moderate genu recurvatum

Question 24

Solid ankle AFO contraindications:

Answer 24

LMN paralysis (flaccidity) or hypotonicity as primary problem
edema

Question 25

Tone inhibiting AFO actions:

Answer 25

Control ankle position throughout Provide stance phase stability via ankle-knee coupling Typically extended toeplate

Question 26

Tone inhibiting AFO indications:

Answer 26

Significant hypertonicity with seriously impaired motor control

Question 27

Tone inhibiting AFO contraindications:

Answer 27

LMN paralysis (flaccidity) or hypotonicity as primary problem

Question 28

Anterior floor reaction AFO actions:

Answer 28

Provide stability in stance via ankle-knee coupling | Control ankle position throughout stance

Question 29

Anterior floor reaction AFO indications:

Answer 29

Weakness or impaired motor control at knee and ankle

Question 30

Anterior floor reaction AFO contraindications:

Answer 30

Ligamentous insufficiency at the knee | Genu recurvatum

Question 31

Weight-relieving AFO action:

Answer 31

Protect lower leg and foot during stance by reducing weight bearing forces

Question 32

Weight relieving AFO indications:

Answer 32

Healing soft tissue, ligamentous, or bone injuries of the lower leg, ankle, or foot

Question 33

Weight relieving AFO contraindications:

Answer 33

Mechanical instability of the knee, or injury to proximal tibia Pt intolerance of PTB WB forces (rare)

Question 34

Bilateral Metal upright (bars) AFO indications:

Answer 34

``` Foot drop, post-polio, neuropathic feet poor knee control in sagittal plane ankle varus/valgus foot drop with uncontrolled edema poor skin below the knee ```

Question 35

Bilateral Metal upright (bars) AFO contraindications:

Answer 35

Pt’s concerns with bulk/weight | limits shoe wear

Question 36

Free motion/articulated/hinge AFO actions:

Answer 36

Allows sagittal plane motion Free DF and PF Limits coronal plane instabilities

Question 37

Free motion/articulated/hinge AFO indications:

Answer 37

Posterior tib tendon dysfunction | Subtalar or talar joint instabilities

Question 38

Free motion/articulated/hinge AFO contraindications:

Answer 38

Weak quads, sagittal plane ankle weakness | High impact sports

Question 39

DF Assist AFO actions:

Answer 39

Assist in clearance of toes while allowing for some PF Variable DF assist allows for controlled foot flat stance phase

Question 40

DF Assist AFO indications:

Answer 40

DF weakness

Question 41

DF Assist AFO contraindications:

Answer 41

Mod-severe tone levels in pts with altered knee control

Question 42

Posterior Stops in AFO action:

Answer 42

Immobilize ankle in swing and stance phase | If you only have a PF stop and DF is free, then it facilitates knee flexion in early stance

Question 43

Posterior Stops in AFO indications:

Answer 43

Structural collapse of the ankle foot, severe spasticity

Question 44

Posterior Stops in AFO contraindications:

Answer 44

Inadequate hip strength, absent quads, fluctuating edema, fixed/contracted spastic gastrocs

Question 45

DF stop/free plantar flexion action:

Answer 45

Facilitates knee extension and stiff ankle in late stance

Question 46

DF stop/free plantar flexion indications:

Answer 46

Weak PF and weak quads

Question 47

DF stop/free plantar flexion contraindications:

Answer 47

DF weakness | Knee hyperextension

Question 48

Solid Ankle foot orthosis (non articulated) indications:

Answer 48

Ankle instability/weakness in more than one plane Equino varus mod-severe pes plano valgus mild-mod genu recurvatum

Question 49

Solid Ankle foot orthosis (non articulated) contraindications:

Answer 49

edema

Question 50

Spiral AFO actions:

Answer 50

Spiral has unwinding effect

Question 51

Spiral AFO indications:

Answer 51

Ankle DF weakness and/or PF ALONG with mild-mod ML instability

Question 52

Spiral AFO contraindications:

Answer 52

inadequate hip strength mod-severe spasticity severe ML ankle instability fluctuating edema

Question 53

Ground/Floor Reaction AFO actions:

Answer 53

Provide ground forces to the knee which assist in stabilizing the knee during ambulation For patients with weak quadriceps - it can achieve knee stability while maintaining efficiency by reducing weight and bulkiness

Question 54

Ground/Floor Reaction AFO indications:

Answer 54

``` Crouched gait Foot drop with knee instability quadriceps weakness MS Spina bifida ```

Question 55

Ground/Floor Reaction AFO contraindications:

Answer 55

Genu recurvatum ACL Severely ER feet Pts that do not have adequate trunk control or flaccid quad strength