Intro to Orthotics (1) Flashcards
1
Q
what is an orthosis
A
external device
restricts or assists movement
transfers load to other body parts
2
Q
new nomenclature
A
described by joint it covers and controls
3
Q
LE orthotic levels
A
FO
SMO
AFO
KAFO
KO
HKAFO
HI
4
Q
FO
A
foot
5
Q
SMO
A
supra-malleolar
6
Q
AFO
A
ankle/foot
7
Q
KAFO
A
knee/ankle/foot
8
Q
KO
A
knee
9
Q
HKAFO
A
hip/knee/ankle/foot
10
Q
HO
A
hip
11
Q
what is the base of support for all orthoses
A
shoe
12
Q
the goal of an orthosis
A
give as much fxn as possible w/ least deviation from normal
13
Q
why’re there usually some issues w/ orthoses
A
gait or dysfxn created by orthotic use
additional weight of the orthosis
14
Q
gait or dysfxn created by orthotic use
A
limited ROM
balance issues
15
Q
additional weight of the orthosis
A
increased energy consumption
16
Q
what is the fxn of the orthosis defined by
A
pathologic condition
dx of the patient
17
Q
dx of the pt –> fxn of orthosis
A
why is it given
condition of the pt
18
Q
orthosis fxn
A
more than 1 fxn often
19
Q
5 fxns of an orthosis
A
support
create fxn
correct
protect
feedback
20
Q
support –> 5 fxns
A
muscle weakness
bone weakness
ligamentous weakness
21
Q
create fxn –> 5 fxns
A
enhance movements
springs or materials
22
Q
correct –> 5 fxns
A
deformities
23
Q
deformities –> correct –> 5 fxns
A
forces applied must be tolerable
pediatric v. adult
scoliosis is most common
24
Q
protect –> 5 fxns
A
healing tissue
25
healing tissue --> protect --> 5 fxns
vulnerable tissue
prevent re-injury
26
feedback --> 5 fxns
facilitate muscle
enhance alignment
scoliosis O
27
scoliosis O --> feedback --> 5 fxns
correct curve during exercise
28
how do orthotics work
through force application
29
orthotic control system
3 point force system
30
3-point force systems
reduction in unwanted angular rotation
stabilization about a joint, bone or skeletal segment
31
3 points of force in the force system
3 forces arranged w/
1 middle force
2 opposite forces
32
what do the 3 forces create
a torque
the force arms for each force must be considered
33
best 3 point pressure system includes
2 forces equidistant from center force
forces have long lever arms
center force should be close to the joint being controlled
34
forces have long lever arms
greater distance from center
less force we have to apply
35
additional stabilizing forces
compression and distraction
36
compression
external support producing compressive load
37
distraction
immobilize and stabilize
increase lateral stability
38
abnormal forces
when forces become excessive they can cause damage or injury to the body
39
abnormal force consideration
compression
shear force
frictional force
40
compression --> abnormal
fxn of force per unit area
an abnormal amount produces damage
41
solution to abnormal compression
increase area
increase force arm
contour orthosis well
pad area
42
shear force --> abnormal
coplanar forces acting on the same body in the opposite direction
deep force producing destruction in nerves and blood vessels
43
solution of shear force
minimize movement b/w brace and body part
44
minimize movement b/w brace and body part --> shear force solution
align and fit brace properly
placing pressure points in tolerant areas
put something b/w brace and skin
45
frictional force
superficial force
skin breakdown
does not result in deeper damage
46
solution to frictional force
proper fit and alignment (minimize movement)
good hygiene
put something b/w brace and skin
47
principles of the fit are determined by
looking at the limb as a whole
look at normal static alignment and dynamic relationship
48
principles of fit
alignment
joint alignment
49
what must we consider with alignment
relationship b/w orthosis, anatomical landmarks, body contours
50
for fit and alignment to be proper
foot flat on the floor
anatomical and mechanical should be congruent
joints should be horizontal
orthosis should conform to anatomical contours of the body
forces should be dispersed over large area for comfort and safety
51
anatomical and mechanical should be congruent
unless intentionally not
52
forces should be dispersed over large area for comfort and safety
total contact
reliefs
build up
53
reliefs --> forces should be dispersed over large area for comfort and safety
boney prominences and pressure sensitive area
54
build ups --> forces should be dispersed over large area for comfort and safety
relieve pressure prox/dist
55
joint alignment
hip
knee
ankle
foot plates
56
hip --> joint alignment
1-2 cm above the superior apex of the greater trochanter
57
knee --> joint alignment
2 cm proximal to tibial plateau
58
ankle --> joint alignment
through the centers of the malleoli
at the level of the distal tip of lateral malleoli
59
foot plates --> joint alignment
full --> end of foot
3/4 plates --> proximal to MT heads
60
orthotic prescription is best
improve ADL
positive effect on balance
increase pt compliance
61
what does a prescription of an orthosis do
improves gait and WBing
increases activity level
minimized energy expenditure
62
most common finding w/ LE orthotic
static balance improved
63
LE orthotics improved
lateral stability
increase WBing
postural control
walking speed
64
when are pts most complaint with orthotics
increase mobility esp w/ gait
dependability of orthosis
comfort
given appropriate expectations
65
given appropriate expectations
pt education
66
how may clinicians be able to help pts optimize their mobility
asking about environmental obstacles
recommending strategies for utilization of mobility aids, depending on the activity and situation
67
less control v. more control
less control has less coverage and more flexible
more control has greater coverage, more rigid and closer to body
68
precautions
alignment considerations
spasticity
bowel bladder incontinence
69
how long should a pt initially wear a orthotic
30-60 min
70
what should a pt do before and after removal of the orthotic
inspect it and the skin
making sure there are no damage to the skin, after each time of wear
71
redness initially
should disappear after 15-20 min
72
gradually --> wearing schedule
increase wearing time by an hour then 2 hours etc.
73
by the end of the two week period --> wearing schedule
should be able to wear it full time
74
when should a pt seek our a medical provider
rubbing
blistering or skin breakdown
orthosis is damaged
swelling
new pain or change in the intensity of pain
toes become discolored or theyre difficult to move
odor or exudates from pre-existing sores
