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Orthotics > Intro to Orthotics > Flashcards

Intro to Orthotics Flashcards

1
Q

What is an orthosis

A
  • Orthotic Devices are externally applied
    devices “used to modify the structural
    and functional characteristics of the
    neuromuscular and/or skeletal system”
  • Devices used to protect some parts of the
    body from potential injury
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2
Q

Orthoses devices can include -

A
  • Braces
  • Splints
  • Serial casts
  • Shoe inserts
  • Helmets
  • Protective and supportive taping
  • Corsets
  • Functional Electrical Stimulation
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3
Q

What are orthoses generally named for?

A
  • Area of body they cover
  • Type of material utilized- plastic, metal, soft
  • Components
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4
Q

Healthcare professionals involved in the care of a patient who requires an orthotic intervention:

A
  • PT
  • OT
  • SLP
  • Orthotist
  • Physician (Physiatrist)
  • Nurse
  • Case Manager
  • Patient and Family (Caregiver)
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5
Q

What is an Orthotist

A
  • An American Board Certified (ABC)
    Orthotist or Prosthetist is an allied health
    professional who is specifically trained and
    educated to manage the provision of
    comprehensive orthotic and prosthetic
    care, based upon a clinical assessment and
    a physician’s prescription, to restore
    function and/or cosmesis
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6
Q

Education of an orthotist

A
  • Educational Background- Typically requires
    Masters Degree following undergraduate
    degree
  • Certification in Orthotics (CO) or Orthotics
    and Prosthetics (CPO)
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7
Q

Purpose/ Function of an Orthosis

A
  1. Safety
  2. Reduce Pain
  3. Provide Stability/ Prevent Deformity
  4. Correct aLignment
  5. Accommodate fixed deformity/prevent further deformity
  6. Enhance performance
  7. Provide kinesthetic feedback
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8
Q

Purpose/ Function of an Orthosis - Safety

A
  • Orthosis may be required to maintain safety at joint/body part
  • Maintaining alignment to allow healing; Post surgical fixation
  • Allow clearance during mobility
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9
Q

Purpose-Function of an Orthosis - Reduce Pain

A
  • Inflammation
  • Joint Instability
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10
Q

Purpose/Function of an Orthosis - Provide Stability/Prevent Deformity

A
  • Ligamentous Laxity
  • Muscle imbalance/weakness
  • Abnormal muscle tone
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11
Q

Purpose/Function of an Orthosis - Correct alignment

A
  • Improve joint stability
  • Improve biomechanical function
  • Poor alignment at one joint may impact other joints
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12
Q

Role of an orthotist

A
  • Expertise in components of orthotists available
  • Creation of Orthotic device
  • Communication with healthcare team to ensure
    accuracy of need/improvement
  • Ongoing adjustments to orthotic as needed
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13
Q

How do orthotists adjust orthotics as needed?

A
  • consideration of patient condition- is it a
    progressive condition?, is it a condition the
    patient may improve during therapy?
  • if patient requires orthosis for life,
    adjustments due to changes in body size, limb
    size, growth?
  • Wear/tear of device?
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14
Q

Role of PTs for orthoses determined by physician/surgeon for safety/post surgical fixation

A
  • Determination of orders for Orthotic- OOB, when in weightbearing, walking, high level activities
  • Patient ability to adequately don/doff
  • Alignment, fit, use, care
  • Skin management
  • Function in device
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15
Q

Role of PT for LE Orthotics

A

Assessment for need for orthotic- generally utilized for safety or improved independence with ambulation; if patient needs for safety in stand pivot transfers may also be covered

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16
Q

Pre Orthotic Assessment for LE orthotics

A
  • Patient demographics- weight, height, condition
  • Tone
  • ROM
  • Strength
  • Functional mobility with/without device
  • Patient goals
  • Swelling
  • Sensation
  • Anticipated activity levels
  • Degree of deformity/ correction/ accommodation needed
17
Q

Role of Physical Therapist in Orthotic Management

A
  • Assessment of Orthotic Components
  • Alignment, fit
  • Accomplishment of goals- remediation of
    impairment, functional limitations, or disabilities
    with use of orthosis
  • Ability to use/care/don/doff device
  • Skin Management/Wearing schedule
  • Ability and safety with performing
    mobility/functional activities
18
Q

Role of Physical Therapist in Orthotic
Management - Prescription

A

evaluate patient’s functional abilities and participate in pre-orthotic evaluation

19
Q

Role of Physical Therapist in Orthotic Management - Application

A

train the patient to utilize orthosis during functional activities; assess fit and function over time/use

20
Q

role of PT in Orthotic Management - Fabrication

A

Advanced level physical therapist skill- therapists who participate in fabrication pursue post-entry level training- serial casting

21
Q

Acquiring Device

A
  • Identification of need
  • Orthotic Prescription
  • Management may be based on clinic/hospital
    agreements OR patient’s insurance provider
  • Orthotic clinics vs. Orthotist coming in
22
Q

Orthotic Materials

A
  • Plastic
  • Metal
  • Hybrid
  • Wood
  • Leather
  • Carbon Fiber
  • FES based systems
23
Q

Considerations for orthotics

A

strength, stiffness, durability, density, corrosion resistance, function, comfort, cosmesis, fabrication time, cost/coverage

24
Q

strength

A

maximal external load that the material can support or sustain

25
Q

stiffness

A

amount of bending or compression that occurs when a material is loaded

26
Q

Durability

A

fatigue resistance- determined by the material’s ability to withstand repeated cycles of loading or unloading

27
Q

Density

A

material’s weight per unit of volume- related to energy cost

28
Q

Corrosion resistance

A

degree to which the material is susceptible to chemical breakdown

29
Q

Function

A

Does it accomplish goals? Does patient see value?

30
Q

Comfort

A

Will the patient wear it? How does it impact skin?

31
Q

Cosmesis

A

what does it look like?

32
Q

fabrication time

A

Orthotist generally needs a week to create-meaning if need orthotic in rehab, generally referral needs to be put in week one

33
Q

Cost/Coverage

A

Some insurance providers have preferred vendors; Medicare will not cover orthotic if patient not returning home; Medicare will not allow patient to receive orthotic more than 2 days prior to discharge home

34
Q

Fabrication options

A

*Pre-Fabricated- Off the shelf Options
*Custom Fit
*Custom- best for patients with specific needs, higher level needs, body size needs, and long term use

35
Q

AFO custom fabrication

A

*Cast (usually fiberglass) of the patient’s foot is made- negative impression
*Pour plaster into the negative impression to create a positive cast of the limb
*Plastic is then wrapped on the positive cast to create AFO

36
Q

Understanding forces in orthotic design

A

3 point presssure systems
slide 21

37
Q

considerations moving forward

A

CKC vs OKC
GRF

38
Q

Psychological Impact

A

*Will patient accept it?
*How will patient feel about using it in the community?
*Will the patient feel safe using it?

Orthotics (9 decks)

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