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Orthodics > Intro to Orthotics > Flashcards

Intro to Orthotics Flashcards

1
Q

orthosis

A

any device added to the body to stabilize or immobilize a body part, prevent deformity, protect against injury, or assist with function

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2
Q

Some Basic Goals of Orthoses

A

Maintenance or correction of body segment alignment

Assistance or resistance to joint motion

Axial loading of the orthosis & therefore relief of distal weight bearing forces

Protection against physical insult

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3
Q

FO

A

foot orthosis

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4
Q

AFO

A

ankle foot orthosis

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5
Q

KO

A

knee orthosis

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6
Q

KAFO

A

knee ankle foot orthosis

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7
Q

HKAFO

A

hip knee ankle foot orthosis

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8
Q

HO

A

hip orthosis

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9
Q

Function of ideal orthosis:

A

Meets the individuals mobility needs and goals
Maximizes stance phase stability
Minimizes abnormal alignment
Minimally compromises swing clearance
Effectively pre-positions the limb for initial contact
Is energy efficient with the individual’s preferred assistive device

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10
Q

Accomodative FO

A

When foot cannot attain neutral, FO may shim the gap to that fixed position

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11
Q

Corrective FO

A

May help the foot attain a neutral position

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12
Q

Metatarsal bars

A

flat surface placed behind the metatarsal head, that are used to relieve pressure from the metatarsal heads.

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13
Q

What are met bars designed to help?

A

to help metatarsalgia and relieve plantar pressure by adding a wedge of firm material across the sole of the shoe just proximal to the met heads

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14
Q

Most common orthosis

A
  1. Dynamic AFO= DAFOs
  2. Total contact: can be dynamic or solid
  3. floor reaction
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15
Q

What are DAFOs designed for?

A

redistribute plantar pressures of spastic equinovarus from the anterior foot to the heel

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16
Q

What does the DAFO improve?

A

swing limb clearance, stride length, cadence, and self-selected walking speed of children with diplegic cerebral palsy

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17
Q

Height of met bars:

A

1/4 inch in vertical height

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18
Q

University of California Biomechanics Laboratory (UCBL)

A

Rigid plastic total contact design
Hind foot / mid foot correction
Heel cup extends proximal to inframalleolar area and distally to the metatarsal heads
Typically extends all the way to the end of the foot

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19
Q

What does UCBL control?

A

flexible calcaneal deformities (rearfoot valgus or varus) as well as transverse plane deformities of the midtarsal joints (forefoot abduction or adduction

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20
Q

What dsyfunction is an UCBL for?

A

subtalar joint instability

functional alignment of children and adolescents with flexible pes planus, a longitudinal arch deformity

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21
Q

Supra Maleolar Orthosis (SMO)

A

shortest type of AFO
Low profile design that crosses the ankle (extends more proximal than UCBL)
Less invasive trim lines than a standard AFO, better M-L control than UCBL

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22
Q

What is a SMO used for?

A

Designed to Control pes planus

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23
Q

Cut of SMO:

A

Rounded cut at the superior aspect of the SMO tells you it’s an SMO and typically they only go the metarsals. Allows toe off at terminal stance
lateral distal trim: to 5th met head
medial distal trim: proximal to 1st met head

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24
Q

Total Contact AFO:

A

provide better control of not only PF and DF but also inversion eversion

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25
Q

Plastic AFO indications

A

weight
cosmesis
total contact
change shoes

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26
Q

Plastic AFO contraindications

A

Edema
Insensate feet
Adjustability

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27
Q

Posterior leaf spring AFO

A

most common AFO, narrow posterior shell, no medial-lateral support

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28
Q

DF Assist (allowing ankle motion):

A

aggressive spring assist (tilts forward)

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29
Q

Carbon fiber:

A

energy returning

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30
Q

Spiral AFO

A

limited control in all planes

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31
Q

Bilateral Metal Upright (bars)

A

Commonly used in specific scenarios

i.e. Post-Polio, Neuropathic feet, and CVA

32
Q

SAFO=Solid Ankle Foot Orthosis

A

resist plantarflexion during swing phase

33
Q

Floor reaction AFO- (FRO)

A

Uses floor reaction force through toe aspect of foot plate to prevent forward tibial progression & subsequent knee collapse
Designed for high tone vs low tone of CVA
Blocks forward progression

34
Q

Who is a FRO used for?

A

Used for patients with quadriceps weakness and motor control of the knee. CP children with crouch gait, post polio

35
Q

Who is contraindicated for a FRO?

A

NOT APPROPRIATE FOR GENU RECURVATUM OR ACL DEFICIENT KNEES

36
Q

Bichannel adjustable ankle lock (BiCAAL):

A

an ankle joint with the anterior and posterior channels that can be fit with pins to reduce motion or springs to assist motion

37
Q

Anterior Stop (dorsiflexion stop):

A

determines the limits of ankle dorsiflexion
can be used to control for knee hyperextension; if the stop is set to allow too much dorsiflexion, knee buckling could result

38
Q

Posterior stop (plantarflexion stop):

A

determines the limits of ankle plantar flexion

can be used to control for an unstable knee that buckles

39
Q

Spring assist (Klenzak housing):

A

double upright metal AFO with a single anterior channel for a spring assist to aid dorsiflexion

40
Q

Posterior leaf spring (PLS):

A

a plastic AFO that inserts into the shoe; widely used to prevent foot drop.

41
Q

a plastic AFO that inserts into the shoe; widely used to prevent foot drop.

A

Control for varus or valgus forces at the ankle.
Medial strap buckles around the lateral upright and correct for valgus
Lateral strap buckles around the medial upright and corrects for varus

42
Q

Unweighting AFO

A

May be patella tendon bearing (PTB), specific weight bearing or total surface bearing, TSB

43
Q

Immobilizing AFO

A 
Commonly used with a lower extremity deficiency when ankle immobilization is desired
distal tibia/ fibula fracture
foot bone fractures
tendocalcaneus rupture
Diabetic Foot (Charcot Foot)
44
Q

What is knee orthosis (KO) used for?

A

Useful for malalignment
genu varum,
valgum,
recurvatum

45
Q

Several Types of KO’s

A

Athletic KO-
Non-articulated KO-
Custom or OTS KO-
OA off loading joint

46
Q

Athletic KO-

A

Preventative.
Controversial as short lever arms may not be sufficient to diminish realistic damaging forces.
Proprioception thought to play a role

47
Q

non-articulated KO-

A

usually for short term use

difficult to transfer with

48
Q

Off-the-Shelf KO-

A

Offers limited control of the knee.

Restricts gross motion

49
Q

Components of knee ankle foot orthosis (metal KAFO)

A 
Shoe
Stirrup
Ankle joints
Side bars
Calf band
Knee joints
Distal thigh band
Proximal thigh band
50
Q

When are KAFOs prescribed?

A
  1. hyperextension or recurvatum that jeopardize structural integrity of the knee joint, and/or
  2. abnormal or excessive varus or valgus angulation that occurs during weight bearing in stance phase
51
Q

When does the rehab team consider a KAFO?

A

when stability during stance cannot be effectively provided by one of the AFO options

52
Q

Knee Joints

A 
Free
Variable ROM 
Posterior offset
Drop lock
Bail lock
53
Q

Single/Double Bar KAFO-

A

Accommodates volume fluctuation,
Cooler than total contact,
Highest material strength.
Several lock options

54
Q

Total Contact KAFO-

A

More customizable.

Better load distribution

55
Q

Craig Scott Orthosis

A

Also known as a double-bar hip-stabilizing orthosis. A lightweight variation of a traditional KAFO designed for persons with paraplegia after SCI

56
Q

Ischial Weight Bearing (unweighting) KAFO-

A

Ischial containment or Quadrilateral style brims with high trimlines.
Generally used with paralytic limbs.
Not as effective with larger or obese individuals.

57
Q

Hip Knee Ankle Foot Orthosis

A

Very restrictive and laborious to swing-to or through in gait
Children with myelomenigocele, SCI patients.

58
Q

Specific HKAFO: Reciprocating Gait Orthosis (RGO)

A

Commonly used in cases of spina bifida and spinal cord injury.
Combines flexion of one hip with extension of the opposite hip.
The flexion power of one hip is utilized to extend the opposite hip.

59
Q

ARGO: Alternating Reciprocal Gait Orthosis

A

Used with SCI patients and children with neuromuscular conditions (CP, Spina Bifida).

Super high energy consumption so they never really have been functional for most SCI patients.

60
Q

Hip Orthosis (HO)

A

Hip Abduction Orthosis for Leg calve Perthes (AVN) or congenital hip dislocations
Standing Walking AND Sitting Orthosis (SWASH) or Toronto Hip Abduction Orthosis
Some Orthoses can intervene at the hip without crossing the hip

61
Q

Patten bottom attachment

A

Distal attachment to keep foot off the floor. Requires a lift on the opposite foot. Used with Legg-Calve Perthes disease

62
Q

Hip Abduction Orthosis

A

Commonly used post-operatively to position the femoral head optimally within the acetabulum. Hip dislocation patient are often fitted with these orthosis.

63
Q

Specific Case Hip Orthosis (HO):

S.W.A.S.H Orthosis

A

Standing Walking And Sitting Hip Orthosis

Maintains femoral abduction in standing, walking and sitting

64
Q

Lateral Trunk bending:

A

same as prosthetics…medial side of KAFO too high, insufficient shoe lift, Hip Pain, weak or tight abductors on the orthotic side; short leg; poor balance

65
Q

Circumduction or Vaulting

A

locked knee, excessive plantar flexion (inadequate stop, plantar flexion contractures), Weak hip flexors or weak dorsiflexors

66
Q

Anterior trunk bending (Patient leans forward during stance):

A

Weak quads, inadequate knee lock, weak quadriceps, hip or knee flexion contracture

67
Q

Posterior trunk lean (excessive lordosis)during stance

A

Inadequate hip lock: Weak gluteus maximus, bilateral knee extension braces (craig scott)

68
Q

Hyperextension of knee

A

Inadequate plantar flexion stop, inadequate knee lock (KAFO), poor fit of calf band, weak quads, lax knee ligaments, extensor spasticity; pes equinus (plantar flexion at mid foot)

69
Q

Knee Instability

A

Inadequate dorsiflexion stop: inadequate knee lock: knee and/or hip flexion contracture; weak quadriceps or knee pain

70
Q

Foot Slap

A

inadequate dorsiflexion assist: inadequate plantarflexion stop; weak dorsiflexors

71
Q

Toe first/Toe walking

A

Inadequate dorsiflexor assist: inadequate plantar flexion stop: inadequate heel lift, heel pain, extensor spasticity, pes equinus, short leg

72
Q

Flat foot

A

inadequate longitudinal arch support: pes planus

73
Q

Excessive Pronation:

A

valgus position of calcaneus, transverse plane malalignment: weak invertors; pes valgus, genus valgum, spasticity

74
Q

Supination:

A

varus position of the calcaneus. Transverse plane malalignment: weak evertors: pes varus, genu varum

75
Q

Excessive Stance width

A

KAFO too high on medial upright, HKAFO hip joint aligned in excessive abduction, knee is locked, abduction contracture/tightness, poor balance, sound limb is too short

Orthodics (16 decks)

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