Introduction to Orthotics and Prosthetics/ UE Orthosis Flashcards
What is orthosis?
- Stabilize the body
- Assist Weak Muscles
- Stop undesirable motions
What does an Orthotist do?
A professional job who designs, fabricates and adjust to people who need orthosis devices in order to get back on ADL’s.
What is the primary purpose of all upper limb orthoses, and how does it relate to the the rehabilitation program and their prescription?
- Substitute weak or absent muscles.
- Protect damaged or diseased segments.
- Prevention of deformity
- Correction of Contractures
- Attachment of other assistive devices.
It refers to a device that is applied externally to the body to support or improve the function of that body segment.
Orthosis
Any external device use to modify structural and functional characteristics of the neuromuscular skeletal system.
Orthosis
Functions of Orthosis
- Corrects Alignment
- Accommodates Deformity
- Protect painful areas.
Biomechanical Principles of Orthosis
- Three-point control concept
- Tissue tolerance to compression and shear forces
- The biomechanics of levers and forces
- Selection of materials
- Static versus dynamic control
This biomechanical principle is a primary force that applied generally at the joint to be corrected, and counterforces are applied both above and below the primary force.
Three-point control concept or Three-point pressure system
Avoiding prolonged excessive pressure over the bony prominences will preserve the skin integrity and pt. comfort. What biomechanical principle is applied?
Tissue tolerance to compression and shear forces
How many/much is the pressure sensitive bony prominences in the wrist, hand, and fingers alone?
More than 30 pressure-sensitive bony prominences
How many/much pressure and time can a patient tolerate in a high pressure duration curve?
100-300 mmHg for 2-4 hours continuously
How many/much pressure and time can a patient tolerate in a low pressure duration curve?
20-50 mmHg for 12 hours a day continuously
This biomechanical principle deals about a seesaw that has a force applied at both ends with a central fulcrum.
The biomechanics of the lever and the forces.
What should be the rehabilitation specialist must take to consider to understand the biomechanics of the lever and the forces?
The relationship between the magnitude of the pressure applied (forces) and the distance of the fulcrum (lever).
How many/much applied to a proximal and distal to the central fulcrum?
One force (central fulcrum) and two forces
T or F
The farther from the fulcrum or from the joint, the less pressure needed to generate a fixed forced across the joint.
T
This principle depends on the flexibility, strength and durability in which it is necessary to achieve a proper outcome.
Selection of materials
Two basic types of hand grips.
Power and Precision
Basic Prehension Patterns
Pinch, Grasp, and Hook
If there is a clawhand deformity, how should you immobilized the pt.’s hand as a PT?
Wrist should be Slight extension and neutral pronation/supination
Fill in the blanks:
The ___ joints of the fingers should be immobilized in extension, but the _______ Joints should be immobilized into flexion to maintain ______ ligaments. The thumb should be immobilized opposite the fingers in ________ and ______.
IP; MCP; Collateral; palmar abduction and extension.
This type of orthosis have no movable joints incorporated into the design. This may allow active joint motion in one direction but block motion in another direction.
Static Orthosis
This type of orthosis have movable joints that can limit motion. This increase motion through traction and substitute for weak muscles using supplemental force (assist).
Dynamic Orthosis
This type of orthosis and will incorporate features of both static and dynamic orthoses into one device.
Hybrid Orthosis
All upper limb orthosis is classified into what?
1 out of 3 categories of orthosis: can be static, dynamic, or hybrid.
The static orthosis may also be changed or adjusted to alter the motion allowed or alter the pressure across a joint for stretching purposes. What do you call this term?
Static Progressive Splint
T or F
The IP and MCP joints should be immobilized as soon as possible to prevent contracture and adhesions of the long flexor and extensor tendons.
False: mobilize
Types of UE Orthosis
- Non-Articular
- Static
- Serial Static
- Static Motion Blocking
- Static Progressive
- Dynamic
- Dynamic Motion-Blocking
- Dynamic Traction Splints
- Tenodesis Splint
- Continuous Passive Motion Orthoses
- Adaptive or Functional Usage
This type of splint provides supports to a body part without crossing any joints.
Non-Articular
Type of Non-Articular Splints
- Non articular Sarmiento Brace
- Sugar Tong Splint
- Gel Shell Splint
It is used to immobilize the humerus after a fracture allows
full range of motion of all the joints involved in the injured extremity.
Non articular Sarmiento Brace
■ Is ideal for splinting fractures of the radius, ulna, or wrist.
■ Prevents flexion and extension at the wrist, limits flexion and extension at the elbow,
and prevents supination and pronation.
Sugar Tong Splint
A splint that exert pressure over a healing scar to prevent hypertrophic scarring.
Gel Shell Splint
This type of splint provides static support to hold a joint or joint stationary.
Static Splint
What splints would you use if patient has a CTS?
Volar Wrist Splints
This splint is used for immobilization for a distal phalanx fracture.
Hand-based static thumb splint with IP joint.
This type of splint is also static but is periodically changed to alter the joint angle at
which the splint is positioned. This also provides a prolonged gentle stretch.
Serial Static
This type of splint permits motion in one direction but blocks
motion in another.
Static motion-blocking
This splint is designed to allow flexion but to block
hyperextension of the proximal interphalangeal (PIP)
joint and for Swan Neck Deformity.
Swan Neck Splint
This type of splinting is the one most commonly used for
regaining joint motion.
Static Progressive
What is the difference between the static progressive and serial static?
static progressive splints uses elastic pull band.
■ Decreases the static line length as it is turned, thereby increasing the range of motion
■ Most commonly used splint for regaining joint motion
■ Some patients may tolerate static progressive over dynamic orthosis, possibly due to the
joint position constant while the tissue accommodates gently and gradually to the
tension, without the influence of gravity or motion.
Merit Static Progressive Component
This type of splint provides an elastic force to regain motion.
Dynamic Splints
Type of Dynamic Splints
- Capener Splint
- Finger Extension Splint
- LMB Extension type of finger splint
This is a dynamic splint which uses a SPRING COIL assist to increase extension in a PIP joint with a mild contracture.
Capener Splint
This type of dynamic splint which uses a spring coil or WIRE TENSION assist designed to increase extension in a PIP
joint with a mild contracture
Finger-Extension Splint
This type of dynamic splint produces extension of the proximal interphalangeal or distal interphalangeal joints of
the fingers or thumb.
LMB Extension Type of Finger Splint
○ This type of splint allows certain motions but blocks others
○ It utilizes a passive, elastic line of pull in the desired direction but permits active
motion in the opposite direction.
Dynamic Motion-Blocking
This type of dynamic motion-blocking splint is used for flexor tendon repairs
where it passively pulls the finger into flexion with an elastic thread or rubber band. It also allows active digital extension, while parts of the splint block full extension
of the MCP joint and the wrist.
KLEINERT POSTOPERATIVE SPLINT
This type of splint offers traction to a joint while allowing controlled motion.
Dynamic Traction Splint
- This type of dynamic traction splint gives constant longitudinal traction while the joint is gently flexed and
extended. - This is also called as?
- Intra Articular Fracture Splint
- Schenk Splint
This type of splint facilitates function in a hand that has lost motion due to
nervous system injury.
Tenodesis Splint
This type of tenodesis splint assists the patient with a C6 spinal cord injury to achieve a functional
pinch. Also, active extension of the wrist produces, through tenodesis action,
controlled passive flexion of the fingers against a static thumb post.
REHABILITATION INSTITUTE OF CHICAGO TENODESIS SPLINT
These are electrically powered devices that mechanically move joints through a
desired range of motion.
CONTINUOUS PASSIVE MOTION ORTHOSES
These devices promote functional use of the upper limb with impairment due to
weakness, paralysis, or loss of a body part.
ADAPTIVE OR FUNCTIONAL USAGE
This type of adaptive or functional usage encompasses the hand and holds various small items such as fork, pen,
or toothbrush.
Universal Cuff
Any device that replaces a body part.
Prosthesis
Specifications for the ideal prosthesis/orthosis
Function
Comfort
Fabrication
Cosmesis
Economics
What is the most important factors used to determine which type of orthosis or type of material to choose?
- Weight
- Age
- Activity Level
- Potential
First consideration of the process
Material Selection
Important Characteristics of Prosthetic and Orthotic Materials
- Strength
- Stiffness
- Durability
- Density
- Corrosion Resistance
- Ease of fabrication
Give me the materials that are used for orthosis and prosthesis
Metal and Plastic Components
Give me example of metals used for orthosis and prosthesis
Aluminum, carbon fiber, and stainless steel
Give me example of plastics used for orthosis and prosthesis
Polypropylene and Polyethylene
