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Rehabilitation Engineering Part 2 > L23 Orthotic Devices > Flashcards

L23 Orthotic Devices Flashcards

1
Q

Orthosis

A
  • Greek orthos, meaning to “straighten”
  • Provides functional stability to a joint or prevents, corrects, or compensates for a deformity or weakness
  • Lend stability to weak joint
  • Correct or maintain alignment
  • Correct skeletal deformities
  • Shoe insert  reciprocating gait orthosis
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2
Q

Goals of Orthoses

A
  • Maintain or maximize function
  • Prevent deformity or contracture
  • Improve positioning or range of motion
  • Allow protection and position for proper healing and recovery
  • Improve mobility and quality of life
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3
Q

Orthotic Considerations

A
  • Cost
  • Energy efficiency
  • Cosmesis
  • Temporary vs. Permanent
  • Therapeutic vs. Assistive
  • Dynamic vs. Static
  • Powered or non powered
  • Encourage normal movement
  • Facilitate movement
  • Don/Doff
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4
Q

Static

A
  • prevent or limit motion
  • No moveable parts
  • Reduce stress and maintain joint alignment
  • Prevent deformities and soft tissue contracture
  • Scar reduction; reduce
    inflammation and pain
  • Position for proper healing
  • Protection against further injury
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5
Q

Dynamic

A

*Facilitate movement
*Moveable parts
*Increase range of motion (ROM); stretch soft tissue contractures
*Assist muscle weakness or spasticity
*Allow for exercise -> improve ROM and strength

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6
Q

Three-point pressure system

A

Principal force acting at or near joint opposed by two forces: one proximal and one distal to joint

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7
Q

Leverage

A

mechanical advantage of a force applied at a distance from a fulcrum; increase lever arm length - decrease force necessary to stabilize joint - increase comfort

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8
Q

Ground Reaction Force

A

Can be used to stabilize a joint more
proximal to orthosis

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9
Q

Axial Forces

A

Directed along the long axis of the bone; reduce axials force by transferring weight through an orthosis

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10
Q

Pressure

A

force over area; generally beneficial to distribute forces that orthosis applies to body over a large area

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11
Q

Shear stress

A

Caused by tangential forces applied to loading bearing surface of the body; minimize shear stress at the interface between body and orthosis

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12
Q

Creep

A

Time-dependent strain or change in shape of material due to stresses and loading; depends on stiffness and viscoelastic properties of material; creep occurs in muscles and soft tissues

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13
Q

Cervical Orthoses

A

hard and soft

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14
Q

Cervical thoracic (CTO)

A

provides motion control in all three planes

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15
Q

Cervicothoracolumbosacral (CTLSO)

A

Treatment of scoliosis; end point
control, transverse support and correction of the curve

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16
Q

Spinal Orthoses

A
  • Cervical (CO)
  • Cervical thoracic (CTO)
  • Thoracolumbosacral (TLSO)
  • Lumbosacral (LSO)
  • Cervicothoracolumbosacral (CTLSO)
17
Q

Lower Limb Orthoses

A
  • Foot Orthoses (FO)
  • Ankle-Foot Orthoses (AFO)
  • Knee Orthoses (KO)
  • Knee-Ankle-Foot Orthoses (KAFO)
18
Q

Foot Orthoses (FO)

A

Aemi rigid or rigid inset that corrects foot alignment, improves function, relieves pain

19
Q

Ankle-Foot Orthoses (AFO)

A

Controls amount of dorsiflexion and plantarflexion of ankle; CP, foot drop, weak muscles

  • Semi-rigid L-shaped braces stabilize both the foot and ankle to bring muscles and joints into alignment.
  • braces extend up the calf,
  • made of metal or hard plastic
  • straps that can hold the device in place
  • bring stability to foot, ankle and lower leg
  • used to correct foot drop.
  • AFOs account for 26 % all orthotics in US
20
Q

Knee Orthoses (KO)

A

Provide support, correct deformity, prevent injury, knee OA

21
Q

Knee-Ankle-Foot Orthoses (KAFO)

A

Severe knee extensor and hamstring weakness, knee instability, spasticity of hamstrings; persons with SCI

22
Q

Process for Making AFOs

A

1- Taking measurement of the body segment
2- Taking a negative impression
3- Creating a positive model
4- Modifying the positive model
5- Shaping the orthosis or prothetic socket
6- Fitting to the patient

23
Q

3D Printed AFOs

A
  • CYBER team (University of Michigan, Altair Engineering and Stratasys) to transform the design, comfort, utility and customization of Ankle Foot Orthotics (AFO)
  • create the digital workflow for additive manufacturing design
  • fused deposition modeling (FDM®) fabrication methods and Altair® OptiStruct® analysis software for the production of customized ankle-foot orthoses (AFO)
24
Q

3D Printed Foot Orthoses

A
  • Clemson University
  • foot problems from diabetes need foot
    orthotics that can take weeks to make and
    are not always the right softness
  • 6 or 7 foam-like materials

Researchers at Clemson:
* Laser scan patient’s foot and use pressure sensing
to identify high pressure areas
* Create an orthotic with 3D printing
* Vary the hardness of the material in a
thousand different blends
* Alter the internal geometries to make them harder or softer in different areas

25
Q

Hocoma Lokomat

A
  • Driven gait orthosis
  • Used to treat individuals with neurological diseases or injuries such as stroke, SCI, brain injury, MS and cerebral palsy
26
Q

Upper Limb Orthoses

A
  • Finger Orthoses: immobilization of specific joints
  • Hand Orthoses: arthritis; immobilization after surgery
  • Wrist-Hand Orthoses (WHO): rheumatoid arthritis, stroked, radial
    nerve palsy
  • Elbow Orthoses (EO): posterior or anterior immobilization
  • Shoulder Orthoses: after humerus fracture or shoulder surgery
  • Shoulder-Elbow-Wrist-Hand Orthoses (SEWHO): brachial plexus
    injury, after burns for prevention of contractures
27
Q

Static Orthosis

A
  • A rigid device with no moving parts
  • Fabricated from plaster or low
    emperature thermoplastic materials
    Indications for Static Orthotic Intervention
  • To support body part during the acute phase of injury
  • To support unstable joints or inflamed tissues
  • To protect repaired structures
  • To substitute for decrease muscle function
  • To prevent or minimize undesired motion
  • To maintain ROM increases
28
Q

Serial Static Orthosis

A

A rigid device fabricated low temperature thermoplastics or plaster that provides progressive mobilization as ROM is gained

29
Q

Static Progressive Orthosis

A
  • Similar to serial static
  • Component pieces are included with the thermoplastic orthosis –to progress ROM
  • MERiT (maximize end range time) –or TERT (Total End Range Time)
30
Q

Indications for Serial Static or Static Progressive Orthosis

A
  • To resolve joint stiffness, soft tissue or tendon tightness to increase PROM
  • Recommended for long-standing scar or adhesion difficulty
  • The scare is encouraged to grow
31
Q

Dynamic Orthosis

A

A rigid device with moving parts that provides mobilization to joints and soft tissues through adjustments of the components Indications for Dynamic Orthoses

  • To resolve joint stiffness or tendon tightness
  • To provide muscle substitution
  • To correct or minimize joint deformities
  • To allow controlled mobilizing forces

Rehabilitation Engineering Part 2 (11 decks)

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