LE Flashcards
What is the name for the following AFO?
Trim lines behind malleoli; Provides DF assist
PLS / posterior leaf spring
intrinsic
What is the name for the following AFO?
Trim lines through malleoli; Provides DF assist, some M/L stability, some knee control
SSAFO / semi-solid AFO
intrinsic
What is the name for the following AFO?
Trim lines anterior to malleoli; Limits all foot/ankle motion, Provides DF assist, M/L ankle stability, knee control
SAFO / solid AFO
intrinsic
What is the name for the extrinsic AFO made with bichannel adjustable ankle locks or double action joint that can adjust to many levels of fxn?
DMU / double metal uprights
What length is typical for accommodative FO?
full length
What length is typical for semi-rigid FO?
3/4-full length
What length is typical for rigid FO?
3/4 length
Indications for KAFO
o Little to no voluntary control at knee and foot with some voluntary control of hip and trunk musculature
o Malignment of knee: genu valgus or varus or to a lesser degree, knee flex contractures, severe genu recurvatum
Contraindications for KAFO
o Unable to meet energy demands
o Lack of adequate strength
• Decreased hip/trunk strength to allow swing phase
• Lack of control in standing balance or use AD
o Open wound in area of orthosis
What is the upper component of a KAFO called?
AK = above the knee
What are the Metal vs. Plastic arguments for KAFO?
o Same decision making as AFO’s
o Skin, swelling, adjustability at ankle, pt. preference
o Risk/benefit
What is the most common KAFO joint type?
drop lock
Locks drop manually (or by gravity) when knee is extended for gait
Unlock in sitting by pulling two locks up
(If manual, have to lock/unlock both sides simultaneously)
How does Bail lock KAFO fxn?
Horizontal lever placed from uprights around and behind knee joint
When lifted, knee joint unlocks
How does CABLE RELEASE KAFO fxn?
Trigger switch easier for pts to reach (vs drop locks)
Only requires one hand
How does OFF SET KNEE KAFO fxn?
Mechanical knee joint posterior to anatomical knee joint
What is the purpose of functional knee orthoses?
o provide alignment
o valgus or varus control
o un-weighting one side of knee
Return to activities!
The purpose of patello-femoral orthoses:
provide support and patellar tracking
Which KAFO joint only requires one hand to lock/unlock?
cable release
Generally, what knee joint is used for craig scott KAFO?
bail locks
Describe craig scott KAFO:
- T-shaped foot plate for M/L stability
- Ankle joint with a ant/post adjustable stops (generally 10 degreed DF)
- Heavy duty double metal (steel) uprights
- Pre-tibial band (anterior)
Describe the fxn of stance control KAFO:
Heel strike causes knee lock to engage (Allows for extension during stance phase)
Toe-off causes knee lock to disengage (Allows for flexion during swing phase)
Describe the fxn of ischial WB KAFO:
Creates larger WB support area for ischium
Decreases lower leg WB
HKAFO indications:
o Complete or partial loss of voluntary trunk and LE control
HKAFO contraindication:
o Unable to meet energy demands
o Inadequate neck and UE strength and coordination
o Hip flexion contracture > 30 degrees
A thoracic attachment to support trunk can be added to RGO’s and is called:
THKAFO
HKAFO with knee joints off set posteriorly; rigid pelvic band covering gluteal/sacral areas; cables connected to each hip are called:
RGO = reciprocal gait orthosis
What is the fxn of RGO’s?
Assists with advancing the LE in a patient with very weak musculature or no active muscles.
How? tension in the cables alternate between the stance leg and the swing leg
What does gait look like in RGO’s?
Lateral-diagonal wt shift and backwards lean with the upper body to start the motion of one leg moving forward.
- activates the cables to assist with swing and provides only a primitive reciprocal gait
Examples of pt.’s who might use RGO?
o Motivated dependent patients
o Pt.’s who want to walk down the aisle
o Peds who are lighter for benefit of walking