LE Orthosis Flashcards
1
Q
Principles of LE orthosis
A
Used only as indicated and as long as necessary
Allow joint movement
Must be functional
2
Q
Where should an orthotic ankle joint be centered?
A
Tip of the medial mallelous
3
Q
Where should an orthotic knee joint be centered
A
over the prominence of the medial femoral condyle
4
Q
Positioning of an orthotic hip joint
A
Allows patient to sit upright @ 90 degrees
5
Q
Foundation for most LE orthoses
A
Shoes
6
Q
function of shoes
A
transfer weight to the ground
protection from terrain and weather
7
Q
shoes have the greatest WB on what parts of the foot?
A
slightly lateral to the ball of the foot
posterolateral edge of the heel
8
Q
parts of a shoe
A
upper
sole
heel
9
Q
upper is divided into three parts which are:
A
vamp
quarter
tongue
10
Q
anterior aspect of the upper part of a shoe
A
vamp
11
Q
posterior aspect of the upper part of the shoe
A
quarter
12
Q
open lace
A
blucher
13
Q
closed lace
A
balmoral
14
Q
recommended for individuals c limited manual dexterity
A
strap
15
Q
recommended for a more precise adjustment
A
lace
16
Q
distinguished by a separation between the anterior margins of the lace
A
blucher
17
Q
lace stay is continuous with the vamp
A
balmoral
18
Q
important feature of a blucher
A
permits substantial adjustability
19
Q
in what conditions are blucher laces recommended
A
for edematous pts c paralyzed toes
20
Q
advantages of blucher lace
A
ease of donning
greater foot entry space and adjustability
21
Q
where are low quarter shoes terminated at
A
below the malleoli
22
Q
advantages of low quarter shoes
A
does not restrict foot or ankle motion
23
Q
advantages of high quarter shoes
A
covers both malleolus
provides foot stability
can accommodate pes equinus
24
Q
advantages of a broad and low heel
A
provides the greatest stability
distributes the weight between the back and the front of the foot
25
indications of high heels
heel pain
achilles tendinitis
rigid pes equinus
26
disadvantages of high heels
puts stress on metatarsals and knees
27
what does high heels promote?
knee flexion and hip flexion
28
height of heel that aids transition through the stance phase
1 in (2.54 cm)
29
what does a higher heel do?
places ankle in greater plantarflexion and forces the tibia forward
30
protects the toes from stubbing and
vertical trauma
Toe boxing
31
condition for using toe boxing
should be high enough to
accommodate hammer toes or similar deformity
32
longitudinal plate that reinforces the sole
between the anterior border of the heel and the
widest part of the sole at the metatarsal heads
Shank
33
stiffens the quarter and generally
terminates at the anterior border of the heel
Counter
34
anterior border of the heel
breast
35
posterior border of the heel
pitch
36
widest area of the foot
ball
37
how much should be the allowance from the longest toe for a shoe to be well-fitted?
1/2 inch
38
requirements of a well-fitted shoe
1/2 inch allowance from the longest toe
Widest part of the shoe corresponds c the broadest part of the foot
Snug from heel to ball of the foot
Quarters don't gap excessively
39
Reduce load on painful heel
Heel-spur insert orthosis
40
feature of a heel-spur insert orthosis
has a concave relief to minimize pressure on the tender area
41
prevent depression of the subtalar joint and flattening of the arch
Longitudinal arch support
42
what is flattening of the arch called?
pes planus
43
provides minimum support to the medial longitudinal arch
Scaphoid pad
44
where is the scaphoid pad positioned?
medial border of the insole with the apex between the sustentaculum tali and the navicular tuberosity
45
used to relieve pain and activity limitation associated c pes cavus
insert orthoses
46
Transfers weight from metatarsal head to
the metatarsal shaft
Metatarsal pad
47
Indications for using metatarsal pad
reduce plantar
pressure; particularly in pts c
diabetic neuropathy
48
where are metatarsal pads placed?
apex should be under the metatarsal shafts
49
Alters alignment of the rearfoot
Heel wedge/post
50
What are the two types of wedges?
medial and lateral
51
medial heel wedge corrects...
pronation
eversion
pes varus
pes planus
flat foot
52
lateral heel wedge corrects...
supination
inversion
pes varus
pes cavus
clubfoot
53
Anterior border of medial side is extended
forward
Thomas heel
54
Indication for using thomas heel
Pes valgus
55
Transfers stress from MTP joints to MTP shafts
Metatarsal bar
56
How is the metatarsal bar positioned?
posterior to the MTP heads
57
Indication of using MTP bar
metatarsalgia
58
Reduces the distance the wearer must travel during the stance phase
Rocker bar/bottom
59
What does the rocker bar do?
Shifts load from MTP joints to MTP shafts and improves late stance phase
60
Indication for using rocker bar/bottom
Pts c difficulty in push-off
61
Raises one foot in order to shift balance
Shoe lifts
62
Indication for using shoe lifts
LLD
63
Components of an AFO
foundation
ankle control
foot control
superstructure
64
provides good control of the foot and is removable and lightweight
insert foundation
65
a u-shaped traditional foundation for AFO
stirrup foundation
66
a type of stirrup that provides maximum stability of the orthosis on the shoe
solid stirrup
67
three segments of a split stirrup
central portion
medial angled side piece
lateral angled side piece
68
advantages of a split stirrup
simplifies donning as the wearer can detach uprights from the shoe
69
a dorsiflexion assist
posterior leaf spring
70
indication for using a posterior leaf spring
weak dorsiflexion, foot drop
71
when is posterior leaf spring not indicated?
when a pt has medio-lateral ankle instability
72
bulkier than the posterior leaf spring
Klenzak joint/Dorsiflexion spring assist
73
mechanism of a Klenzak joint
coiled spring compresses in stance and
rebounds during swing.
74
advantage of a Klenzak joint
the tightness of the coil can be adjusted
75
prevents toe dragging and controls knee buckling
Plantarflexion Resistance/Posterior Stop
76
indications for using for a Posterior Stop
weak dorsiflexors
77
what does a Posterior Stop promote?
dorsiflexion due to weak pre tibials
78
the triceps surae is made up of
Gastrocnemius (medial and lateral)
Soleus
79
Indication for using Dorsiflexion resistance/Anterior stop
pts c paralysis of the triceps surae
80
what does an Anterior Stop do?
controls genu recurvatum and buckling
promotes plantarflexion and knee extension
81
function of a posterior pin
limits plantarflexion
82
function of a posterior spring
assists dorsiflexion
83
function of an anterior pin
limits dorsiflexion
84
function of an anterior spring
assists plantarflexion
85
indication for using a posterior pin
plantar spasticity, toe dragging, pain c ankle motion
86
indication for using a posterior spring
flaccid PF, knee hyperextension
87
indications for using an anterior pin
weak PF, weak knee extensors, pain c ankle motion
88
Limits all foot and ankle motions
Plastic Solid AFO
89
Indications for using Plastic Solid AFO
hemiplegia
spastic diplegia
90
resists/assists both PF and DF
Bi-channel adjustable ankle locks
91
medial T-strap
valgus correction strap
92
posting for medial T-strap
lateral
93
lateral T-strap
varus correction strap
94
posting for lateral T-strap
medial
95
Able to offset/unload weight from knee area
Superstructure
96
components of a superstructure
two uprights
shell
band/brim
97
Reduce amount of weight transmitted through
the foot
Patellar tendon bearing-brim
98
Indication for patellar tendon bearing-brim
post-op pain
99
Imposes posteriorly directed force providing
extension moment in the stance without
preventing flexion during swing
Floor reaction orthosis
100
what does floor reaction orthosis promote?
places foot in slight PF
101
controls motion in all planes
spiral AFO
102
disadvantages of spiral AFO
cannot accommodate fluctuating leg volume
103
components of an orthosis with knee flexion instability
solid heel
AFO in fixed DF
Anterior trim line on AFO
104
components of an orthosis with knee extension stability
cushioned heel
AFO in fixed PF
posterior trim line
Posterior offset knee jt
105
Components of KAFO
Knee control
Knee cap
Genu Valgum/Varus correction
Superstructure
106
Stabilizes the knee in extension during the
early stance phase of gait.
Offset knee jt
107
How is a offset knee jt positioned?
posterior to the midline of the leg
108
contraindication for using an offset knee jt
knee flexion contracture
109
most common knee control and is manually and gravity manipulated
Drop ring lock
110
Drop ring lock knee control is challenging for pts who have
Limited hand function
111
What should be done to provide maximum stability when using drop ring lock?
lock medial and lateral joints
112
contraindication for using drop ring lock
knee flexion contracture
113
Provides simultaneous locking of both
uprights
Pawl lock c bail release
114
Pawl lock c bail release is used for pts who have
dexterity problems
115
how is the pawlock unlocked?
pulling up of bails
116
disadvantages of using pawlock
increases energy expenditure
117
Allows joint locking at different angles of knee
flexion
Serrated knee lock
118
Indication of serrated knee lock
Pts c knee extension contracture
119
Provides sagittal knee stability
knee cap
120
disadvantages of knee cap
may restrict sitting
121
