LE orthosis Flashcards
What orthotic is best for controlling the rear foot and treating flexible pes/planus/ valgus foot and plantarfascitis
UCBL foot orthosis
What are the contraindications of the UCBL foot orthosis
moderate to high tone
toe walking
athletic activiites
T or F: The trim line of the UCBL crosses the ankle
F
What kind of orthosis controls the rear foot and midfoot, and can be used in both intermittent toe walking and severe pes plano valgus foot
supramalleolar orthosis
T or F: the supramalleolar orthosis is effective in controlling knee
T or F: The SMO facilitates foot clearance in swing
F
T
What is the secondary effect of the SMO
Mild control of ankle inversion/eversion
What kind of orthosis is best for drop foot
Posterior leaf spring
what kind of orthosis supports the weight of the foot and enhances limb clearance
posterior leaf spring
what kind of orthosis assists with controlled lowering of foot during loading response
posterior leaf spring
What are the contraindications of the SMO
High tone and posturing
What are the contraindications of the Posterior leaf spring
when stance control is needed
when inversion or supination control is needed
What is an alternative to the posterior leaf spring
Off the shelf carbon AFO
What is the purpose of the solid ankle AFO
blocks movement of ankle in all planes
can impact movement and position of the knee
What are the indications of the solid ankle AFO
control of stance (excessive knee hyperextension or excessive knee flexion)
dorsiflexion assist
mod/severe hypertonicity
T or F: a solid ankle AFO causes you to lose all rockers in gait
T
What are the contraindications of the solid ankle AFO
Open chain problems when ankle movement in stance should be preserved
The articulate AFO allows for what rocker to work compared to the solid ankle AFO?
second/ankle rocker of stance
How does the articulate AFO work?
DF restraint on back controls tibial translation
PF block (white plastic on side) decreases amount of PF
What kind of AFO is best to assist weak quads and weak plantarflexion
Ground reaction force AFO
What are the contraindications to the Ground reaction AFO
Notable recurvatum during stance (text book answer) (Dr. Szott says they’re still used for hyperext)
What kind of AFO applies an external extension moment to the knee and has good midfoot and rearfoot control
ground reaction AFO
what is the different about the ground reaction AFO with a rear entry
no rear foot control
can be articulated to allow free PF to maintain first rocker
What type of orthosis is indicated for an AT RISK foot
Metal double upright
What is the primary effect of the metal double upright AFO
Can use pins and springs
pins- block motion
springs- assist motion
secondary: Can control mild inversion/eversion with T-strap
What is the ideal shank/angle?
10-12 degrees incline
What needs to be considered when measuring shank ankle?
What shoes the patient wears, shoes will change the angle
Pt has fluctuating edema, what kind of AFO do they need
metal double upright
What muscle group is weak if you need to block plantarflexion range of motion with a pin
Dorsiflexors
When should a KAFO be considered?
Poor quad!!
When excessive movement occurs at knee during stance that cant be controlled by AFO
Pt has excessive recurvatum that compromises structure of knee joint
KAFO
Pt has abnormal valgus or varus angulation at knee during stance
KAFO
What are the contraindications of using metal AFOs
Issues with energy expenditure
need to control transverse plane
Pt is obese, what kind of AFO is best
metal
What are the contraindications for using plastic AFO
obesity and fluctuating edema
Advantages and disadvantages of metal vs plastic AFO
Metal: Strong, fixed to shoe, heavy and less cosmetic
Plastic: Light weight, can wear different shoes, but hot
What kind of KAFO joint allows unrestricted flexion and blocks ext to 180 degrees
Single axis knee
How does the single axis locking knee joint work?
Drop lock falls with gravity and locks when standing, requires each side be unlocked to sit
what kind of KAFO joint moves ground reaction force anterior to joint creating an extensor moment that mechanically augments stance stability
posterior offset knee joint
what kind of knee joint is best for pt’s with hyperextension
posterior offset
What kind of knee joint is indicated for flexion contractures, and can accommodate varying degrees of flexion
variable position knee joint
what kind of knee joint has a semi-automatic locking mechanism with 10 different positions
can assist into standing/straightening
Rachet lock “interlocking knee joint”
how does the bail lock knee joint work
Permits unlocking of both joints simultaneously when strap hits back of chair, allowing them to sit down
What kind of knee joint has stumble recovery and is controlled by a microprocesor
stance control “c-leg”
- weight activated or ankle activated
how does a stance control KAFO work?
Locks during stance
unlock during swing
using microprocessor
What is a HKAFO
hip ankle foot orthosis
cumbersome to don/doff
more so used for therapeutic weight bearing/walking in low functioning patients
Pt has a double metal upright and is experiencing toe drag during swing, what do?
add a spring in the back to assist dorsiflexion during swing
Pt has double metal upright and experiences excess DF in SLS, what do?
put a pin in the front to block excessive dorsiflexion
Pt has a double metal upright and experiences mild inversion/eversion control problems
use T-strap to control inversion/eversion
What kind of orthotic would we not want to give to a pt with notable recurvatum in stance
ground reaction AFO (textbook answer)
What kind of AFO would we give someone who is excessively crouched during gait due to weak plantarflexors
ground reaction AFO
How should we adjust an articulate AFO to accommodate someone who experiences excessive DF during SLS
Increase the DF restraint to allow less DF
What kind of LE AFO is indicated for hypertonicity
Solid Ankle AFO
note: supramalleolar AFO can be used for mild hypertonic child
What kind of AFO is best for toe walking
supramalleolar orthois
Pt is experiencing foot drop and excessive recurvatum in stance d/t poor control of the knee, will a supramalleolar AFO help with these?
F.
Supramalleolar AFO not effective in controlling knee
