LE orthosis Flashcards by Alexander Lee

What orthotic is best for controlling the rear foot and treating flexible pes/planus/ valgus foot and plantarfascitis

UCBL foot orthosis

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What are the contraindications of the UCBL foot orthosis

moderate to high tone

toe walking

athletic activiites

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T or F: The trim line of the UCBL crosses the ankle

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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

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T or F: the supramalleolar orthosis is effective in controlling knee

T or F: The SMO facilitates foot clearance in swing

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What is the secondary effect of the SMO

Mild control of ankle inversion/eversion

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What kind of orthosis is best for drop foot

Posterior leaf spring

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what kind of orthosis supports the weight of the foot and enhances limb clearance

posterior leaf spring

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what kind of orthosis assists with controlled lowering of foot during loading response

posterior leaf spring

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What are the contraindications of the SMO

High tone and posturing

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What are the contraindications of the Posterior leaf spring

when stance control is needed

when inversion or supination control is needed

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What is an alternative to the posterior leaf spring

Off the shelf carbon AFO

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What is the purpose of the solid ankle AFO

blocks movement of ankle in all planes

can impact movement and position of the knee

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What are the indications of the solid ankle AFO

control of stance (excessive knee hyperextension or excessive knee flexion)

dorsiflexion assist

mod/severe hypertonicity

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T or F: a solid ankle AFO causes you to lose all rockers in gait

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What are the contraindications of the solid ankle AFO

Open chain problems when ankle movement in stance should be preserved

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The articulate AFO allows for what rocker to work compared to the solid ankle AFO?

second/ankle rocker of stance

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How does the articulate AFO work?

DF restraint on back controls tibial translation

PF block (white plastic on side) decreases amount of PF

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What kind of AFO is best to assist weak quads and weak plantarflexion

Ground reaction force AFO

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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)

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What kind of AFO applies an external extension moment to the knee and has good midfoot and rearfoot control

ground reaction AFO

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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