LE Orthotics Flashcards
Orthotics
-custom fit for neuromsucular and musuloskeletal impairmens
-control boney segments
-pick up slack of ligs and tendons
-manage COG over BOS
-Manage open or closed kinetic chain
-3 point force system
Naming LE Othosis
-first letter of each joint crossed
KAFO: knee, ankle, foot
4 Basic Components of Gait
-Weight Bearing
-Stance Limb Progression: GFR
-Shock Absorption
-Energy Conservation: co-contraction fo antagonists is rare
Goals of Orthotics
-prevent deformity: skeletal alignment
-provide stability: block or allow motion
-facilitate function: GFR
Shank to Vertical Angle vs Ankle Angle
-10 deg
-angle of ground to tibia
-different than ankle angle
-adding a wedge increases SVA by changing AA
Considerations for Orthotics
-Pt measurements
-Edema
-Diagnosis
-Trimlines
-Height
-Shoewear
-Wedging
UCBL
-university of california biomechanics lab orthosis
-foot orthosis
-lowest level of control
Function:
-controls rearfoot
-blocks forefoot
Use:
-valgus/varus, plantar fascitis, low tone
Contraindications:
-high tone
-toe walking
-athletic acivities
Supramalleolar Orthosis (SMO)
-SAFO/SMO/DAFO
-ankle/foot orthosis
Function:
-controls rearfoot and midfoot
-mild ankle control IN/EV
-indirectly controls foot clearance in swing
Use:
-flat foot, intermittent toe walking, low tone
Contraindications:
-high tone
-posturing
-dominant toe walking
Posterior Leaf Spring (PLS)
-AFO (like solid AFO with more flexibility)
-trimlines behind malleoli
Function:
-swing phase control
-controlled lowering during LR by providing heel rocker (blocks PF)
-clears toes
Use:
-weak DF, plantar fascitis, low tone
Contraindications:
-needing stance control
-IV and supination control needed
Solid Ankle AFO
-highest level of control below knee
-trimlines @ malleoli
Function:
-blocks all motion/rockers in ankle
-control knee positions
-controls stance phase
Use:
-control stance phase, knee hyperextension, hypertonicity
Contraindications:
-open chain issues
Articulated AFO
-allows for ankle rocker
-can alter PF stop
Function:
-controls ankle motion
-blocks PF
-controls tibial translation vis DF restraint
-swing phase
Use:
-weak DF, knee hyperextension
Contraindications:
-quad absence
-balance issues
Ground Reaction AFO
-rigid section over tibia
-allows full transfer of weight
Function:
-external extension moment to knee
-midfoot control
Use:
-weak PFs, weak quads
Contraindications:
-significant knee hyperextension
Ground Reaction AFO w/ Rear Entry
-rigid section over tibia w/ open back
-can be articulated
Function:
-external extension moment to knee
-allows PF
-no rearfoot control
Use:
-smooth transitions through first rocker
Contraindications:
-significant knee hyperextension
-need rear foot control
Metal Double Upright (DAA)
-Double Action Ankle
-attaches to shoe
-contains pins (blocks motion) and springs (allows motion)
Function:
-can aid or block motion
-“T” strap can control IN/EV
Use:
-foot at risk (edema/wounds)
Contraindications:
-if too heavy
Metal Double Upright, Klenzak Ankle
-attaches to shoe and calve
-contains springs in back for DF assist
-lifts toes
Function:
-can aid DF in swing phase
-lifts toes
-“T” strap can control IN/EV
Use:
-foot at risk (edema/wounds)
Contraindications:
-if too heavy
Off-Shelf Carbon AFOs
-swing phase device only
-assist with toe off
KAFO Uses
-when knee control is needed during stance phase that can’t be controled with AFO
-<3/5 MM
-weak quads
-flail limb
Metal KAFOs
Advantages:
-strong, durable, adjustable
Disadvantages:
-heavy, less cosmetic, must attach to shoe, fewer contact points
Indications:
-need strength
-obese
-edema
Contraindications:
-issues with energy expenditure
-when transverse plane control is needed
Plastic KAFOs
Advantages:
-light weight, switching shoes
Disadvantages:
-hot
Indications:
-need total control
-need energy conservation
-transverse plane control
Contraindications:
-obesity
-edema
Metal Ankle Joints
-resist PF or DF
-strong
-can adjust
-heavy
Plastic Ankle Joints
-self aligning
-very strong
-provide motion assist
-Hard to adjust
KAFO Joints
Microprocessor Controlled Knee Joint:
-provides stance AND swing control
-Stumble recovery
Variable Knee Position Joint:
-can support aa knee with flexion contractures
Posterior Offset Knee Joint:
-support for knee hyper due to weak quads
-uses GFR to exend knee
