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PTRS 746 Exam 2 > LE Orthotics > Flashcards

LE Orthotics Flashcards

1
Q

Q: What is PRAFO?

A

Pressure Relieving Ankle Foot Orthosis

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2
Q

Content: PRAFO

A

Indicated for (PF) contracture prevention and pressure relief (prevent pressure sores)

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3
Q

Q: What can PRAFOs be used for? (3)

A
  1. Neuro involvement (CVA, SCI, TBI, etc.)
  2. Orthopedic (hip fracture, amputation)
  3. Long-term immobility (ICU)
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4
Q

Q: In general for orthotics a __ _________ pressure system is used.

A

3, point

  • critical for LE orthotics/prosthetics
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5
Q

Content: Design considerations for (LE) Orthotic (13)

A
  1. Diagnosis
  2. Prognosis
  3. Comorbidities
  4. Height
  5. Weight
  6. Cost
  7. Cosmetics
  8. Degree of deformity
  9. Degree of correction
  10. Musculoskeletal factors
  11. Mobility requirements
  12. Stability requirements
  13. Anticipated functional level
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6
Q

Content: Trim Lines for LE Orthotics (6)

A
  1. Proximal (determines knee movement)
  2. Anterior (determines ankle movement)
  3. Ankle
  4. Foot (M/L movement)
  5. Metatarsal (effects push off)
  6. Posterior (higher = increases moment)
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7
Q

Content: LE Orthotic Evaluation (2)

A
  1. Functional ROM (midtarsal, subtalar, talocrural, knee/hip)
  2. Functional Muscle Strength (focus on general LE muscle groups)
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8
Q

Content: Foot alignment and function for prescription (3)

A
  1. Supination
  2. Pronation
  3. Skeletal deviations (hallux valgus)
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9
Q

Content: Ankle alignment and function for prescription (3)

A
  1. Foot drop
  2. Medial/lateral instability
  3. PF contracture
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10
Q

Content: Knee alignment and function for prescription (4)

A
  1. Flexion
  2. Genu recurvatum
  3. Genu varum
  4. Genu valgum
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11
Q

Q: What is the foundation of any orthotic?

A

Shoes

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12
Q

Content: LE Orthotics - Prefabricated (5)

A
  1. “Off the shelf”
  2. Limited fit and function
  3. Mild involvement
  4. Temporary use
  5. Diagnostic procedures
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13
Q

Content: LE Orthotics - Custom Fit (5)

A
  1. Prefabricated device modified to fit a specific pt.
  2. Provide limited fit and function
  3. Mild to moderate involvement
  4. Temporary use
  5. Diagnostic procedures
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14
Q

Content: LE Orthotics - Custom fabricated (3)

A
  1. Individualized fit for maximal function
  2. Moderate to severe involvement
  3. Extended or permanent use
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15
Q

Content: Foot Orthotics - Supramalleolar (SMO/DAFO) (3)

A
  1. Allows DF and PF
  2. Provides forefoot, midfoot, and subtalar stability
  3. Tone management (primary indication for this brace)
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16
Q

Content: Ankle Orthotics - Ground (or Floor) Reaction (3)

A
  1. Pre-tibial cuff facilitates knee extension
  2. Rigid foot plate facilitate push-off
  3. Capable of tri-planar motion control
    - Common with ALS pts.
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17
Q

Content: Ankle Orthotics - Patellar Tendon Bearing

A

Reduces force on midfoot and heel by moving the major of the WB to just below the patellar tendon

  • Can be used with Charcot foot
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18
Q

Content: Ankle Orthotics - Solid Ankle (2)

A
  1. Trim lines encompass malleoli
  2. Maximum motion control in all planes
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19
Q

Content: Ankle Orthotics - Semi Solid (3)

A
  1. Trim lines bisect malleoli
  2. Allows some DF in late stance
  3. Provides some M/L stabilization
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20
Q

Content: Ankle Orthotics - Posterior Leaf Spring (4)

A
  1. Stores energy during loading
  2. Releases energy to facilitate swing
  3. Provides little M/L stability
  4. Provides DF assist
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21
Q

Content: Ankle Orthotics - Articulated (4)

A
  1. Various materials
  2. Addresses multiple biomechanical functions
  3. Varying levels of adjustability
  4. Size/weight and cosmetics may be problematic
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22
Q

Content: Ankle Orthotics - Oklahoma ankle joints with plantar flexion stop

A

Adjustable ROM

23
Q

Content: Ankle Orthotics - Gillette ankle joints (2)

A
  1. Various sizes and durometeres
  2. DF assist
24
Q

Content: Ankle Orthotics - Camber axis hinge

A

Provides variable ROM or fixed ankle postions

25
Q

Content: Ankle Orthotics - Metal Upright (4)

A
  1. Easily adjustable
  2. Maximal stabilization
  3. May be indicated for pts. with high risk feet or fluctuating edema
  4. Weight and cosmetics are major concerns
26
Q

Content: Pathologic Gait - Dorsiflexors (3)

A
  1. Peak activity during swing and heel strike of normal gait
  2. Compensatory gait patterns: stepage gait or circumduction of leg
  3. Orthotic considerations: DF assist (Gillette, Posterior Leaf Spring)
27
Q

Content: Pathologic Gait - Plantarflexors (3)

A
  1. Peak activity during push off of normal gait
  2. Compensatory gait patterns: lurching gait or antalgia
  3. Othrotic considerations: Make foot plate rigid and move metatarsal line forward OR DF stop to create a rigid lever (tibia and ankle locked together)
28
Q

Content: Pathologic Gait - Quadriceps (3)

A
  1. Peak activity during swing, heel strike, loading of normal gait (really the whole time)
  2. Compensatory gait patterns: Hyperextension (relying on skeletal stability), Trunk flexion (to lock the knee)
  3. Orthotic considerations: Posteriorly offset knee joint (with KAFO) to provide stability through stance and reduce trunk flexion
29
Q

Content: Knee Ankle Foot Orhtosis - Locked Knee (3)

A
  1. Maximal stability
  2. Creates functional leg length discrepancy
  3. Increases energy expenditure
30
Q

Content: Knee Ankle Foot Orthosis - Stance Control (4)

A
  1. Provides stability during stance (locks)
  2. Allows knee flexion during swing (unlocks)
  3. Larger and more expensive
  4. Locking mechanisms vary
31
Q

Content: Knee Ankle Foot Orthosis - Requirements (2)

A
  1. Adequate cognitive function
  2. Hip flexion and extension strength > or = to 3/5
32
Q

Content: Knee Ankle Foot Orthosis - Contraindications (5)

A
  1. Knee flexion contracture > 10
  2. Spasticitiy
  3. Uncorrectable valgus/vaurs > 15
  4. Poor balance or ataxia
  5. Hip flexion strength < 3/5
33
Q

Q: What does the metatarsal trim line effect?

A

The balance between push off and heel rock

34
Q

Q: Where should you avoid placing the metatarsal trim line and why?

A

In the toe crease, pt. will curl toes around in of plate making them susceptible for pressure sores

35
Q

T/F: MMT evaluation may not match their function

A

True, may be 2/5 all around but be able to walk

36
Q

Q: Who is it more difficult to put a plastic brace on? (2)

A
  1. Those with peripheral neuropathy/diabetes
  2. Those with venous/arterial insuffiency - may be assoc. with changes in leg size
37
Q

Diagram: Identify the LE Orthosis

A

Pressure Relieving Ankle Foot Orthosis (PRAFO)

38
Q

Diagram: Identify the LE Orthosis

A

Prefabricated

39
Q

Diagram: Identify the LE Orthosis

A

Custom fabricated

40
Q

Diagram: Identify the LE Orthosis

A

Supramalleolar (SMO/DAFO)

41
Q

Diagram: Identify the LE Orthosis

A

Ground Reaction

42
Q

Diagram: Identify the LE Orthosis

A

Patellar Tendon Bearing

43
Q

Diagram: Identify the LE Orthosis

A

Solid Ankle

44
Q

Diagram: Identify the LE Orthosis

A

Semi Solid or Custom Fit

45
Q

Diagram: Identify the LE Orthosis

A

Posterior Leaf Spring

46
Q

Diagram: Identify the LE Orthosis

A

Articulated

47
Q

Diagram: Identify the LE Orthosis

A

Oklahoma ankle joints with PF stop

48
Q

Diagram: Identify the LE Orthosis

A

Gillette ankle joint

49
Q

Diagram: Identify the LE Orthosis

A

Camber axis hinge

50
Q

Diagram: Identify the LE Orthosis

A

Metal Upright

51
Q

Diagram: Parts of a double stopped ankle

A

Posterior chamber for PF stop or DF assist

Anterior chamber for DF stop

52
Q

Diagram: Identify the LE Orthosis

A

Locked Knee

53
Q

Diagram: Describe the types of locks

A

Left = Bail Lock

Right = Drop Lock

54
Q

Diagram: Identify the LE Orthosis

A

Posterior Offset

PTRS 746 Exam 2 (9 decks)

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