LE Orthotics --> part 2 (1) Flashcards

1
Q

what must be addressed for those w/ knee weakness

A

stance phase and swing phase

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2
Q

stance phase –> knee weakness

A

quad weakness

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3
Q

quad weakness –> stance phase

A

knee instability at heel strike

weight acceptance during mid stance

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4
Q

knee instability at heel strike –> stance phase

A

GRF is posterior to the knee

eccentric contraction of the quads control movement

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5
Q

weight acceptance during midstance –> stance phase

A

there could be knee bucking at mid-stance

quads stabilize during mid-stance

soleus from below gives some control of knee extension

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6
Q

swing phase –> knee weakness

A

quad weakness and hamstring weakness

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7
Q

quad weakness –> swing phase

A

consistent knee flexion (60 degrees)

knee flexion (leg clearance) during swing

eccentric quads control motion

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8
Q

hamstring weakness –> swing phase

A

consistent knee extension in preparation for HS

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9
Q

why is control of the knee difficult

A

changes in walking speed

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10
Q

general description of KAFO

A

thigh shell

knee joint

calf/pre-tibial shell

closure (strap)

w/ or w/o articulated ankle

foot plate

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11
Q

foot and ankle components of KAFO

A

same as AFO

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12
Q

knee joint axes

A

single axis

polycentric/multi-axis

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13
Q

single axis –> knee joint

A

hinge

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14
Q

polycentric/multi-axis –> knee joint

A

changing axis

hard to align

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15
Q

what do all knee joints give

A

ML control

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16
Q

knee controls

A

free knee

offset knee joints

locks

adjustable locks

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17
Q

free knee

A

free flexion/extension to 0 degrees

used primarily for ML control

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18
Q

offset knee joints

A

axis is posterior to uprights

19
Q

what does the position of the offset knee create

A

an extension moment

20
Q

the offset knee joint allows

A

free flexion and extension

free during swing

21
Q

how is the offset knee joint locked during stance

A

GRF

22
Q

why would we use an offset knee joint

A

quad weakness

23
Q

locks –> knee control

A

ring drop lock

swiss lock/ bail lock/ cam lock

adjustable locks

24
Q

ring drop lock is

A

manual

25
Q

to unlock the ring drop lock

A

lift it

26
Q

the ring drop lock could be

A

spring loaded

27
Q

the ring drop lock has an

A

retention button

28
Q

when would we use a ring drop lock

A

problems w/ spasticity, contractures, and balance

29
Q

swiss lock/bail lock/cam lock –> unlocking

A

bail to unlock

lift bar up

30
Q

how does the swiss lock/cam lock/bail lock lock

A

automatically w/ extension

31
Q

the swiss lock/cam lock/bail lock has no

A

binding

32
Q

when is it better to use a swiss lock/cam lock/bail lock lock

A

better w/ spasticity

better w/ contractures

less balance issues

33
Q

adjustable locks are

A

range limiting

34
Q

what do adjustable locks limit

A

motion/post surgery

35
Q

when are adjustable locks used

A

contractures

36
Q

stance control KAFO

A

SCKO

locks during stance and unlocks during swing

37
Q

how is the SCKO activated

A

weight or gait (position)

activates the locking and unlocking

38
Q

when does the knee lock –> SCKO

A

HS weight accepted/knee extended

39
Q

when will the knee unlocks –> SCKO

A

end of MS to PO when weight is removed/knee hyperextends

40
Q

some SCKO use

A

sensors and computers

41
Q

indications for a SCKO

A

weak quads

knee instability

polio or post-polio syndrome

MS

SCI

spinal trauma

unilateral paralysis

42
Q

contraindications for a SCKO

A

no hip muscle

poor mental status

spasticity

knee contracture

weight limitation

43
Q

poor mental status –> contraindications SCKO

A

difficult to learn to use orthosis