Lecture 5: UE orthotics Flashcards
name an orthotic that goes from shoulder to the fingers
SEWHFO
(shoulder elbow wrist hand finger orthotic –> crosses all these joints)
additional: hinged or dynamic
What are 2 goals for orthotic intervention?
- prevent movement
- pace structure at most comfy/resting position
goal of immobilization device
- pain relief
- protect swollen structures
- maximize function
- maintain tissue length
- reduce fx, protect healing structures
- prevent contractures
- influence spasticity
goal of mobilization orthosis
- move/stretch certain soft tissue to create change
- very beneficial! *helps facilitate CELL GROWTH
How does a mobilization orthosis work?
older collagen cells are absorbed, replaced with new collagen cells
Restriction orthosis is what?
restricts or blocks aspect of joint motion
-applied to limit motion, can restrict some portion of movement while allowing motion in opposite direction
what are 2 types of static orthoses?
- static: immobilized
- serial static: made with low temp plastics, can be remolded
(applied with units they cross in a lengthened position)
types of dynamic orthoses?
- dynamic
- static progressive
What is a dynamic orthosis?
-elastic force to mobilize tissues for ROM increases!
-OUTRIGGERS
What are static progressive orthoses?
apply low load to tissue’s end range in one direction (low load, long duration)
force is static/non-elastic
-INELASTIC TAPE, STRAPPING MATERIALS, LINE, TURNBUCKLES, HINGES
*like braces, adjustments
in order to disperse pressure, you should ____ the area of force
INCREASE
*against all contours, make sure there are enough conformities
What is position of function for the hand?
Wrist:
MP:
PIP:
DIP:
Thumb:
Wrist: 20-30 extension
MP: 35-45 flexion
PIP: 45 flexion
DIP: relaxed flexion
Thumb: palmar abduction
What is position of rest for the hand?
Wrist:
MP:
PIP:
DIP:
Thumb:
Wrist: 30-40 extension
MP: 60 to 90 flexion
PIP and DIP: extension
Thumb: palmar abduction
*for volar plate and ligaments
what are straps for orthotic components?
not just for putting them on! also positioned for certain purposes
THICKNESS: ___ is better for fingers, ____ is better for proximal!
thinner: fingers
thicker: proximal
*or weight considerations
straps: what material can be used?
velcro usually
*can be canvas, leather, bandages
*wide enough to distribute pressure, avoid bony prominences
What is a stockinet?
To help absorb and disperse perspiration
Improves comfort
Easier to change than replacing bonded liner
What is open cell and close cell foam?
open cell: collapses w/ sufficient pressure
close cell: air cannot escape, always some cushion
What are outriggers?
used as pulley or to attach dynamic components
low profile: acts as pulley
high profile: for direct attachment of elastic components
dynamic component of orthotic design: pull should be ___ to bone
perpendicular to long axis of bone
(otherwise can cause pressure, shear, wounds)
what is better about high profile vs low profile outrigger?
high: less adjustment to maintain 90 degree pull
but less attractive, inconvenient, more cumbersome, not able to get clothes over orthotic
vascular/nerve injury precautions for orthotics
be careful over bony parts,
sensation impairments,
especially with circumferential orthotics!
be careful of areas with venous/lymphatic return
Orthotic Checkout:
- achieve purpose?
- maintain proper joint position?
- does it fit contours?
- does it restrict or immobilize not necessarily?
- Is it long enough?
- Is it stable?
- Are edges smooth?
- Are all possible pressure points relieved?
- Does orthotic allow optimal functional use of hand?
When evaluating, patient should try wearing orthosis for ____ minutes
15-20 minutes
