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A: pediatrics > Lecutre 8: Pediatric Orthotic Problme Solving > Flashcards

Lecutre 8: Pediatric Orthotic Problme Solving Flashcards

1
Q

What is midfoot break associated with

A

Ankle DF movement

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2
Q

What is the SVA (shank to vertical angle) angle affected by

A

What type of shoe the pt is wearing

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3
Q

What is teh PTG

A

Patient
Task
Goal

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4
Q

What is the difference between R1 vs R2

A

R1- is the catch during ROM
R2- full ROM

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5
Q

Can the ankle AFO angle be set at neutral if the patient does not have the ROM range

A

No

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6
Q

PTG means patient , task and goasl can it can also mean what

A

Prioritize the goals

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7
Q

What are the task for the non ambulatory AFO

A
  1. Contracture Management
  2. Wound heeling, protection, or prevention
  3. Positioning
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8
Q

What are the therapeutic benefit of the force application from a orthosis

A

▪Resist motion
▪Assist motion
▪Transfer force
▪Protect a body part

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9
Q

What is the major element in during comfort for a othrosis

A

Minimizing pressure by maximizing the area

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10
Q

The greater the portion of the body that the orthosis cover then what happens

A

The lower the unit pressure

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11
Q

The amount of ____ and the area of the ___ subjected to the force influences the comfort of the corthosis

A

Force

Body

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12
Q

What is the most common basic pressure system for most orthoses

A

3 point force system

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13
Q

What does the 3 point force system consist of

A

Principle force acting in one direction and two counterforces acting in the opposite direction

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14
Q

What point pressure system is parapodium

A

4

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15
Q

How many groups of classfication is there for the Winters Gait

A

4 groups

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16
Q

What is group 1 characterized by for winters gait classification

A
  • foot drop during swing
  • flat foot or forefoot contact during IC
  • excessive hip and knee flexion drug in swing
  • adequate DF during stance
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17
Q

What is group 2 characterized by in the winters gait classification

A

More constant PF throughout gait

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18
Q

What is group 3 characterized by in the winters gait classification

A

Progressing to knee hyperextension and increased lumbar lordosis

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19
Q

What is group 4 characterized by in the winters gait classification

A

Most severe pattern

Limited hip movement and significantly increased lumbar lordosis

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20
Q

What are common compensations in the gait of children with hemiplegia (case 4)

A
  • hemi pelvic retraction
  • increased push off on unaffected side
  • early firing of fibularis longus
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21
Q

What outcome measures are discussed in case 4 (hemiplegic)

A
  • Gait Deviation Index (GDI)
  • Salfort Gait Tool (SF-GT)
  • Visual Gait Assessment
  • GMFM
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22
Q

What is a supramallelar orthoses

A

Type of AFO that crosses the ankle

does not help at the knee

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23
Q

Who is the sure step SMO designed for

A

Children with Down syndrome

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24
Q

What is the difference between a typical SMO and a surestep SMO

A

Shorter toe plate and trim lines for the surestep

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25
Q

What is the surestep SMO designed to promote/imporove

A

High level activities such as jumping and hoping by improving sub talar joint alignment

26
Q

What kind of disorder is Down syndrome and what is the reason

A

Genetic disorder

Trisomy 21 (additional chromosome)

27
Q

What is Down syndrome characterized by (5)

A

▪ Hypotonia
▪ Ligament Laxity
▪ Flatfeet
▪ Cognitive limitations
▪ Delayed Milestones

28
Q

What kind of instability is present in approx 15% of all people with DS

A

Atlantoaxial instability

29
Q

When shoudl xray be taken for a person with DS

A

Between ages 3 and 5 years

30
Q

What kind of hip issues can a kid with DS have

A

▪ DHD
▪ Acetabular dysplasia

31
Q

who is a SMO with PLS extension designed for

A

Clients that have sagittal plane talocrual joint issues in addition to coronal subtalar joint issues

32
Q

What are 2 examples of clients that would benefit from a SMO with PLS extension

A

▪ITW
▪Spastic Hemiplegic CP functioning at a GMFCS level II

33
Q

Who are ground floor reaction AFO designed for

A

Pateints with duchenne mm dystrophy

34
Q

What does the ground floor reaction AFO provide

A

Knee extension moment during ambulation

35
Q

What is the most common inherited muscular dystrophy and mm diseae of childhood

A

Duchenne muscular dystrophy

36
Q

What is a Fatal disease of progressive weakness of skeletal and respiratory
muscles

37
Q

What is the typical life expectancy for Duchenne Muscular Dystrophy

A

20 and 30 years

38
Q

For Duchenne Muscular Dystrophy there is a protein present where

A

Skeletal mm, smooth mm and in the brain

39
Q

What is absent in Duchenne Muscular Dystrophy

A

Dystorphin

whihc is critical for mm fiber stability

40
Q

How does boys with Duchenne Muscular Dystrophy usually present

A
  • clumsy
  • may walk up on their toes
  • show gross motor regression
41
Q

What are the gait characteristics for duchenne’s

A
  • wide BODY
  • lumbar lordosis
  • knee hyperextension
  • toe walking
42
Q

there will be ___ of the calf mm and a (+) ___ sign for duchenne

A

▪Pseudohypertrophy

▪Gower

43
Q

When do cortiosteriods improve mm mass, strength and function for duchenne

A

First 6 months

44
Q

When is ambulation for duchenne usually lost by

45
Q

What affects about 75-90% of non ambulatory children with DMD

46
Q

When is sx intervention for scoliosis considered for kids with DMD

A

When the curve reaches approx 30° .. especially if the child is under 14 years of age

47
Q

What delays the development of scoliosis for kids with DMD

A

Prolonged walking and standing

48
Q

What is the primary impairment causing activity limitation from DMD

A

Mm weakness

49
Q

What is the predictable pattern of invovlment for DMD

A

Proximal to distal

Starts early in neck flexors and abdominal mm and then progresses to pelvic girdle and knee extensors and then down to limbs

50
Q

Spinal muscular atrophy is a ___ ____ disorder

A

Autosomal recesssive

51
Q

What is a Gene disruption characterized by degeneration of anterior horn cells of the spinal cord, muscle atrophy, wide spread muscle weakness, and absent deep tendon reflexe

A

Spinal muscular atrophy

52
Q

What is the most severe classification for SMA

53
Q

When is type 1 SMA manifested before

54
Q

When does type 2 onset occur fro SMA

A

Between 7 to 18 months

55
Q

When is the onset of type 3 SMA

A

Onset after 18 months

56
Q

What is the mildest form of SMA

57
Q

All 3 types of SMA are characterized by what 4 things

A
  • limb and trunk weakness
  • mm atrophy
  • hypotonia and areflexia
  • progressive MSK issues
58
Q

If a pateint has a tight gastroc will they pronate or supinate

59
Q

Resting or non ambulatory AFO is preventing what

A

Contracture

60
Q

When would u use a articulating AF0

A

whne a joint allows to much motion and we need to control it

61
Q

What are the most common types of joints used for a articulating AFO

A

◦ Overlapping
◦ Oklahoma
◦ Tamarack

A: pediatrics (29 decks)

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