Lower Extremity Orthoses and Shoes Flashcards
Principles of lower limbs orthoses
- Use only as indicated and for as long as necessary
- Allow joint movement wherever possible and appropriate.
- Orthoses should be functional throughout all phases of gait.
- Orthotic ankle joint should be centered over the tip of medial malleoulus.
- Orthotic knee joint should be centered over prominence of medial femoral condyle.
- Orthotic hip joint should be in a position that allows patient to sit upright at 90.
- Patient compliance will be enhanced if orthosis is comfortable, cosmetic and functional.
Foundation for most LE orthoses.
Shoes
Functions of shoes
- Transfer body weight to the ground.
- Protection from terrain and weather.
- Greatest wear on: ball of the foot slightly lateral and posterolateral edge of the heel.
Parts of a shoe is dived into?
- Upper: Vamp, Quarter, Tongue
- Sole
- Heel
- Reinforcements
What should you do if the shoes is to be used with an AFO having an insert as a foundation?
Extend the vamp to the proximal portion of the dorsum to secure the shoe and thereby the rest of the orthosis on the foot.
Vamp consists of ?
- Lace
- Strap
This provides more precise adjustment over the entire opening.
Lace
This is for individuals with limited manual dexterity to help them manage more easily.
Strap
Types of Vamp
- Blucher
- Balmoral
- Lace stays are separated from the vamp.
- Ease of donning
- Greater foot entry space and adjustability.
- Good for edematous and paralyzed patients.
Blucher
What type of vamp is preferable and why?
Blucher because it is distinguished by anterior margins of the lace stays and the vamp where they are separated.
The lace stays is continuous with the vamp. What type of vamp is this?
Balmoral
Types of Quarter
- High Quarter
- Low Quarter
- Terminates below the malleoli
- Does not restrict foot or ankle motion.
- NOT recommended for patient that has ankle or foot instability.
Low Quarter
- It covers both the malleoli
- Foot Stability
- Can accommodate pes equinus deformity.
High Quarter
The bottom part of the shoe that has an outer or inner.
Sole
Function on insole, outsole or insert.
Shock Absorption
Types of sole
- Orthotic Sole
- Leather Sole
- Natural/Synthetic Sole
- Toe Spring
Thicker and bulkier compared to the other shoes because of the outer and inner sole to allow metal attachment between the shoe and the orthosis.
Orthotic Sole
This absorbs little impact that provides minimal tractions compared to a natural or synthetic soles.
Leather Sole
This type of sole allows rocker effect for efficient toe-off and slight rise of the sole.
Toe Spring
If a lift is added to the sole to compensate for LLD. What type of sole should you use?
The lift should be beetled to the toe spring.
This type of heel provides the greatest stability and distributes the force between the back and front of the foot most evenly.
Broad Low Heel
For adults, a _____ inches (____ centimeters) heel tilts the center of gravity slightly through ________but does not disturb normal _____ and ____ alignment significantly.
1 inch: 2.5 cm: stance phase: hip and knee.
This increase the contraction of the medial gastrocnemius and tibialis anterior.
Slight heel lifts
This type of heel stress to metatarsals and the knee and not recommended for patients who have metatarsalgia.
High heels
Indication for high heels.
- Heel pain
- Achilles tendinitis
- Rigid Pes Equinus
- Promotes hip and knee flexion
The sole is permanently flexed. What deformity?
Talipes Equinus
Weakness or absence of calf muscles in which the axis of the calcaneus becomes vertically oriented.
Talipes Calcaneus
Abnormally high medial longitudinal arch.
Talipes Cavus
Combination of talipes equinus and talipes vagus, markede by plantarflexion, everted, and abducted foot.
Talipes Equinovalgus
Clubfoot. Foot point downward and inward.
Talipes Equinovarus
Deformity characterized by a dorsiflexed, inverted and adducted foot.
Talipes Calcaneovarus
Deformity marked by dorsiflexion, evertion, and abducted foot.
Talipes Calcaneovalgus
Deformity of the foot in which it is rotated and outward.
Talipes Varus
Permanent eversion of the foot. so that only the inner side of the sole rest the ground. Outward turning of the heel resulting in foot flat.
Talipes Valgus
This type of reinforcement is located at the vamp which protects the toes from stubbing and vertical trauma.
Toe Boxing
This type of reinforcement accommodates hammer toes or toes is flexed.
Toe Boxing
This type of reinforcement is a longitudinal plate that reinforces the sole between the anterior border of the heel and the widest part of the sole at the metatarsal heads.
Shank
This type of reinforcement is necessary if an orthotic attachment is to be riveted to the shoe.
Corrugated steel shank
This type of reinforcement stiffens the quarter and generally terminates at the anterior border of the heel.
Counter
Type of reinforcement that can be seen in the anterior border of the heel.
Breast
Type of reinforcement that can be seen in the posterior border of the heel.
Pitch
Type of reinforcement is the widest area of the foot.
Ball
Proper Shoe Fit
- 1/2 inch length allowance from the longest toe.
- Widest part of the shoe corresponds to the broadest part of the foot.
- Snug from heel to ball of foot.
- The quarters do not gap excessively leaving free space on the medial and lateral to the heads of the first and fifth metatarsal.
