Lower Limb Orthotics Flashcards
Lower limb orthotics can be used in
Clubfoot applications
Clubfoot orthotics have
a hard polymer layer, soft foam layer, arch support, and a corrective wedge
Flatfoot orthotics have
extra arch support to lift the foot into natural position
Denis-Browne Splint (Bar)
Also called a foot abduction orthotic, primarily used as a night brace in small children to restrain foot motion and stabilize alignment. Developed for the treatment of clubfoot, but has lots of design variations
Ankle foot orthotic (AFO)
AFO braces surround the calf and part of the foot; used to control the position and motion of the ankle. It compensates for weakness and corrects the deformity. Used to help prevent foot drop. Around $500 - $750
What are AFOs used to help
Stroke injury, spinal cord injury, polio multiple sclerosis, muscular dystrophy, peripheral neuropathy
Types of AFO
Solid AFO (SAFO) and Hinged AFO (HAFO). Chosen by how much movement is required of the ankle
Supra-Malleolar Orthosis (SMO)
Supports the foot to leg above the malleoli (ankle bones). Used to control pronation and flatfoot. Designed to maintain a vertical or neutral heel while supporting the three arches of the foot
Inserts
Relieve stress and stretching of the plantar foot (plantar fasciitis), supports the arch (either flatfoot or high arches), supports heel, and changes the foot alignment (along with the use of wedges)
Traditional Approach
A plaster cast of the foot is made, with the cast providing a negative over a polymer is vacuum wrapped. The orthotic is custom trimmed and padded based on the orthotists’ experience
Traditional approach disadvantages
Non-weight bearing, forces are static, orthotic design and manufacturer depends on orthotists experience level, accuracy and quality may be poor, limb geometry not be properly captured - fit can be poor, no guarantee of functional improvement
gait based orthotic desgin
gait parameters are used to design the orthotic – this is not the traditional approach
Gait based orthotic design advantages
design is based on dynamic ambulating data; design process is computerized and predictive in nature; the orthotic design may be easily updated for growth or other factors; the computerized design is easily retrieved if a new orthotic needs to be constructed
Kinematics
protocols have been established for the measurement of gait; certain gait parameters have been related to certain deformities (ex - navicular height for flatfoot)
plantar pressure
COP (Center of pressure); the design parameters are changed in order to minimize the deviation of the COP from normal
