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Orthotics > Midterm > Flashcards

Midterm Flashcards

0
Q

Toe spring does what/affects what phases of gait ? Also what pathology would you use it with (1 example)?

A

Toe spring facilitates advancement & affects swing phase & toe off phases of gait. Useful for hallux arthritis & other pathologies that inhibit MTP mobility

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1
Q

Why would you use an extra depth toe box?

A

Either post surgically or for a pt w DM who developed hammer toes as a result of peripheral neuropathy

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2
Q

Rocker bottom sole does what?

A

Advances foot during late stance BUT inhibits MTP DF & windlass mechanism

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3
Q

Standard heel height =

A

1-2 cm; usually add 1 cm if want more ht

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4
Q

Wearing heels increases what forces ?

A

The vertical forces on the met heads x2

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5
Q

High heels increase demand on what muscles?

A

Peroneals and knee musculature

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6
Q

Types of lasts

A

Slip, board or combination

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7
Q

Point of using a flare/disadvantage? Where would you want to put a flare (and why)?

A

Use a lateral flare to relate stance stability (decr. Chance of lat ankle sprain) BUT it increases pronation forces. Want to out it in forefoot because most ankle sprains are PF/INV

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8
Q

If you want added midsole stiffness could add..

A

A shank (in athletic shoes, rubber of a higher density)

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9
Q

Difference in gait when barefoot running =? What injuries do you become more prone to getting?

A

Initial contact is different; more muscle-tendon strain on the forefoot (increased chance of Achilles tendonitis)& on the rear foot more impact & joint loading forces (incr chance of stress fx)

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10
Q

What would you use to unweight metatarsal heads (ie with metatarsalgia)?

A

Metatarsal cookie & cut outs

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11
Q

For minor bunions (ie <stage 3) use…

A

Spacers

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12
Q

Which closure design is better for AFO usage?

A

Blucher

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13
Q

Advantage of using high tops=?

A

Reduce inversion in lab conditions BUT didn’t reduce ankle Sprains in basketball players

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14
Q

When is glut Max activation peaked?

A

During loading response

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15
Q

When does the iliopsoas activation peak? (2 times)

A

During terminal stance & initial swing

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16
Q

What muscles control the PF moment at the ankle during IC & LR?

A

Tib ant, EHL & EDL

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17
Q

During IC & LR, —- are activated to control the — moment at the hip and promote —- movements

A

Glut max& hamstrings activated to control the flexion moment at the hip and promote hip control and extension

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18
Q

ROM of hip during gait=? Peak flexion occurs during.. Peak ext during..

A

10 ext to 30 flexion; peak flexion : IC, peak ext : PSw

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19
Q

Max DF occurs during – phase

A

Midstance as tibia moves over foot

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20
Q

How many degrees of pronation/supination are normally required during gait?

A

4-6 deg of each

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21
Q

Peak pronation occurs during ..

A

Midstance

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22
Q

Peak supination occurs during ..

A

Pressing

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23
Q

When does peak MTP ext occur? How many degrees ?

A

Preswing; 55•

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24
Q

What is activated during IC to restrain the hip flexion moment?

A

Hamstrings and glut max

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25
Q

During loading response, the critical events are ..

A

Hip stability & controlled knee flexion & PF for shock absorption

26
Q

When Does the GRF vector change? What does it change to?

A

Changes from the end of LR to end of MSt ; hip - flex to ext; knee - flexion to ext ; ankle - PF to DF

27
Q

What is the critical event in midstance?

A

Controlled tibial advancement, which is done by the gastroc ; this control inherently controls knee extension

28
Q

What two muscles are active during midstance to prevent the swing leg pelvis from dropping?

A

Glut min & med

29
Q

What muscles initiate the forward rotation of the pelvis during midstance to assist in the swing limb advancement?

A

TFL, glut med & glut min (all do ER?)

30
Q

What is the foot doing during midstance? And what muscles are activated in the leg/foot?

A

Foot begins to supinate (still pronated) ; peroneus longus is activated to stabilize the first ray on the ground while the rest of the foot supinates

31
Q

What ms helps restrain the hip ext moment during terminal stance?

A

TFL

32
Q

During IC, what types of moments/forces are acting on the knee? What controls/stabilizes the knee?

A

Ext moment & valgus thrust; the quads and hamstrings both contract to stabilize the knee during wt acceptance & the gracilis, Vastus medialis & semitendinosis contract to control the valgus thrust

33
Q

What happens at the midtarsal jt when the STJ is in pronation?

A

Pronation is the loose packed position of the STJ so when it’s pronated, the midtarsal joint is free to supinate/pronate to adjust to the ground surface in loading phase

34
Q

Why does the adductor Magnus fire during terminal swing?

A

To control the body’s fall toward the opposite limb

35
Q

In preswing, what muscles work to counter the extension moment at the hip to initiate hip flexion?

A

Adductor longus and rectus femoris

36
Q

When is the tibia released to advance over the foot? What muscle reduces its contraction to allow for this?

A

During preswing; the gastroc

37
Q

During preswing, what occurs as a result of tibial advancement over the foot?

A

The vector at the knee moves posteriorly, creating passive knee flexion (which is then controlled by the rectus femoris)

38
Q

What is the critical event in terminal swing?

A

Knee ext to prepare for a stable landing

39
Q

At what phases of the gait cycle are the pelvis/femur/tibia externally rotating?

A

Midstance thru preswing

40
Q

What might you see as a result of weak posterior tibialis?

A

Excessive pronation in loading response and midstance

41
Q

Weakness of the peroneals results in — during the gait cycle

A

Excessive varus at the STJ ( usually holds first ray to ground as foot supinates in midstance)

42
Q

Evidence for using insole to prevent LBP?

A

Strong evidence AGAINST it

43
Q

Should you use a FO to prevent PFPS?

A

Weak evidence

44
Q

People w PFPS have more RF ___

A

Varus

45
Q

Mod evidence supports —- usage for medial knee OA

A

Lateral wedge

46
Q

Mod evidence supports —- usage for knee valgus pain reduction

A

Medial wedge

47
Q

Poor shock absorption of GRFs during LR can result in —- at the foot

A

Insufficient pronation & excessive jt loading forces

48
Q

Poor dampening of internal torque & reversal of limb IR during LR can result in —- at the foot

A

Excessive pronation

49
Q

If you have a R Achilles’ tendon rupture, what type of orthotic should you use?

A

B heel lift to reduce stress on Achilles without introducing a LLD

50
Q

If a pt has a LLD, what type of orthotic would you recommend?

A

Heel lift (internal 1cm)

51
Q

If pt has MP OA/hallux rigidus, what type of lift would you prescribe?

A

Sulcus length lift

52
Q

How do you determine the ESTIMATED amount Of STJ motion a patient has ?

A

Degrees of motion between RF position in STJ neutral and in relaxed calcaneal stance

53
Q

A deep heel seat reduces —-

A

Pronation by 1 deg

54
Q

Using semi rigid material reduces —-

A

Pronation by 2 deg

55
Q

If a pt incr in RF varus in stance, most likely are — or — type pt

A

PF 1st ray or FF Varus

56
Q

If have compensated FF valgus, will see — at loading ; should use — as orthotic

A

STJ inversion ; lateral FF wedge post

57
Q

To reduce shock , may use .. (3)

A

Heel plug, additional soft material, or 1st ray cut out

58
Q

Dual density may reduce — by —

A

Reduce pronation by 1 degree

59
Q

To correct for RF varus, use — post , — length

A

RF medial wedge; 3/4 length

60
Q

If someone is an excessive supinator, may compensate by .. (2)

A

FF valgus or PF 1st ray

61
Q

If pt excessively pronates, may compensate by ..(2)

A

RF or FF varus

62
Q

If pt compensates for FF varus by excessively pronating, use — orthotic — length

A

Use FF medial wedge and RF medial wedge , sulcus length

Orthotics (2 decks)

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