Neuro Peds - 02 - Orthotics Flashcards
basic rule for LE orthoses when contracture or deformity is present
If a deformity if correctable or flexible, the orthosis will be made in the corrected position
If the deformity if fixed, the orthosis will accomodate the deformity
basic rules for skin inspection
ok:
redness is broad, even and dispersed over wide area, and disappears in 10-15 minutes
AFO
ankle foot orthosis
CTLSO
cervical thoracic lumbar sacral orthosis
WHFO
wrist hand forearm orthosis
SO
shoulder orthosis
sacral
UCB
university of berkley
three kinds of shoes to wear with orthoses
accomodating
correcting
support
FES
Functional E-STim
indications – upper motor neuron lesion, contraindications – seizures disorder, pace maker
– can they tolerate;
estim can work really well with pediatrics – activating muscle that need to be strengthened; helps if he has had it at home; functional estim goes off every step
reasons for KAFO
mod to severe deformity at the knee instability of the knee post operative control of motion paralysis weakness of hips and this ROM splinting of gastrocs critical control needed during stance and swing phase, in all planes of motion, including the knee joint
reasons for HKAFO
upper level lesion spina bifida, with parapodium, made for walking
RGO
reciprocating gait orthosis
DMO
dynamic movement orthosis
– device with panels to create correctional postures – success with postural stability – does not replace plastic brace – suit can help scapular retraction and hip ER
spinal orthosis
for scolisos
correctional force
counter-force
cranial remolding
for plagiocephaly -flat on one side, bulge opposite
brachcephaly - flat on the back
scapo - conehead
when to start cranial remolding
asap. by 18 months it is too late
UE orthoses
tiny hands, don’t need a whole lot
neoprene works on small ones
encourage action and functional position
how to know when outgrown
bony alignment no longer aligned
check foot plate, ankle joint, tibia something
what do foot orthotics fix?
mild to moderate: planovalgus calcaneal valgus or varus hypotonia with associated midfoot collapse supination cavus foot
where is critical control needed for foot orthotic?
during stance phase
- in coronal and transverse planes
what does SMO help?
moderate to severe: planovalgus calcaneal valgus or varus hypotonia foot and ankle deformity excessive ROM at ankle in gait
where is critical control needed for SMO?
during stance and swing phase
- in all planes of motion
what does AFO help?
moderate to severe: planovalgus calcaneal valgus or varus hypotonia foot and ankle deformity foot drop excessive ROM at joints in gait
where is critical control needed for AFO?
during stance and swing phase
- in all planes of motion
why use KAFO?
moderate to severe: deformity at the knee instability of the knee post operative conrol of motion paralysis, weakness of hips and thighs ROM splinting for gastrocs
where is critical control needed for KAFO?
during stance and swing phase
- in all planes of motion
- including the knee joint
don’t forget nighttime uses
stretch plantar flexors or dorsiflexors
