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Assistive Tech > O - Foot Orthoses > Flashcards

O - Foot Orthoses Flashcards

1
Q

what is an orthosis

A

device used to assist, resist, facilitate, stabilize, or improve ROM and functional capacity

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2
Q

what is a foot orthosis

A

custom or stock orthosis used to treat foot

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3
Q

what is a custom foot orthosis

A

device derived from 3D representation of pt’s foot

via plastic cast, foam box, scanning

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4
Q

what are custom foot orthosis categories

A

rigid
semi-rigid
soft/flexible

functional/biomechanical
accommodative

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5
Q

what dictates the type/category of orthosis

A

type of material used

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6
Q

what type of materials are used for custom foot orthoses and what are each of its functions

A

soft/flexible = shock absorbing
hard/rigid = motion controlling

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7
Q

what are the guiding principles behind custom orthotic devices

A

exams identify deficits contributing to development of path

varying features of orthosis can modify foot mechanics to dec pain and improve function

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8
Q

custom vs prefabricated orthotics in pts w plantar fasciitis

A

similar benefits

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9
Q

a lit review demonstrated effectivness of custom foot orthoses in what patholgies (4)

A

stress fx/reactions
foot pain
PFPS
soft tissue running related injuries

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10
Q

what does literature say about custom vs prefabricated orthotics overall

A

evidence showing both work and there are a lot of similarities in material

may be hard to justify time, effort and cost needed for custom as a result

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11
Q

balanced foot orthotic:

what is it
what type of orthotic
what models/theories is it based on

A

uses posts at RF and/or FF to control abnormal motion

biomechanical

  • podiatric model
  • root theory
  • STJ neutral theory
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12
Q

total contact foot orthotic

what is it
what type of orthotic

A

provides total plantar surface contact including medial longitudinal arch

accommodative

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13
Q

what 2 orthotics fall under the foot orthosis theory

A

balanced foot
total contact foot

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14
Q

balanced foot vs total contact foot orthotic

how are they cast
functions

A

balanced foot orthotic:
* foot cast in off-weight STJN position
* STJ functions around neutral
* control abnormal motion w posts/wedges at RF/FF

total contact:
* foot cast in resting position
* normal function doesn’t overload tissues
* med and lat long arches stabilized thru total plantar surface contact

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15
Q

what are 2 reasons as to why foot orthotics work

A
  • impact lower limb kinematics
  • shock attenuation
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16
Q

how much motion control is considered clinically significant when orthotics impact lower limb kinematics

A

individualized - a subtle number may be enough to dec load on tissues and dec the pt’s sx

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17
Q

how do foot orthoses help w shock absorption

A

dec loading rate and vertical impact force

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18
Q

do foot orthotics help w NM control

A

limited/no evidence

can help w controlling RF which improves postural ocntrol

19
Q

how does PFPS present

A

ant knee pain w:
* squatting
* stair climbing
* running

20
Q

PFPS

what potential risk factors have been identified

A

weakness prox (hip) and distal (foot)

21
Q

PFPS

what are specific potential risk factors in the kinetic chain (6)

A

excessive foot pronation
dec knee flex angle
inc hip IR during jump land
dec quad/HS strength
inc hip ER strength
increased navicular drop

inc hip ER strength may be compensatory
inc navicular drop is a component of excessive pronation

22
Q

PFPS

how could excessive pronation lead to PFPS

A

tibial IR leads to femoral IR
inc contact pressure on lateral facets of patella

23
Q

PFPS

how would foot orthoses help to treat PFPS

A

foot orthoses may dec pain by limiting foot pronation and lower limb rotation

24
Q

PFPS

what did a study reveal when looking at PFPS in runners and their:
* hip ABD and ER strength pre/post run
* arch heigh pre run
* LE kinematic data pre/post run

A

arch height didn’t change
runners w PFPS displayed weaker hip ABDs which was more pronounded at end of runners

top down study

25
Q

PFPS

what did a study find when examining ROM of TC, ST, knee during walking&running after an foot orthotic intervention

A

was helpful for walking not w running
* control GRF w walking, but once you start running w higher impact - not so helpful

during walking it was able to dec knee motion in frontal plane during contact & midstance –> but motion was inc w running

26
Q

PFPS

what did a study find when comparing outcomes in the following groups:
1. foot orthoses + PT
2. PT
3. foot orthoses
4. flat inserts

A

foot orthoses > flat inserts
no diff b/w 2 and 3
no diff b/w 1 and 2

practicioners may seek to hasten recovery by prescribing prefabricated orthoses

27
Q

PFPS

what did a study find with prefabricated orthoses and runners w PFPS

A

did produce significant overall improvement
* pts w inc midfoot mobility (aka pronation) were more likely to have more success w the orthotic

28
Q

plantar foot pain

what does the CPG say about foot orthotic and plantar foot pain

A

clinicians should use orthotics (custom or prefab) to support med arch and cushion heel

esp in individuals who respond positively to antipronation taping techniques

improve function for short and long term periods

aka start w antipron tape –> see how they respond and then talk about orthoses if it helps

29
Q

plantar foot pain

what did a study find when comparing customized to prefabricated orthotics

A

no significant difference, will benefit from either one

30
Q

plantar foot pain

what improvements were seen in plantar foot pain after 2 weeks of an orthotic intervention (2)

A

healing
foot alignment improving

used to prescribe orthoses for forever, this is now something that may be more temporary

31
Q

plantar foot pain

what did a study find about custom vs prefab in duration of improvement of sx

A

short term improvement in pain and function
* temporary use while they heal, work to improve other components

32
Q

plantar foot pain

what did a systematic review find about the clinical effectiveness of foot orthoses in treatment and prevention of lower limb injuries

A

customized semi-rigid foot orthosses demonstrate mod to large benefits in treating and preventing plantar fasciitis

semi-rigid prevent excessive amts of motion

33
Q

plantar foot pain

4 what are non-custom foot orthotic options

A

vasyli
freedom BFO
superfeet
powerstep

34
Q

plantar foot pain

vasyli orthotic:
* characteristics
* lifespan
* function

A

lower density = less durable

short lifespan (3-16mo)
* temporary utilization

able to modify RF and FF posts

35
Q

plantar foot pain

freedom BFO orthotic:
* characteristics
* lifespan
* function

A

flexible

lifespan 2-3mo

wedge modifications

inexpensive, temporarily try it out see if it works w/o huge cost if it doesn’t

36
Q

plantar foot pain

superfeet orthotics
* characteristics
* function

A

come in different materials and durability

insoles designed for various footwear and activity

37
Q

plantar foot pain

powerstep
* characteristics
* function

A

extrinsic 2deg post

give some support and control motion

38
Q

exercise related lower leg pain

what are 5 possible reasons for pain b/w knee and ankle during exercise

A
  1. medial tibial stress syndrome (MTSS)
  2. chronic exertional compartment syndrome
  3. stress fx
  4. foot/ankle tendinopathy
  5. nerve/vascular entrapment
39
Q

exercise related lower leg pain

what did studies find w foot/ankle position/mobility and exercise related lower leg pain

A

no association found

no relationship found b/w foot type and orthotic use

findings all over the place, hard to find good clinical direction

40
Q

exercise related lower leg pain

what did one study find with efficacy of orthotics and prevention of ERLP

A

orthotics more helpful for preventative/protection purposes

dec amt of injuries occurring

41
Q

stress fx

what did studies show of the efficacy of orthotics

A

dec incidence of stress fx/reactions
* orthoses help w shock attentuation
* helpful w absorbing GRF, if hx of stress fx

42
Q

stress fx

what did a study show with the efficacy of orthoses in post tib stress fx

A

custom semi-rigid foot orthoses mod to larg benefits in treatign and preventing

43
Q

what are mr jims take homes on prescribing foot orthotics and PT

A
  • not a lot of high level evidence to support
  • careful w interpretting low level studies
  • decision making guided by “expert” opinion and individual results
  • PTs are mvmt dysfunction experts, don’t obsess over orthotics and think of things we can do for kinetic chain and impairments first

he goes for footwear change first -> taping -> prefab before custom

Assistive Tech (17 decks)

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