Orthoses Flashcards
Flexible AFO’s
Purpose: Provide dorsiflexion movements; does NOT stabilize subtalar joint.
Mechanism: Light weight control of varus/valgus deformities
Indications: Foot drop
Rigid AFO
Purpose: Does NOT allow any ROM at ankle beyond neutral, prevents varus/valgus deviations
Mechanism: Wider calf shell, sets foot/ankle to neutral
Indications: Complete loss of DF strength, Foot drop, Genu recurvatum
Posterior Leaf Spring (PLS)
Purpose: Helps weak DF movements by resisting ankle PF movements while walking and during swing phase
Mechanism: Narrow calf shell and narrow ankle trim line behind the malleoli, but provides no middle or side control of the ankle.
Indications: Instability of the knee, helps prevent foot drop.
Plantar Stop (Posterior Stop)
Purpose: An AFO that produces a flexion movement at the knee during heel strike
Mechanism: Commonly set to neutral
Indications: Controls PF spasticity and contractures, limits knee extension
Dorsiflexion stop (Anterior Stop)
Purpose: Compensates for the function of gastroc/soleus complex by assisting with push-off and assisting the knee joint into extension
Mechanism: Set at 5 degrees DF, best substitutes for gastroc/soleus function
Indications: Weak calf muscles, weak quadriceps, limits knee flexion
Reciprocating Gait Orthoses (RGO)
Purpose: Provides contralateral hip extension with ipsilateral hip flexion; crutches are often used in conjunction to provide control.
Mechanism: Contralateral hip extension occurs passively with each step employing a cable system
Indications: Resists femoral adduction
Hip Guided Orthoses
Purpose: Needs good upper limb strength, trunk balance, and active hip flexion
Mechanism: Gait is initiated with active unilateral hip flexion and can be assisted by swaying trunk when hip flexion is inadequate
Indication: Spina bifida
HKAFO
Mechanism: Hip joint and pelvic band attached to the lateral upright of a KAFO
Indications:
-Hip flexion/extension instability
-Hip adduction/abduction weakness
-Hip IR/ER instability
SACH Heel (Cushioned)
Purpose: Absorbs impact during heel strike/contact; used to relieve strain on plantar fascia
Mechanism: Reduce unnecessary knee movement by allowing more rapid ankle PF
Conditions: Plantar fasciitis, hyperpronation
Heel Wedge
Purpose: Promotes inversion/eversion and prevents hind foot from sliding down the incline
Metatarsal Bar
Purpose: Flat surface placed behind the metatarsal head, set proximal to metatarsal heads
Mechanism: Used to relieve pressure from metatarsal heads
Rocker Bottom
Purpose: Builds up the sole over metatarsal heads and improves push-off, may be used for sensory issues
Indications: Weak or inflexible feet, ulcers
Forefoot Posting
Purpose: Supports the forefoot, contraindicated for insensitive feet
Mechanism: Medial wedge is prescribed for forefoot varus; Lateral wedge is prescribed for forefoot valgus
Indications: Forefoot varus leads to pronation of the foot
Rearfoot Posting
Purpose: Alters position of the subtalar joint or rearfoot from heel strike to foot flat
Mechanism:
Varus post limits or controls eversion of the calcaneus and IR of the tibia after heel strike.
Valgus post controls calcaneus and subtalar joint that are excessively inverted and supinated at heel strike
Thomas Heel
Purpose: Used to support the longitudinal arch and correct for flexible pes valgus
Mechanism: Wedge with an extended anterior-medial border
Indications: Pronated foot
