Orthosis Flashcards
What is an orthosis?
- A device that is Externally applied or Attached to a body segment and that Faciliates or Improves function by support, correcting or compensating for a skeletal deformity or weakness
What is the regions of the body in aaos nomenclature?
upper limb
- S= shoulder
- E= elbow
- W= wrist
- H= Hand
Lower limb
- H= hip
- K= knee
- A= ankle
- F=foot
Spine
- C= Cervical
- T=thoracic
- L= lumbar
- S= sacroiliac
What is the control of the designated function of Orthoses?
- F- free motion allowed
-
A- assist
- application of external force to increase range or velocity of a desire motion
- R- resist movement of a external force
- S - stop -ie static unit to deter motion
- H - hold ie elimination of all motion in a prescribed plane
- L -lock- optional lock
What are the ideal characteristics of Orthoses ?
- Lightweight
- Durable
- Biomechanically effective
- Cosmetically pleasing
- Easy to don and off
- Rapid provision and replacement
- Washable
- Adjustable
- Comfortable
- Free of pressure areas
What are the functional characteristics of Orthoses?
- Provisional support- prevent weak muscles/ligaments being stretched- TLO to support a collapsing osteeoporosis spine
- Limitation of motion - KO to prevent hyperextension
- Correction of deformity - force affected joint into near alignment and redirect growth e.g.a- tlso- Thoracolumbarsacral orthosis
- Assistance of motion- hkafo- hipkneeanklefoot orthosis in myelomeningocele
- Miscellaneous - warmth, placebo effect
- Combination-many combine several functions e.g.KAFO for leg with polio, gives support, limits movement at the knee, may correct ankle varus and springs assist ankle dorsiflexion
What other ways can you define the function of orthosis?
- Static- has no moving parts and is used to immobilise a part of the body
- Dynamic- moving parts by movement is controlled by an energy store
What must an orthosis have for proper control?
- 3 points of contact to control the joint
What are the criteria for a supportive orthosis ?
- Joint must be maintained in an optimium anatomical position during rest period
What is the purpose of a corrective orthosis ?
- Is to impose or control a set of forces on a body part
- Each force has magnitude and direction & the resultant worked out
What is Newton’s 3rd law of reaction?
- For every reaction there is an equal and opposite reaction
What is the ground reaction force?
- The force exerted by the ground on the body
- it is the magnitude but opposite in direction to the force exerted on the ground by the body
- if the GRF doesn’t pass thru the centre of the joint it creates a moment on that joint
Where is the GRF in mid-stance?
- Posterior to the hip
- -> hip extension moment counter balanced by the gradual tightening of the anterior hip capsule
- The GRF is anterior to the knee
- -> knee extension moment that resisted by the tight posterior knee capsule
- the GFR falls anterior to the ankle
- -> ankle dorsiflexion moment that is resisted by contraction os gastronemius soleus muscle complex
- ie in mid stance there is very little muscle activity required to maintain an up right position
Where is the GRF in pre-swing?
- the force passes behind the knee
- acts as a flexor- reducing the work requirements for knee flexion
How do orthosese function?
- By application of mechanical forces to the musculoskeletal system
How can orthosis modify the system of external forces and moments across a joint?
-
Direct
- Control of moments about a joint
- control of translation forces across a joint
- control of axial forces across a joint
-
Static
- Control of line of action