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VIVA > Orthotic precription > Flashcards

Orthotic precription Flashcards

1
Q

Goals of orthotic therapy for achilles tendinopathy

A

-Limit eversion and internal rotation of tibia preventing the twist of achilles tendon
-Reduce load of tendon
-Stabilze midtarsal joint to provide a efficient lever for heel lift

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2
Q

Recommendations for achilles tendinopathy

A

–medial heel skive, to control heel eversion
-Heel lift 3mm, decreases tensile load of heel lift

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3
Q

Goals of orthotic therapy for limitus and HAV

A

-Promote first ray plantarflexion
-Reduce compression in the 1st MTPJ
-Improve Hallux range of motion

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4
Q

Recommendations for Hallux limitus or HAV

A

-Heel cup 14mm
-Minimum cast fill
-Heel skive 2 deg
-inversion 2 deg
-Reverse Morton’s, allows first ray plantarflexion, decreases compression at 1st MPJ, reduces tensile force of plantar fascia

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5
Q

What are some mechanical causes within the foot for FHL

A

-Rearfoot eversion
-Forefoot valgus
-1st Ray plantarflexion

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6
Q

When would you use a Morton’s extension

A

-to take pressure away from the 2nd met head
-Limit 1st MTPJ ROM

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7
Q

When would you use a Reverse Morton extension

A

-Decrease pressure at 1st MPJ
-limit inversion at forefoot
-promote 1st ray function

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8
Q

What is the purpose of rearfoot valgus posting?

A

-stabilizes inverting rearfoot
-eversion of heel at heel strike

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9
Q

When to use Valgus posting

A

-Over supination of subtalar joint

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10
Q

What would you prescribe in peroneal tendonitis

A

-Forefoot valgus extension, to decrease inversion of the foot, reducing tensile load of PL

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11
Q

Goals for orthotics in metatarsalgia

A

-transfer forces away from the met heads
-provide extra cushioning to forefoot

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12
Q

What are some recommendation for metatarsalgia

A

-Poron forefoot extension
-metatarsal bar

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13
Q

Goals for Morton neuroma

A

-reduce intermetatarsal pressure
-separate affected metatarsal heads

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14
Q

Recommendation for neuroma

A

-forefoot extension with poron
-Neuroma pad

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15
Q

What are some conditions associated with pes cavus foot type

A

-Metatarsalgia
-Heel pain
-Lateral ankle stability

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16
Q

Goals for pes cavus

A

-Increase plantar surface contact area, distribute pressure evenly
-resist excessive supination, prevent lateral ankle sprains
-resist both excessive pronation and supination forces, flexible pes cavus foot

17
Q

Recommendation for pes cavus

A

-Poly, effectively redistrubte pressure evenly
-deep heel cup, provide more stability to rearfoot
-valgus extension, promote pronatory moment and conteractive excessive supination
-Heel lift, 3mm promote ankle dorsiflexion

18
Q

Goal for tarsal tunnel syndrome

A

-decrease tibial nerve traction by control heel eversion by plantarflexing foot and providing medial arch support

19
Q

Recommendation for Tarsal tunnel syndrome

A

-Deep cup limit heel eversion
-Medial heel skive, greater force medial to the axis of STJ reducing heel eversion
-heel lift 4mm, encouraged ankle joint plantarflexion

20
Q

What does the heel post do?

A

-Provides more stability inside the shoe
-EVA Compression more tolerable and shock absorption

21
Q

What does a medial heel skive do?

A

-Increases supinatory moment to reduce excessive pronation
-Shift the force further medial at the heel
-Increases lever arm medial to STJ axis and spinatory torque around the axis
-A deeper heel cup is needed

22
Q

Goals for plantar fasciitis

A

-Prevent first ray dorsiflexion
-incorporate valgus correction
-Maintain close contour with arch
-Reduce rearfoot eversion that leads to first ray dorsiflexion

23
Q

Reccommendations for Plantar fasciitis

A

-Valgus wedge (forefoot valgus deformity)
-Morton extension (if 1st ray is plantarflexed)
-Minimum arch fill (raise the TNJ to prevent 1st ray dorsifelxion)
-Invert rearfoot

24
Q

Goals of post tib dysfunction

A

-Reduce pronation in foot at rearfoot and forefoot
-Shifting the force medial to the subtalar joint axis

25
Q

Post tib dysfunction recommendation

A

-Varus wedge or medial heel skive, increase lever arm medial to the STJA, increasing supination moment
-Medial flange, warps up around the arch to apply supinator torque and limit excessive pronation
-Sweet spot navicular, accommodate navicular

26
Q

Tarsal tunnel goals

A

-Support the MLA
-decrease eversion of the heel
-Plantarflex the ankle joint

27
Q

Tarsal tunnel prescription recommendations

A

-Minimum arch fill, support the MLA
-medial heel skive, increase supination moment
-Heel lift, plantarflex the ankle joint

28
Q

If supination resistance if high what tissues will be affected

A

-Increased load on the supinators
-More force needed to institute the windlass
-External rotators have more difficult time
-Increased bending strain in medial tibial

29
Q

Recommendation for high supination resistance

A

-Deep heel cup medially
-Increased rigidity
-Varus wedging to increase supinator force

30
Q

If supination resistance is low what tissues will be affected

A

-Peroneal tendons
-Lateral ankle ligament

31
Q

Recommendation for low supination resistance

A

-Deep heel cup
-Valgus wedge
-max arch fill
-Cuboid pad

32
Q

What does an easy jacks test indicate?

A

-Windlass if efficient
-Easy for heel to come off the ground

33
Q

What does an difficult Jacks test indicate?

A

-Windlass less efficient
-increase plantar fascia
-Harder to left heel off the ground
-Overall increase work of the supinators

34
Q

What are recommendations for a high/difficult jacks test?

A

-Inversion of rearfoot
-elevate the lateral forefoot
–reverse Morton’s
–forefoot valgus extension
–plantarflex 1st during modelling
–first ray cut out
–increase flex under distal first ray

35
Q

Benefits of high heel cup

A

-More contour of heel
-More control
-Stiffer and wider
-Depend on footwear

36
Q

Benefits of medial and lateral heel cup height

A

-Increase in medial will control early midstance pronation
-increase in lateral will control heel inversion in cavus foot type

37
Q

What does a medial heel skive do and why better option than a Flare

A

-Supinatory moment at heel contact through to early stance
-Resisting pronation
-Lateral heel skive has opposite effect
-They are better than Flare or Rearfoot posts as they fit into footwear easier

VIVA (19 decks)

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