ORTHOTIC PRESCRIBING HIGH YIELD Flashcards
in the thickness of materials, what do we consider?
some materials still measured in fractions of an inch
when measured in inches we use thicknesses of 1/8, 5/32, 3/16, and 1/4
material that we fabricate orthotic
what is the general rule fro orthotic prescribing?
the thicker the material, the more rigid the device constructed
more rigid device means?
more biomechanical control
so in rigid material, the greater the thickness, the stronger the device
in the patients weight, what materials are considered?
flexible material
rigid material
name this material as it relates to patients weight?
the thickness will dictate amount of flex orthotic will have during gait, more flex of device, less biomechanical control
flexible material
name this material as it relates to patients weight?
the heavier the patient, the thicker the material to prevent breakage of device
rigid material
what are the considerations for heel modifications?
deep heel seat
rearfoot post flare
this measurement for a deep seat heel gives a deep heel cup?
normal
shallow
> 16 mm
12 is normal
<10 is shallow
high medial heel cup and low lateral heel cup is what type of condition?
tibial valgum (knock kneed)
low medial heel cup and high lateral heel cup is due to center of gravity being directed laterally is what type of condition?
uncompensated rearfoot varus
high tibial vacuum (bow-legged)
what are the types of rearfoot post flares?
medial flare
lateral flare
name this type of flare?
limits pronatory or eversion motion of calcaneus
-can be used in conjunction with high medial heel cup
medial flare
name this type of flare?
limits inversion or supinatory motion of calcaneus
-used in conjunction with high lateral heel cup
lateral flare
what is the significance of Kirby heel skive?
increases resistance to pronation moments at the STJ
most conditions call for balancing the positive cast to _____?
vertical
how are all forefoot postings built?
intrinsically into the orthotic
what type of forefoot post is most frequently used?
exceptions?
intrinsic
forefoot valgus, extrinsic forefoot post may be used
what are the 3 common widths seen as options for orthotic devices?
general width for male?
general width for female?
normal width
narrow width
wide width
D-width
C-width
so top covers can be planted on orthotic in 3 different ways, what are they?
on the orthotic itself (metatarsal length)
extending under the metatarsal heads
(sulcus length)
extending under the toes (full length)
what is the purpose of the top cover?
not a necessity but it does make the orthotic look better and may hold the foot onto the device better
what materials is the top cover made of?
Spenco (neoprene)
leather (cowhide)
naugahyde (synthetic)
what is to note of the positive cast?
good bisection of heel of negative cast
what are the three options for pouring the positive cast?
neutral
inverted
everted
name this pour
most common, fully compensated rearfoot varus
neutral
name this pour
uncompensated or partially compensated rearfoot varus
inverted
name this pour
rearfoot valgus, peroneal spasm
everted
in a positive cast, this prevents poured plaster from sticking to plaster of negative cast
negative cast lined with soap and water solution
in a positive cast, due to pouring, even before the cast is dried, where do we place the wedge?
under the forefoot to place heel bisection in neutral, inverted or everted
in positive cast during the pouring process, once dry, how is the negative cast from surface of the positive cast?
plaster model of foot in neutral STJ with MTJ maximally pronated (locked)
what are the additions or mods made to the positive cast after the negative cast is removed?
add forefoot platform for intrinsic posting
add medial or lateral arch plaster fill to accommodate forefoot platform
-consider minimal archfill and maximal archfill
extrinsic rearfoot post
lateral expansion
why is lateral expansion important?
it consists of roughly 1/8 of plaster added to lateral surface of positive cast
- added to accommodate laterally displaced fat pad of calcaneus
- adding this will make heel cup fit better
how do we press the orthotic onto the positive cast?
heat orthotic material in the oven
press the material onto positive cast using a press
after material is pressed, grind material into shape and width
add any extrinsic post
