ORTHOTIC PRESCRIBING HIGH YIELD

Question 1

in the thickness of materials, what do we consider?

Answer 1

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

Question 2

what is the general rule fro orthotic prescribing?

Answer 2

the thicker the material, the more rigid the device constructed

Question 3

more rigid device means?

Answer 3

more biomechanical control

so in rigid material, the greater the thickness, the stronger the device

Question 4

in the patients weight, what materials are considered?

Answer 4

flexible material

rigid material

Question 5

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

Answer 5

flexible material

Question 6

name this material as it relates to patients weight?

the heavier the patient, the thicker the material to prevent breakage of device

Answer 6

rigid material

Question 7

what are the considerations for heel modifications?

Answer 7

deep heel seat

rearfoot post flare

Question 8

this measurement for a deep seat heel gives a deep heel cup?

normal
shallow

Answer 8

> 16 mm

12 is normal
<10 is shallow

Question 9

high medial heel cup and low lateral heel cup is what type of condition?

Answer 9

tibial valgum (knock kneed)

Question 10

low medial heel cup and high lateral heel cup is due to center of gravity being directed laterally is what type of condition?

Answer 10

uncompensated rearfoot varus

high tibial vacuum (bow-legged)

Question 11

what are the types of rearfoot post flares?

Answer 11

medial flare

lateral flare

Question 12

name this type of flare?

limits pronatory or eversion motion of calcaneus
-can be used in conjunction with high medial heel cup

Answer 12

medial flare

Question 13

name this type of flare?

limits inversion or supinatory motion of calcaneus
-used in conjunction with high lateral heel cup

Answer 13

lateral flare

Question 14

what is the significance of Kirby heel skive?

Answer 14

increases resistance to pronation moments at the STJ

Question 15

most conditions call for balancing the positive cast to _____?

Answer 15

vertical

Question 16

how are all forefoot postings built?

Answer 16

intrinsically into the orthotic

Question 17

what type of forefoot post is most frequently used?

exceptions?

Answer 17

intrinsic

forefoot valgus, extrinsic forefoot post may be used

Question 18

what are the 3 common widths seen as options for orthotic devices?

general width for male?

general width for female?

Answer 18

normal width
narrow width
wide width

D-width

C-width

Question 19

so top covers can be planted on orthotic in 3 different ways, what are they?

Answer 19

on the orthotic itself (metatarsal length)

extending under the metatarsal heads
(sulcus length)

extending under the toes (full length)

Question 20

what is the purpose of the top cover?

Answer 20

not a necessity but it does make the orthotic look better and may hold the foot onto the device better

Question 21

what materials is the top cover made of?

Answer 21

Spenco (neoprene)

leather (cowhide)

naugahyde (synthetic)

Question 22

what is to note of the positive cast?

Answer 22

good bisection of heel of negative cast

Question 23

what are the three options for pouring the positive cast?

Answer 23

neutral
inverted
everted

Question 24

name this pour

most common, fully compensated rearfoot varus

Answer 24

neutral

Question 25

name this pour

uncompensated or partially compensated rearfoot varus

Answer 25

inverted

Question 26

name this pour

rearfoot valgus, peroneal spasm

Answer 26

everted

Question 27

in a positive cast, this prevents poured plaster from sticking to plaster of negative cast

Answer 27

negative cast lined with soap and water solution

Question 28

in a positive cast, due to pouring, even before the cast is dried, where do we place the wedge?

Answer 28

under the forefoot to place heel bisection in neutral, inverted or everted

Question 29

in positive cast during the pouring process, once dry, how is the negative cast from surface of the positive cast?

Answer 29

plaster model of foot in neutral STJ with MTJ maximally pronated (locked)

Question 30

what are the additions or mods made to the positive cast after the negative cast is removed?

Answer 30

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

Question 31

why is lateral expansion important?

Answer 31

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

Question 32

how do we press the orthotic onto the positive cast?

Answer 32

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