Orthotic Therapy Flashcards
What is a biomechanical foot orthosis?
any device capable of controlling motion pathology in the foot and leg by maintaining the foot in or close to its neutral subtalar position
What are the goals of biomechanical orthosis?
minimize abnormal motion, encourage healing, decrease inflammation, improve motion
What is the shell/module of orthosis?
conforms to plantar contours and begins at hell and extends just proximal to met heads
rigid- carbon graphite
soft- foam
What are posts in an orthotic?
stabilize shell, provides motion control in frontal plane, placed at WB sites (calc and met heads), fill spaces created by deformity
For a rear foot varus what type of posts should be used?
medial wedge
For a valgus foot type what type of post should be useD?
lateral wedge
What are the most common types of posts?
extrinsic as material is added to plantar surface of the shell , easy to adjust, excellent strength
con- adds extra bulk in shoe
What are pros and cons of intrinsic post?
post is embedded in shell so its hard to adjust but there is less bulk in shoe
What are top covers?
dorsal part of orthosis in contact with pt, can extend to met heads, sulcus or toes
What is a normal heal seat?
6-8 mm
deep is 12+ mm
What is the role of a heel seat?
controls calcaneal position
deeper = wider
provides extra bulk to shoe
When would a first ray cut out be utilized?
if there is a rigid PF 1st ray
Where is padding placed if inserted into orthosis?
placed on shell and held in place by top cover
What is general goal of posting strategies?
to take away excessive motion not normal motion
How does an accommodative orthosis differ from a biomechanical orthosis?
allows for compensation as foot is likely hypo mobile, comforms to foot and dissipates forces and is designed for comfort with softer material
What are contraindications for a biomechanical orthosis?
acute pathology, decreased ROM, incomplete evaluation
What is common among geriatric populations?
decreased subtalar joint ROM, abnormal influences at knee and decreased hip ROM
For a pt who is chronologically old what type of orthosis is recommended?
either biomechanical with semi flexibility or accommodative that uses more aggressive materials as they are likely still active
For a pt who is physiologically old what type of orthosis is recommended?
accommodative that is flexible with minimal posting and has shock absorption
When does foot function in a pediatric pt become “normal”?
5-7 years old
What are common developmental neonatal characteristics?
increased ante version, increased varus bowing of tibia, minimal to no external malleolar position, rear foot in 10 degrees varus in STJN, forefoot varus in 12-15 degrees, increased ankle DF
What are common developmental characteristics of 12 month old?
femoral anterversion 10-15 degrees, external malleolar position 10-15 degrees as fibula is moving backwards, rear and forefoot varus under 10 degrees, relaxed calcaneal stance 5 degrees everted
What are common developmental characteristics in 5 year old?
femoral anterversion 10-15 degrees, external malleolar position 15-25 degrees as fibula is moving backwards, rear foot varus 2-4 degrees forefoot varus 0-2, relaxed calcaneal stance 4 degrees everted
What type of orthotic is recommended for runners?
full length top with cushion, avoid very rigid shell or posting material due to large amount of impact
What type of orthotic is recommended for aerobics?
avoid excessive rear foot posting due to abrupt direction changes, cushion forefoot due to increased weight bearing
What type of orthotic is recommended for court sport athletes?
avoid aggressive rear foot posting, full length top covers to avoid sliding
What type of orthotic is recommended for field sport athletes?
intrinsic post to avoid adding bulk to cleat, durable top covers to withstand elements
What is break in period for orthosis?
increase wear by 1-2 hours each day remember Hoke’s law
What is life expectancy of orthosis?
2-7 for biomechanical, 6-12 months for accommodative
