Orthotic Therapy

Question 1

What is a biomechanical foot orthosis?

Answer 1

any device capable of controlling motion pathology in the foot and leg by maintaining the foot in or close to its neutral subtalar position

Question 2

What are the goals of biomechanical orthosis?

Answer 2

minimize abnormal motion, encourage healing, decrease inflammation, improve motion

Question 3

What is the shell/module of orthosis?

Answer 3

conforms to plantar contours and begins at hell and extends just proximal to met heads

rigid- carbon graphite
soft- foam

Question 4

What are posts in an orthotic?

Answer 4

stabilize shell, provides motion control in frontal plane, placed at WB sites (calc and met heads), fill spaces created by deformity

Question 5

For a rear foot varus what type of posts should be used?

Answer 5

medial wedge

Question 6

For a valgus foot type what type of post should be useD?

Answer 6

lateral wedge

Question 7

What are the most common types of posts?

Answer 7

extrinsic as material is added to plantar surface of the shell , easy to adjust, excellent strength

con- adds extra bulk in shoe

Question 8

What are pros and cons of intrinsic post?

Answer 8

post is embedded in shell so its hard to adjust but there is less bulk in shoe

Question 9

What are top covers?

Answer 9

dorsal part of orthosis in contact with pt, can extend to met heads, sulcus or toes

Question 10

What is a normal heal seat?

Answer 10

6-8 mm

deep is 12+ mm

Question 11

What is the role of a heel seat?

Answer 11

controls calcaneal position

deeper = wider

provides extra bulk to shoe

Question 12

When would a first ray cut out be utilized?

Answer 12

if there is a rigid PF 1st ray

Question 13

Where is padding placed if inserted into orthosis?

Answer 13

placed on shell and held in place by top cover

Question 14

What is general goal of posting strategies?

Answer 14

to take away excessive motion not normal motion

Question 15

How does an accommodative orthosis differ from a biomechanical orthosis?

Answer 15

allows for compensation as foot is likely hypo mobile, comforms to foot and dissipates forces and is designed for comfort with softer material

Question 16

What are contraindications for a biomechanical orthosis?

Answer 16

acute pathology, decreased ROM, incomplete evaluation

Question 17

What is common among geriatric populations?

Answer 17

decreased subtalar joint ROM, abnormal influences at knee and decreased hip ROM

Question 18

For a pt who is chronologically old what type of orthosis is recommended?

Answer 18

either biomechanical with semi flexibility or accommodative that uses more aggressive materials as they are likely still active

Question 19

For a pt who is physiologically old what type of orthosis is recommended?

Answer 19

accommodative that is flexible with minimal posting and has shock absorption

Question 20

When does foot function in a pediatric pt become “normal”?

Answer 20

5-7 years old

Question 21

What are common developmental neonatal characteristics?

Answer 21

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

Question 22

What are common developmental characteristics of 12 month old?

Answer 22

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

Question 23

What are common developmental characteristics in 5 year old?

Answer 23

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

Question 24

What type of orthotic is recommended for runners?

Answer 24

full length top with cushion, avoid very rigid shell or posting material due to large amount of impact

Question 25

What type of orthotic is recommended for aerobics?

Answer 25

avoid excessive rear foot posting due to abrupt direction changes, cushion forefoot due to increased weight bearing

Question 26

What type of orthotic is recommended for court sport athletes?

Answer 26

avoid aggressive rear foot posting, full length top covers to avoid sliding

Question 27

What type of orthotic is recommended for field sport athletes?

Answer 27

intrinsic post to avoid adding bulk to cleat, durable top covers to withstand elements

Question 28

What is break in period for orthosis?

Answer 28

increase wear by 1-2 hours each day remember Hoke’s law

Question 29

What is life expectancy of orthosis?

Answer 29

2-7 for biomechanical, 6-12 months for accommodative