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Neuro Rehab Test 2 > Orthotics > Flashcards

Orthotics Flashcards

1
Q

five reasons to order LE orthotics

A
  1. biomechanical alignment
  2. foot clearance during swing
  3. knee/hip stability in stance
  4. knee/hip flexion during terminal stance/pre swing
  5. to influence tone
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2
Q

T/F: to control a joint using orthoses, you must brace across the joint

A

false: you don’t need to brace across the knee to control the knee

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3
Q

T/F: orthotics are superior to FES in assisting gait

A

false: neither is superior

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4
Q

T/F: there is no evidence that one type of AFO is superior to another

A

true

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5
Q

T/F: some orthotic is better than no orthotic

A

true

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6
Q

T/F: articulated AFOs are superior to nonarticulated AFOs

A

depends…. the research is emerging but currently it is thought that articulated AFOs are superior

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7
Q

In what patient population would you choose an articulated ankle hinge in an AFO?

A

stroke patients capable of ambulation because they will likely recover

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8
Q

What kind of AFO is ideal for ALS patients?

A

posterior leaf springs are a good and simple choice to assist with emerging foot drop

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9
Q

Medicare/insurers will generally replace braces every….

A

5 years

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10
Q

what is a drop lock KAFO

A

gravity slides locks into extension for stiff gait but can be unlocked manually to promote knee bend (to sit in chairs, for example)

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11
Q

what is an off-set knee lock mechanism? how is the patient’s leg placed in the brace

A

the patient’s leg is POSTERIORLY positioned in the brace so that the brace provides an extension moment (because it is anteriorly situated to the joint line)

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12
Q

in what 4 situations would you preference a pre-fab AFO

A
  1. “simple” foot drop
  2. intact sensation
  3. knee stability
  4. typical body build
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12
Q

in what 4 situations would you preference a pre-fab AFO

A
  1. “simple” foot drop
  2. intact sensation
  3. knee stability
  4. typical body build
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13
Q

in what 5 situations would you consider a custom AFO over a pre-fab AFO?

A
  1. significant abnormal tone
  2. significant med-lat instability
  3. knee instability
  4. sensory deficits
  5. atypical body build
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14
Q

how would you position the ankle in a make-shift ace wrap AFO?

A

Wrap the brace into ankle EVERSION b/c foot drop will naturally try to invert the ankle as well.

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15
Q

what are the three measurements needed to order a pre-fab AFO

A

shoe size, limb length, and circumference

16
Q

how far do you measure the proximal trim line below the fibular head and why

A

2 inches to avoid compressing the common fib nerve

17
Q

What should the footplate of an AFO look like if a patient has significant spasticity?

A

Footplates should be longer to address the spasticity

18
Q

One advantage and one disadvantage of having a footplate cut at the MTP

A

adv: MTP rocker
disadv: spasticity will be less managed (if present)

19
Q

If your firm AFO is causing knee hyperextension, what can you do?

A

add a heel wedge

20
Q

Why do we use a PF stop

A
  1. avoid foot drop during swing

2. prevent knee hyperextension during stance

21
Q

Why would we use a DF stop

A

to avoid knee instability

22
Q

Why would we use a DF assist

A

assist with foot drop

23
Q

why would we use a PF assist

A

Julie has never seen this

24
Q

AFO holding the ankle in DF will force the knee into more ____

A

flexion

25
Q

AFO holding the ankle in PF will force the knee into _____

A

extension

26
Q

What will an anterior rod do?

A

DF stop

27
Q

what will a posterior rod do?

A

PF stop

28
Q

what will a posterior spring do?

A

DF assist

29
Q

what will an anterior spring do?

A

PF assist

30
Q

What type of AFO would be ideal for a patient with skin issues or volume fluctuations

A

Double (&single) upright AFOs

31
Q

constant pressure to which muscle group can influence tone in AFOs?

A

PF group

32
Q

what type of AFO is common for those with CMT

A

patellar tendon bearing (PTB) AFOs

33
Q

FES and AFOs individually have equally positive effect on ____ in non progressive CNS diagnoses

A

gait speed

34
Q

When would you choose a supramalleolar orthotic (SMO)?

A

good solution for med/lat instability

35
Q

how can you adapt a shoe for someone who might be more prone to a lateral lean?

A

If you think a patient will fall LATERALLY then wedge under their LATERAL foot

36
Q

Is it better to wedge inside or out of the shoe?

A

it doesn’t matter which - Julie

Neuro Rehab Test 2 (11 decks)

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