Orthotics Flashcards
five reasons to order LE orthotics
- biomechanical alignment
- foot clearance during swing
- knee/hip stability in stance
- knee/hip flexion during terminal stance/pre swing
- to influence tone
T/F: to control a joint using orthoses, you must brace across the joint
false: you don’t need to brace across the knee to control the knee
T/F: orthotics are superior to FES in assisting gait
false: neither is superior
T/F: there is no evidence that one type of AFO is superior to another
true
T/F: some orthotic is better than no orthotic
true
T/F: articulated AFOs are superior to nonarticulated AFOs
depends…. the research is emerging but currently it is thought that articulated AFOs are superior
In what patient population would you choose an articulated ankle hinge in an AFO?
stroke patients capable of ambulation because they will likely recover
What kind of AFO is ideal for ALS patients?
posterior leaf springs are a good and simple choice to assist with emerging foot drop
Medicare/insurers will generally replace braces every….
5 years
what is a drop lock KAFO
gravity slides locks into extension for stiff gait but can be unlocked manually to promote knee bend (to sit in chairs, for example)
what is an off-set knee lock mechanism? how is the patient’s leg placed in the brace
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)
in what 4 situations would you preference a pre-fab AFO
- “simple” foot drop
- intact sensation
- knee stability
- typical body build
in what 4 situations would you preference a pre-fab AFO
- “simple” foot drop
- intact sensation
- knee stability
- typical body build
in what 5 situations would you consider a custom AFO over a pre-fab AFO?
- significant abnormal tone
- significant med-lat instability
- knee instability
- sensory deficits
- atypical body build
how would you position the ankle in a make-shift ace wrap AFO?
Wrap the brace into ankle EVERSION b/c foot drop will naturally try to invert the ankle as well.
what are the three measurements needed to order a pre-fab AFO
shoe size, limb length, and circumference
how far do you measure the proximal trim line below the fibular head and why
2 inches to avoid compressing the common fib nerve
What should the footplate of an AFO look like if a patient has significant spasticity?
Footplates should be longer to address the spasticity
One advantage and one disadvantage of having a footplate cut at the MTP
adv: MTP rocker
disadv: spasticity will be less managed (if present)
If your firm AFO is causing knee hyperextension, what can you do?
add a heel wedge
Why do we use a PF stop
- avoid foot drop during swing
2. prevent knee hyperextension during stance
Why would we use a DF stop
to avoid knee instability
Why would we use a DF assist
assist with foot drop
why would we use a PF assist
Julie has never seen this
AFO holding the ankle in DF will force the knee into more ____
flexion
AFO holding the ankle in PF will force the knee into _____
extension
What will an anterior rod do?
DF stop
what will a posterior rod do?
PF stop
what will a posterior spring do?
DF assist
what will an anterior spring do?
PF assist
What type of AFO would be ideal for a patient with skin issues or volume fluctuations
Double (&single) upright AFOs
constant pressure to which muscle group can influence tone in AFOs?
PF group
what type of AFO is common for those with CMT
patellar tendon bearing (PTB) AFOs
FES and AFOs individually have equally positive effect on ____ in non progressive CNS diagnoses
gait speed
When would you choose a supramalleolar orthotic (SMO)?
good solution for med/lat instability
how can you adapt a shoe for someone who might be more prone to a lateral lean?
If you think a patient will fall LATERALLY then wedge under their LATERAL foot
Is it better to wedge inside or out of the shoe?
it doesn’t matter which - Julie
