Orthotics Flashcards
1
Q
Orthotics
A
- Use of specialized mechanical devices to support or supplement weakened or abnormal joints or limbs
2
Q
3 Point System
A
- pressure applied to a body part by 3(or more) pads with the outer pads applying pressure in one direction and the center pad applying a counter pressure in the opposite direction
3
Q
Pressure
A
- force divided by surface area
ie: pounds per square inch
4
Q
How to decrease pressure?
A
- Decrease force
- Increase area
- Increase lever arm: increase distance from axis of motion to pressure pad
5
Q
Purpose of Orthotics
A
- Hold
- Assist
- Resist
- Support
- Stop
- Reduce Axial Loading
- Combinations of all above functions
6
Q
Hold “purpose”
A
- Prevent all motion
7
Q
Assist “purpose”
A
- Facilitate movement in a specific direction
8
Q
Resist “purpose”
A
- Inhibit movement in a specific direction
9
Q
Support “purpose”
A
- Allow for protective movement
10
Q
Stop “purpose”
A
- Allow movement within a pre-defined, limited ROM
11
Q
Reduce Axial Loading “purpose”
A
- Force acting along the lines of an object expressed in compression or tension
12
Q
Pedorthics
A
- Design and fitting of foot orthoses
13
Q
Shoes “Pedorthics”
A
- Extra depth shoe
- Healing Shoe
- Orthopedic Shoe
14
Q
Extra Depth Shoe
A
- Upper contour with additoinal vertical space
- Allows for insertion of orthotics
15
Q
Healing Shoe
A
- For any situation that requires a pressure offload of the forefoot
16
Q
Orthopedic Shoe
A
- Provides support - reinforcements
- 4 Types (Steel Shank, Reinforced Heel Counter, Solid Heel, Low Resilient Heel)
17
Q
Steel Shank
A
- Ortho Shoe
- Longitudinal plate that reinforces the sole
18
Q
Reinforced Heel Counter
A
- Ortho Shoe
- Stiffens the quarter, posterior shoe
19
Q
Solid Heel
A
- Ortho Shoe
- Higher heel reduces tension on the achilles tendon when firm
20
Q
Low Resilient Heel
A
- Permits slight planter flexion in those with limitations in the ankle
21
Q
Internal shoe modifications
A
- the closer the modification is to the foot, the more effective it is
- Scaphoid Pad
- Heel Cup
- UCB / UCBL 3 Point counter pressure
- Metatarsal pad
- Heel pad or lift
22
Q
Scaphoid Pad
A
- Internal
- Prevent depression to the sub-talor joint
23
Q
Heel Cup
A
- Internal
- Silicon Pad under the heel
24
Q
UCB / UCBL
A
- Internal
- 3 point counter pressure system to control calcanneal eversion
- semirigid longitudinal arch support with heel cup
25
Metatarsal Pad
- Internal
- Restricts forefoot abduction
- Transfers stress from metatarsal heads to metatarsal shafts
26
What is effective in reducing plantar pressure?
- Metatarsal Pad
27
Heel Pad or Lift
- Internal
- Soft, with or without cutout for heel spur
- Cushions with concave relief to reduce pressure
28
External Shoe modicfications
- Will erode
- Client limited to wearing the shoe
- Heel Wedge
- Metatarsal Bar
- Rocker Sole
- Built Up Heel and/or sole
29
Heel Wedge
- External
- alters alignment of calcaneous
- Medial Wedge
- Thomas Heel
- Lateral Wedge
30
Medial Wedge
- Heel Wedge
- Lateral Directed force
- aids in realigning by filing void between sole and floor on medial side
31
Thomas Heel
- Heel Wedge
| - Medial wedge with anterior extension for additional support
32
Lateral Wedge
- Heel Wege
| - Shifts weight bearing to medial side of front of foot
33
Metatarsal Bar
- External
- Placed posterior to the metatarsal heads to shift weight to the shafts at late stance, the bar transfers stress to shafts
34
Rocker Sole
- External
- Shifts weight to metatarsal shafts and reduces MTP extension during pushoff
- Facilitates roll-over and toe off when ankle dorsiflexion is limited
35
AFO
- Ankle Foot Orthosis
- Double Upright
- Posterior Leaf Spring
- Solid Plastic AFO
- Toe Off-AFO
- Plastic Hinge AFO
- Ypsilon AFO
- Floor Reaction AFO
- Knee-Ankle-Foot KAFO
36
Double Upright with TStrap
- AFO
- Provides the greatest support and adjustability
- Single or Double spring/stops (anterior/posterior)
37
Anterior Stop
- Limits Dorsiflexion
38
Anterior Spring
- Assists Plantar Flexion
39
Posterior Stop
- Limits Plantar Flexion
40
Posterior Spring
- Assists Dorsiflexion
41
Varas Deformity (T-Strap)
- Strap goes around the medial upright portion
42
Valgus Deformity (T-Strap)
- Strap goes around the later upright portion
43
Indications for Double Upright with T-Strap
- Foot drop
- Poor Knee control in sagittal plane
- Ankle Varus/Valgus
- Foot drop with uncontrolled edema
- Poor skin below knee
44
Posterior Leaf Spring
- AFO
- For weakness that causes toe dragging
- Plastic, lightweight, wear with regular shoes
45
Solid Plastic
- AFO
| - Limits all foot and ankle motion
46
Toe OFF-AFO
- AFO
- Fiberglass, carbon fiver and kevlar orthosis
- Designed to provide dosiflexion assistance for mild to sever foot drop that is accompanied by mild to moderate ankle instability
47
Toe OFF-AFO contraindication
- with moderate to severe spasticity or edem
48
Plastic Hinged AFO (Steel Posterior Step)
- AFO
- Prevents to drag and is plantar flexion resistant
- imposes a flexion force at knee during early stance
49
What can a plastic hinge AFO prevent?
- Knee hyperextension
50
Ypsilon AFO
- Provides dorsiflexion assistance in the presence of mild to moderate drop foot
- Promotes free ankle movements, medial, lateral, and rotational movement
51
Ypsilon Contraindication
- Moderated to severe spasticity or edema
52
Floor Reaction AFO
- AFO
| - Provides a knee extension movement in stance without preventing flexion during swing
53
KAFO
- Knee-Ankle-Foot Orthoses
- Double upright design
- Knee Joints - Standard or offset - posterior to midline of the leg
- Ratchet Joints - used to incrementaly increase ROM for contractures needed for knee flexion contractures
54
Gait Training with Bilateral KAFO's
- Begin in parallel bars (weight shifts, both hands to one hand)
- Shift both hands from front to back, then progress to crutches
- May need mirror for feedback
