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Special Clientele > Orthotics > Flashcards

Orthotics Flashcards

1
Q

Orthotics

A
  • Use of specialized mechanical devices to support or supplement weakened or abnormal joints or limbs
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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
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3
Q

Pressure

A
  • force divided by surface area

ie: pounds per square inch

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4
Q

How to decrease pressure?

A
  • Decrease force
  • Increase area
  • Increase lever arm: increase distance from axis of motion to pressure pad
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5
Q

Purpose of Orthotics

A
  1. Hold
  2. Assist
  3. Resist
  4. Support
  5. Stop
  6. Reduce Axial Loading
  7. Combinations of all above functions
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6
Q

Hold “purpose”

A
  • Prevent all motion
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7
Q

Assist “purpose”

A
  • Facilitate movement in a specific direction
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8
Q

Resist “purpose”

A
  • Inhibit movement in a specific direction
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9
Q

Support “purpose”

A
  • Allow for protective movement
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10
Q

Stop “purpose”

A
  • Allow movement within a pre-defined, limited ROM
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11
Q

Reduce Axial Loading “purpose”

A
  • Force acting along the lines of an object expressed in compression or tension
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12
Q

Pedorthics

A
  • Design and fitting of foot orthoses
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13
Q

Shoes “Pedorthics”

A
  • Extra depth shoe
  • Healing Shoe
  • Orthopedic Shoe
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14
Q

Extra Depth Shoe

A
  • Upper contour with additoinal vertical space

- Allows for insertion of orthotics

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15
Q

Healing Shoe

A
  • For any situation that requires a pressure offload of the forefoot
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16
Q

Orthopedic Shoe

A
  • Provides support - reinforcements

- 4 Types (Steel Shank, Reinforced Heel Counter, Solid Heel, Low Resilient Heel)

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17
Q

Steel Shank

A
  • Ortho Shoe

- Longitudinal plate that reinforces the sole

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18
Q

Reinforced Heel Counter

A
  • Ortho Shoe

- Stiffens the quarter, posterior shoe

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19
Q

Solid Heel

A
  • Ortho Shoe

- Higher heel reduces tension on the achilles tendon when firm

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20
Q

Low Resilient Heel

A
  • Permits slight planter flexion in those with limitations in the ankle
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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
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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
Q

Metatarsal Pad

A
  • Internal
  • Restricts forefoot abduction
  • Transfers stress from metatarsal heads to metatarsal shafts
26
Q

What is effective in reducing plantar pressure?

A
  • Metatarsal Pad
27
Q

Heel Pad or Lift

A
  • Internal
  • Soft, with or without cutout for heel spur
  • Cushions with concave relief to reduce pressure
28
Q

External Shoe modicfications

A
  • Will erode
  • Client limited to wearing the shoe
  • Heel Wedge
  • Metatarsal Bar
  • Rocker Sole
  • Built Up Heel and/or sole
29
Q

Heel Wedge

A
  • External
  • alters alignment of calcaneous
  • Medial Wedge
  • Thomas Heel
  • Lateral Wedge
30
Q

Medial Wedge

A
  • Heel Wedge
  • Lateral Directed force
  • aids in realigning by filing void between sole and floor on medial side
31
Q

Thomas Heel

A
  • Heel Wedge

- Medial wedge with anterior extension for additional support

32
Q

Lateral Wedge

A
  • Heel Wege

- Shifts weight bearing to medial side of front of foot

33
Q

Metatarsal Bar

A
  • External
  • Placed posterior to the metatarsal heads to shift weight to the shafts at late stance, the bar transfers stress to shafts
34
Q

Rocker Sole

A
  • External
  • Shifts weight to metatarsal shafts and reduces MTP extension during pushoff
  • Facilitates roll-over and toe off when ankle dorsiflexion is limited
35
Q

AFO

A
  • 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
Q

Double Upright with TStrap

A
  • AFO
  • Provides the greatest support and adjustability
  • Single or Double spring/stops (anterior/posterior)
37
Q

Anterior Stop

A
  • Limits Dorsiflexion
38
Q

Anterior Spring

A
  • Assists Plantar Flexion
39
Q

Posterior Stop

A
  • Limits Plantar Flexion
40
Q

Posterior Spring

A
  • Assists Dorsiflexion
41
Q

Varas Deformity (T-Strap)

A
  • Strap goes around the medial upright portion
42
Q

Valgus Deformity (T-Strap)

A
  • Strap goes around the later upright portion
43
Q

Indications for Double Upright with T-Strap

A
  • Foot drop
  • Poor Knee control in sagittal plane
  • Ankle Varus/Valgus
  • Foot drop with uncontrolled edema
  • Poor skin below knee
44
Q

Posterior Leaf Spring

A
  • AFO
  • For weakness that causes toe dragging
  • Plastic, lightweight, wear with regular shoes
45
Q

Solid Plastic

A
  • AFO

- Limits all foot and ankle motion

46
Q

Toe OFF-AFO

A
  • 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
Q

Toe OFF-AFO contraindication

A
  • with moderate to severe spasticity or edem
48
Q

Plastic Hinged AFO (Steel Posterior Step)

A
  • AFO
  • Prevents to drag and is plantar flexion resistant
  • imposes a flexion force at knee during early stance
49
Q

What can a plastic hinge AFO prevent?

A
  • Knee hyperextension
50
Q

Ypsilon AFO

A
  • Provides dorsiflexion assistance in the presence of mild to moderate drop foot
  • Promotes free ankle movements, medial, lateral, and rotational movement
51
Q

Ypsilon Contraindication

A
  • Moderated to severe spasticity or edema
52
Q

Floor Reaction AFO

A
  • AFO

- Provides a knee extension movement in stance without preventing flexion during swing

53
Q

KAFO

A
  • 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
Q

Gait Training with Bilateral KAFO’s

A
  • 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

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