Orthotics Flashcards
Plagiocephaly
most common
unilateral occipital flattening accompanied w/ torticollis
anterior ear displacement
Brachycephaly
symmetric but disproportionately wide
scaphocephaly
symmetric but disproportionately long
Use of cranial helmets
ideal treatment age 4 months-7 months (not before 3 months or after 18 months)
promote cranial symmetry by directing cranial growth
Total contact on areas to be restricted, space in deficit areas
soft cervical collar
kinesthetic reminder
Orthotic principle of scoliosis braces
3 pt pressure system
Charleston bending orthosis
3 pt pressure system worn at night
What degree of scoliosis are orthotics used?
30-45 deg
risser sign
0-4 scale tellling skeletal maturity
Increased/decreased trim lines
increased - rigidity, control, decreased ROM
decreased - decrased rigidity, less control, more ROM
To control a joint, an orthotic must
cross it
When are custom-fit orthotics good?
when change in status is anticipated
they are not molded to person but they can be adjusted as necessary
UCBL
controls flexible calcaneal deformities & transverse plane deformities of midtarsal joint & coronal plane deformities at subtalar joints
can add external posts
Solid ankle AFO
max stabilization of ankle all 3 planes
helps prevent drop foot
can be used to influence the knee (DF prevents hyperextension, PF prevents flexion)
ex. severe hypertonicity (post stroke) or equinovarus deformity
Anterior floor reaction
ground reaction force used as primary source of sagittal plane knee stability (keeps it in extension so doesn’t buckle)
long & stiff toe lever can help bring knee into extension
GOOD for pts w/ weak quads/crouched gait (influences knee but allows food to stay neutral)
NOT GOOD for pts with knee instability or genu recurvatum
Posterior leaf spring
low trim lines –> ankle flexibility
allows DF but not PF (subs eccentric pre-tib muscles)
GOOD for those with
NOT GOOD for ankle instability med/lat or for those w/ flexible foot deformities
DF assist
spring is compressed at initial contact and resists PF to control lowering foot
recoil assists with DF at preswing/initial swing
subs for eccentric pre-tib muscles
KAFOs
excessive movement of knee in stance that can’t be fixed with AFO
When would you want a non-locking vs. a locking knee?
non-locking: reduce knee hyperextension or mild/moderate varus/valgus
locking: hyperflexion or severe valgus/varus
Semi-rigid cervical collar
3 pt pressure system + kinesthetic reminder
Minerva CTLSO
For stable fracture
Halo
Rigid for all of C-spine upper T-spine
for unstable fracture
SMO
ankle instability
ex. Down’s syndrome/CP
Level of SCI that requires bilateral KAFOs
L2, L3, L4
Crow boot
AFO for charcot joint
SOMI orthosis
for pts with instability above C4 to control flexion
immobilization/3 pt pressure system
Jewett hyperextension orthosis
prevents flexion/anterior compression for pts w/ compression fx
