Orthotics Flashcards
“P.T.G”
Patient / Task / Goal
OR
“Prioritize the goals”
What is this measuring?
Ankle Angle
What is this measuring?
Shank to Vertical Angle
T or F: If a patient is lacking DF, you should set the Ankle Angle to neutral.
F
Do not set AA to neutral if pt does not have the ROM range
What are the two basic categories of AFOs?
Non-Articulating / Solid
Articulating (w/ joints)
What are the “tasks” associated with an Ambulatory AFO?
5 Attributes of Ambulation
What are the “tasks” associated with a Non-Ambulatory AFO?
Contracture management
Wound healing / protection / prevention
Positioning
Application of a force within an orthosis may help to ___.
Resist motion
Assist motion
Transfer force
Protect a body part
What is an example of an orthosis that serves to resist motion?
Quad paralysis
KAFO with mechanical lock
Stabilizes knee - prevents knee flexion at IC and limits it during LR
What are some examples of orthoses that serves to improve alignment?
Pavlik Harness (DHD)
Hip orthosis to keep femoral head in Acetabulum (Legg-Calve-Perthes Disease)
Cranial shaping orthosis
WHO to minimize ulnar deviation (RA pt)
What are some examples of orthoses that serve to assist motion?
Peroneal Nerve Injury - prevent foot drop or toe drag
Gastroc stretch - nighttime orthoses
What is an example of an orthosis that serves to transfer force?
FO that includes pad underneath metatarsal shafts
Shifts force from painful metatarsal heads (pt with metatarsalgia) to less sensitive shafts
Do NOT put on a nighttime AFO in a way that ___.
elicits an intense stretch
In what two ways can you improve patient’s comfort in an orthosis?
Maximize area covered by orthosis (minimizes pressure)
Lengthen longitudinal element of an orthosis (provide sufficient leverage)
What is the common Pressure System for most orthoses?
3-Point Force System
Principal force acting in one direction and two counter-forces acting in the opposite direction
What orthotic device exerts a Four-Point Pressure System?
Thoracic Hip Knee Ankle Foot Orthosis (THKAFO)
What orthotic devices do NOT apply a Three-Point Pressure System and instead surround the body segment to apply a circumferential or total contact pressure?
Elastic sleeve (burn pt)
Sure Step SMO
Sensory Dynamic Pressure Garment
Theratogs
What are some common compensations in the gait of children with hemiplegia?
Hemi-pelvis retraction
Increased push-off on unaffected side
Early firing of fibularis longus
What are some OMs used in the context of Hemipolymicroglia?
Gait Deviation Index (GDI)
Salfort Gait Tool (SF-GT)
Visual Gait Assessment
GMFM
Midfoot “Break”
DF coming from midfoot rather than TCJ
Surestep SMOs are designed for children with ___ ___.
Down Syndrome
Surestep SMOs are designed to address a STJ issue in which plane?
Frontal (Coronal)
How does a Surestep SMO differ from that of a typical SMO?
Wrap around design
Shorter toe-plate and trimlines
Designed to promote / improve high level activities (jumping) and subtalar joint alignment
What orthotic is this?
SMO w/ a PLS extension
SMOs w/ PLS extensions are designed for who?
Sagittal plane Talocrural Joint issues and coronal Subtalar Joint issues
ITW / Spastic Hemiplegic CP (GMFCS Level II)
Label 1 / 2 / 3
1: Solid Ankle trimlines
2: Semi-Solid Ankle trimlines
3: PLS trimlines
A Ground Floor Reaction AFO is designed for patients with ___. What does it do?
Duchenne Muscular Dystrophy
Provides knee extension moment during ambulation
What kind of orthotic is this?
Posterior Entry AFO
Spinal Muscular Atrophy
Inherited (vs. DMD which is often not)
Gene disruption
Characterized by degeneration of anterior horn cells / muscle atrophy / widespread weakness / absent DTRs
Spinal Muscular Atrophy Classifications
Type 1: Most severe / most common / manifests before 6 months / death typically by 2 years of age
Type 2: Onset between 7 and 18 months / may live into adulthood with proper treatment and monitoring of pulmonary function
Type 3: Mildest / onset after 18 months / children may walk independently or with AD into late adolescence or early adulthood
All 3 types of SMA are characterized by:
Significant limb and trunk weakness
Muscle atrophy (more pronounced in proximal muscles and LEs)
Hypotonia and Areflexia
Progressive MSK issues
T or F: Scoliosis is associated with both DMD and SMA.
T
What kind of orthotic is this?
Multi-Podus or Pressure Relieving AFO (PRAFO)
This is a resting / non-ambulatory AFO
Articulating AFOs have a joint that ___ motion.
allows
What kind of joint is this?
Overlap
What kind of joint is this?
Tamarack
What kind of joint is this?
Oklahoma
