Orthotics Flashcards
4 factors for making decision for orthosis
-advantages
-disadvantages
-indications it will be useful
-characteristics of individual
What are 3 advantages of orthosis
Improve mobility
Influence tone
Protect limb
What are 3 disadvantages of orthosis
Affect ADL/mobility
Expense
Energy cost
2 important ways to protect skin
-wear socks that cover orthotic
-check brace 20 mins after first wear
5 structures/things to check for skin protection after first wear
-med and lat mall
-1st ray
-calc
-edges of orthotic
-REDNESS on orthotic, don’t wear and see orthotist
What are 3 issues that require orthosis?
-gait deviation
-protection from injury
-muscular adaptation
What gait deviation occurs during swing phase? What type of orthosis would be beneficial?
Drop foot
Leaf spring or DF assist
What 3 gait deviations occurs during stance phase
-ankle instab
-ankle PF wk or neuromuscular fxn
-knee hyperext
What type of orthotic would be beneficial for ankle instability
Solid or hinged AFO
What orthotic would be beneficial for ankle PF weakness
Solid AFO with support strap, hinged
How will an AFO affect STS
Decrease DF
How would an orthotic affect gait
Improve gait mechanics
4 considerations when making a decision for orthotic (criteria etc.)
-stable disease, improve/degen
-6 to 8 hours a day (prolong wear w/o skin damage)
-cosmesis
-consider job and recreation
What 3 stances are critical to consider for orthotic
-mid stance**
-mid swing
-terminal swing**
What are 3 importances for custom-molded orthoses
-impaired sensation
-hypotonicity
-risk of progressive deformity
What is an orthosis constructed around? What does it ensure?
Rectified model of limb
Adequate pressure relief over vulnerable areas
3 types of orthosis materials
-thermoplastic
-custom
-carbon fiber
5 dx/impairments that require AFO
-peripheral neuropathy
-stroke
-CP
-SCI
-head injury
What are the 3 force principles? Where on AFO? KAFO?
Posterior, primary, plantar
Post calf, TC jt, under ball of ft
Post knee, patella tendon, post calc
Equation for pressure
Force/area
How to ensure orthosis is most effective (think forces)
Control direction of primary and direction of counter forces
2 benefits of carbon fiber
Light weight and durable
4 conditions/dx for KAFO
SCI, polio, spina bifida, MD
What are mass manufactured orthosis
Off the shelf, based on shoe size
What are cons for mass manufactured orthosis
-problematic with ft deformity and sensory impairment
-lg calves
-wide/narrow ft
3 benefits of commercial DF assist orthotic designs
-prepositions ft for heel strike in IC
-limited med/lat stab during stance allows tibial advancement during stance
-contributes to push off
What is commercial DF assist orthotic design not used for? Why
CNS issues w/ spasticity, doesn’t control rear foot
What impairment is the leaf spring orthotic used for
Drop foot
3 descriptions of lead spring (make of it)
-shallow trim lines (less support and control)
-mass produced
-dynamic thermal plastic AFO
What does leaf spring assist with
Lower ft during LR, part of first heel/rocker
What does hinged AFO allow (think basic)
Sagittal plane motion
3 main benefits of hinged AFO
-increases mobility in fxnal acts
-allows tibial advancement during stance
-prevents excessive PF
Two types of hinged AFO
Pin type and elastic
What is the main advantage of solid AFO
Resists PF
What are 2 major disadvantages of solid AFO
-interferes with transitions through 3 rockers in stance
-prevents tibial advancement during midstance
What impairments does anterior floor reaction orthosis target
Motor control of knee and weak quads
What does anterior floor reaction orthosis restrict
Why
Tibial translation, ext moment
Stabilizes knee during stance
3 criteria for anterior floor reaction orthosis
-poor ankle support in stance
-minimal DF during swing
-knee flex/collapse during midstance
What does the tone reducing/inhibiting dynamic AFO stabilize
Calc and rearfoot
What two AFO’s are used for LMN/hypotonicity
Tone-inhibiting and articulating ankle (aka hinged)
What two AFOs are used for mod to severe hypertonicity
Posterior leaf spring and carbon graphite
