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8531 Bringman > Orthotics 2 > Flashcards

Orthotics 2 Flashcards

1
Q

What aspects of force are important to consider with orthotics?

A
  • magnitude
  • direction
  • applied
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2
Q

What can the forces from an orthosis cause for the pt?

A

can be a source of problem and cause skin issues

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3
Q

Things we worry about in the bed: need to take these into account when using an orthotic

A
  • shear
  • pressure
  • friction
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4
Q

decreased sensation: implications on orthotics and PT

A
  • too hard of plastic on malleoli can cause pressure ulcer

- should CONSTANTLY be performing skin checks

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5
Q

What can cause shear in an orthotic?

A

sweaty foot slides while plastic stays in place

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6
Q

friction and orthotics

A
  • any play or wiggle can lead to pistoning

- ex. wearing a shoe that’s too big

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7
Q

What must the pt do if they have an orthosis?

A

must wear shoes!

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8
Q

Why are shoes so important with an orthosis?

A
  • it’s the interface that holds it onto the foot

- can add things just to the shoe

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9
Q

purpose of shoes

A
  • protection
  • support (depending on type)
  • shock absorption
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10
Q

How can shock absorption be modified for gait?

A
  • can change density

- changes timing of initial contact to loading response

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11
Q

parts of a shoe

A
  • sole
  • heel/bottom
  • upper/top
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12
Q

sole function

A
  • shock absorber
  • stability
  • flexibility
  • allows movement
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13
Q

shank function

A
  • increases stability

- decreases flexibility

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14
Q

What are the parts of the upper?

A
  • vamp (toe box)
  • tongue
  • rear quarters
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15
Q

vamp considerations

A
  • width

- how much space do they need (diabetes, peripheral neuropathy, etc.)

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16
Q

vamp: shoe inserts

A
  • inserts make the whole foot rise in the shoe

- toes can come in contact with the toe box

17
Q

tongue function

A

provides closure system

18
Q

long tongue benefits

A
  • easier to get foot in (especially with spasticity

- provides input to great toe » hip flexion

19
Q

tongue: dress shoes

A

may not have them, but instead have tongue area

20
Q

What should you think about with laces?

A
  • What are their deficits?
  • Do they need velcro closures?
  • Curly cue springy laces?
21
Q

Ideal socks for orthotic use

A
  • cotton
  • white
  • proper fit
  • no toe seam
  • no wrinkles
  • prevent pistoning
22
Q

socks: why cotton?

A

absorb moisture away from the body

23
Q

socks: why white?

A
  • neuro issues to LE

- will be able to see an open wound if it bleeds

24
Q

socks: fit

A
  • not too long or too short

- not too tight around ankle to decrease blood flow

25
Q

socks: Why are wrinkles problematic?

A

If doubled over, more pressure created over that point

26
Q

socks: How do you prevent pistoning?

A
  • ideal to have sock as high as the AFO

- decreases skin contact with plastic

27
Q

If leg length discrepancy is less than ____, can use a heel lift inside the shoe

A

3/8 inch

28
Q

If the leg length discrepancy is _____, can’t use a heel lift in the shoe

A

1/2 inch

29
Q

What is done for a leg length discrepancy of 1/2 inch or more?

A
  • stacked shoes

- either fix the shoe or walk with gait deviation

30
Q

How does gait change with leg length discrepancy?

A

toe contact instead of heel contact at initial contact

31
Q

wedge categories

A
  • heel wedge
  • rearfoot
  • forefoot
32
Q

What does a heel wedge do?

A
  • raises calcaneus

- causes increased knee flexion

33
Q

What can a heel wedge correct and how?

A
  • hyperextension

- changes GRF

34
Q

Two types of deformities are fixed or flexible:

A
  • varus

- valgus

35
Q

What does a rearfoot medial wedge do?

A
  • corrects a flexible valgus deformity

- accommodates a fixed varus deformity

36
Q

Where is a rearfoot medial wedge placed? How does it work?

A
  • at back of shoe
  • creates varus moment to get rearfoot to neutral
  • fills space to keep in anatomical alignment
37
Q

What does a rearfoot lateral wedge do?

A
  • corrects a flexible varus deformity

- accommodates a fixed valgus deformity

38
Q

What does a forefoot medial wedge do?

A
  • corrects a flexible valgus deformity

- accommodates a fixed varus deformity

39
Q

What does a forefoot lateral wedge do?

A
  • corrects a flexible varus deformity

- accommodates a fixed valgus deformity

8531 Bringman (43 decks)

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