Orthotics

Question 1

What is the key principle behind orthotic prescription, especially spinal orthotics?

Answer 1

3 point pressure system

Question 2

Extrinsic and intrinsic spinal support systems

Answer 2

ex– muscles

in – ligaments and discs

Question 3

who is a headmaster collar used for

Answer 3

pt with neuromuscular dysfunction

Question 4

who uses a SOMI most often

Answer 4

(sternal occipital mandibular immobilizer)

bed bound patients

Question 5

what spinal orthotic has the most immobilization control?

Answer 5

Halo

Question 6

3 types of LSO

Answer 6

corset/flexible, chairback, and knight

Question 7

What 2 postures can a Knight-Taylor TLOS correct?

Answer 7

Lumbar lordosis and thoracic kyphosis

Question 8

What are the 3 indication for a jewett hyperextension brace

Answer 8

Compression fracture, kyphosis, arthritis

Question 9

What is a CASH brace and who is it used for?

Answer 9

Cruciform Anterior Spinal Hyperextension

Used for geriatric patients – less restrictive and helps reduce kyphotic posture

Question 10

what is a CTLSO?

Answer 10

a TLSO with a cervical extension

Question 11

4 incidations for orthotic for scoliosis

Answer 11

skeletal immaturity, curves between 20-40 degrees, progression, C or S shaped curve

Question 12

accommodative TLSO addresses what?

Answer 12

a fixed deformity

Question 13

what is a progressive TLSO used for? and what is the most common type used

Answer 13

progressive correction of idiopathic spinal curvatures

Boston brace, worn full time

Question 14

when is a milwaukee brace indicated?

Answer 14

when the curve extends into the cervical spine

Question 15

how often is a charleston bending brace worn?

Answer 15

8 hours/day (only at night)

Question 16

3 indications for UE orthotic

Answer 16

trauma, congenital deformity, disease

Question 17

4 main design types for UE orthotic?

Answer 17

static, serial static, static progressive, dynamic

Question 18

what mechanism is most bone to contracture/shortening?

Answer 18

extensor tendon mechanism

Question 19

what is the intrinsic plus position?

Answer 19

MCP flx, PIP/DIP extension,

Question 20

functional hand position

Answer 20

wrist ext 20-30 deg, thumb palmar abduction, MCP 15-20 flx, slight IP flx

Question 21

what is a PRAFO and what are its indication?

Answer 21

Pressure relieving ankle foot orthotic – for contracture prevention and pressure relief

Question 22

what are the three types of orthotics (in how they are formed and fit)

Answer 22

pre-fabricated – off the shelf
custom fit– off the shelf w/ modifications
custom fabricated – individualized molded fit for maximum function

Question 23

what does a ground reaction AFO facilitate

Answer 23

Knee extension

Question 24

who would use a metal upright AFO?

Answer 24

pt with lacking skin integrity or fluctuating edema

Question 25

Spring and Pin placement in dual action training AFO causes what?

Answer 25

Pin in posterioer = PF stop
Pin in anterior = DF stop
Spring in posterior = DF assist

Question 26

weak dorsiflexors results in what gait compensation pattern

Answer 26

steppage gait (due to foot drop)
Use a DF assist (post leaf spring)

Question 27

weak plantar flexors result in what gait? what orthotic considerations should be taken?

Answer 27

lurching gait w/ inability to push off

Use a more rigid foot plate, a longer foot plate, or a DF stop (results in HE of knee and forces use of hip flexors)

Question 28

Weak quads results in what? What orthotic?

Answer 28

HE/locking of the knee and forward flexion of the trunk

Solid ankle AFO (forces knee flexion), KAFO w/ posterior offset knee