Orthotics

Question 1

What is the three-point pressure principle?

Answer 1

forms the mechanical basis for orthotic intervention

• single force at area of deformity
• two more counterforces act in opposing direction

Question 2

What shoe insert can be used to move pressure from met heads to metatarsal shafts? Where would it be placed? Why is this used?

Answer 2

Metatarsal pad:

• placed posterior to met heads
• allows for more pushoff in weak or inflexible feet

Question 3

What insert can be used to relieve strain on plantar fascia during initial heel contact?

Answer 3

cushion heel

Question 4

The anterior stop in an AFO controls what?

Answer 4

amount of DF

Question 5

What stop would be used to control the excessive bucking occurring in a patient’s knee?

Answer 5

posterior stop (PF stop)

Question 6

What stop would be used to control the excessive hyperextension occurring in a patient’s knee?

Answer 6

anterior stop (DF stop)

Question 7

What is a posterior leaf spring AFO primarily used for?

Answer 7

prevent drop foot

Question 8

What is a minerva brace used for?

Answer 8

scoliosis (it’s a CTLSO)

Question 9

What patients might you see using a resting hand splint? What is the hand positioned in?

Answer 9

wrist held in 10-20deg ext
fingers supported
thumb in partial abduction/opposition

*patients with this: RA, carpal bone fracture, colle’s fracture, stroke with paralysis, carpal tunnel syndrome

Question 10

What does the airplane splint position the arm in? What is this used for?

Answer 10

used for burns

- elbow at 90, shoulder 90abd

Question 11

A patient with an AFO demonstrates circumduction during gait. What could be causing this?

Answer 11

1) muscular: weak hip/knee/dorsiflexors, knee hyperextension
2) orthoses issue: excessive PF caused by inadequate stop

* AKA things that make that swing leg TOO LONG*

Question 12

Which of the following would you NOT expect to cause excessive lateral trunk bending in an orthotic?

a) KAFO medial upright too high
b) too much shoe lift
c) hip pain
d) weak/tight abductors on orthotic side
e) short leg
f) poor balance
e) NONE of the above

Answer 12

B) because an INSUFFICIENT shoe lift would cause you to bend to that side, not too MUCH shoe lift

Question 13

T/F: Hyperextension at the knee might be caused by an inadequate dorsiflexion stop.

Answer 13

false, inadequate PF stop

Question 14

T/F: Initial contact toes first might be caused by an inadequate plantarflexor stop.

Answer 14

true

- or inadequate heel lift, short leg, heel pain, extensor spasticity

Question 15

T/F: Weak invertors can cause excessive pronation.

Answer 15

true

Question 16

Why might a patient stand in an abducted stance with a LE orthotic?

Answer 16

knee locked
abductor shortening
decreased balance
sound limb too short (has to prop out on AFO limb)

Question 17

T/F: Inversion sprains of the ankle should be taped in an everted position.

Answer 17

true: want ligaments that are damaged to be lax, not taped into a position where they’re stretched further

Question 18

Your patient with lateral distal met calluses from walking with a supinated foot will benefit from a posting. Where do you put it?

Answer 18

forefoot lateral wedge to offload that lateral side?? says the book or whatever