Orthotics Flashcards
what is orthotics
the science that deals with the use of specialised mechanical devices to support or supplement weakened or abnormal joints or limbs
what can an orthosis do
improve function
reduce pain
and/or prevent deformity
definition for valgus, varus and equinus
valgus - everted position in frontal plane
varus - inverted position in frontal plane
equinus - plantarflexed position in sagittal plane
features of foot orthosis and examples
moulded walking base used inside footwear
e.g. insoles and heel cups
what does a foot orthosis do
Re-distribution and reduction of plantar pressures
Relieve pain
Improve function
Prevent structural deformity
Correct mobile deformity Accommodate fixed deformity Limit or prevent joint motion
difference between mobile and fixed deformity
mobile
- foot can be manipulated into normal alignment
fixed
- foot cannot be manipulated into normal alignment
difference between mobile and fixed deformity foot orthosis
mobile
- foot orthosis to correct deformity
fixed
- foot orthosis to accommodate deformity
what is part of the physical assessment of a patient referred to the clinic
ROM, Muscle Powers, Sensation, Proprioception,
Circulation, Muscle Tone
how is valgus deformity dealt with
to correct
- Manipulate corrected position and hold foot by applying 3 point forces
- e.g. medial wedge on insole
to accommodate
- Accept foot position and accommodate to
achieve greater stability
- e.g. lateral wedge on insole
how is varus deformity dealt with
to correct
- Manipulate corrected position and hold foot by applying 3 point forces
- e.g. lateral wedge on insole
to accommodate
- Accept foot position and accommodate to
achieve greater stability
- e.g. medial wedge on insole
how is equinus deformity dealt with
Correct – Manipulate corrected position and hold foot by applying 3 point forces
(ensure knee is not made unstable)
Accommodate – Accept foot position and accommodate to achieve greater stability
- e.g. heel raise (ensures knee is not unstable)
if a heel raise is used to accommodate an equinus deformity what may also need to be done
Compensatory heel raise in contralateral shoe may be required
Knee hyperextension can occur if the equinus is not adequately accommodated
what are examples of features of a shoe that are good with orthotics
Soft leather upper
Few internal seams
Padded tongues and cuffs Lace/Velcro fastening
Wide and deep toe box Rocker soles
what are footwear adaptations
raises
wedges
flares
rocker soles
what is the function of shoe/heel raise
To accommodate fixed equinus foot or leg length discrepancy
what is the function of shoe wedges
To correct mobile or accommodate fixed varus/valgus foot
Can be added externally or internally in the heel and sole
what is the function of shoe flares
To increase stability from a varus/valgus foot
what is the function of rocker sole
Increase stiffness of sole
Increase toe spring
Ground reaction point shifted posteriorly
what is an AFO
ankle foot orthosis
Externally applied device which extends from just below the knee, around the ankle and across the sole of the foot
what can an AFO be used for
Correction of the musculo-skeletal system Maintenance of position
Assist motion about a joint
Resist motion about a joint
Protection
Improve walking speed and cadence
Reduce energy expenditure
how can an AFO mechanical characteristics be altered
Increasing/decreasing medial/lateral trimlines
Increasing/decreasing material thickness
Changing cross section shape
Adding reinforcement/stiffeners
Material choice
what will altering the heel height of shoes influence
the GRF around the knee
can also increase or decrease stability
what are knee orthosis
Externally applied device worn on the leg extending from mid-thigh to mid-calf
functional potential of knee orthosis
Relieve pain
Improve function
Prevent structural deformity
Correct mobile deformity
Limit or prevent joint motion
common reasons for knee orthosis fittings
OA
Post surgery
Ligament injury
Mild instability
what is KAFO
Knee Ankle Foot Orthosis
a.k.a Calliper
how are cosmetic KAFO designed
Light in weight
Durable
Improved cosmesis
Typically made from thermoplastic
Side bars made from Aluminium Alloy (soft and light)
how do drop locks work
manual drop locks
When knee is in extension, gravity causes a ring to drop and joint to lock
(manual drop locks - knee is in extension, a ring needs to be moved by hand to lock)
what are semi automatic lock and bale locks
Semi- Auto
When knee is in extension, the
spring activates a ring to
lock
Bale
- Bar or cord activated ring lock joint
what are polycentric lock and spline locks
polycentric lock
- more than one joint centre
spline locks
- Incremented joint to allow fixed setting
(can be used in contracture Mx)
how does KAFO weight bear
requires to take the body weight through the side bars, reducing weight through the leg
what is a HKAFO
Hip Knee Ankle Foot Orthosis
- Basically a KAFO with the addition of a hip joint and pelvic band
- reduces the risk of hip dislocation
what is the aim of a HKAFO and an example of one
aim to stabilise the hip and lower spine in cases where the patient is weak or paralysed
HGO = hip guidance orthosis
what does HGO consist of
bilateral KAFOs linked via specially designed low friction hip joints
Used in conjunction with crutches the HGO allows reciprocal ambulation
Spinal support, instead of a simple pelvic, band can be used where greater trunk stability is required
what are WHO and what does it do
Wrist Hand Orthosis
holds wrist/hand in static position
prevents movement at specific joints
used to prevent contracture development
what are dynamic arthosis
Orthosis has springs and moving components
Holds arm in corrected position while allowing active movement at specific joints
Aids rehabilitation
