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 is an Orthosis?
What is an Orthosis?
What does an orthosis do?
improve function
reduce pain and/or deformity
Who is an Orthotist?
Registered health care professional who specialises in the assessment of the whole body for biomechanical problems, and if appropriate may prescribe, measure, fit or review an orthosis
AFO
Ankle Foot Orthosis
Externally applied device which extends from just below the knee, around the ankle and across the sole of the foot
Used for support and/or correction of foot/ankle deformities
Can also have affect on knee
KAFO
Knee Ankle Foot Orthosis
- custom made externally applied device worn on the leg extending from thigh to foot
(commonly referred to as a “calliper”)
HKAFO
Hip Knee Ankle Foot Orthosis
- addition of the hip section provides control to selected hip motions, as well as the leg
- it can also reduce or minimise the risk of the hip moving out of proper position or dislocating
KO
Knee orthosis
Externally applied device worn on the leg extending from mid-thigh to mid-calf
Valgus
Everted position in frontal plane
Varus
Inverted position in frontal plane
Equinus
Plantarflexedposition in sagittal plane
Foot othrosis
A moulded walking base used inside footwear–Insoles and heel cups
Foot Orthosis- Functional Potential
- Re-distribution and reduction of plantar pressures
- Relieve painImprove function
- Prevent structural deformity
- Correct mobile deformity
- Accommodate fixed deformity
- Limit or prevent joint motion
Mobile Deformity
The foot can be manipulated into a “normal” alignment
Foot orthosis to CORRECT deformity
Fixed deformity
The foot cannotbe manipulated into a ‘normal’ alignment
Foot orthosis to ACCOMMODATE deformity
Assessment pathway
- Referral information and relevant patient history
- Physical Assessment
- static and dynamic gait assessment
- aims and objectives of patient and clinician
Footwear
Accommodate foot in a well fitting and protective surrounding Extra care to be taken with insensate foot Soft leather upper Few internal seams Padded tongues and cuffs Lace/Velcro fastening Wide and deep toe box Rocker soles
Name four common footwear adaptions
Raises
Wedges
Flares
Rocker Soles
What does a shoe/heel raise accommodate for?
equinus foot or leg length discrepancy
What does a shoe wedge correct/accommodate for?
fixed varus/valgus foot
Valgus = medial wedge Varus = lateral wedge
What does a shoe flare correct/accommodate for?
increase stability from varus/valgus foot
What does a rocker sole correct/accommodate for?
increase stiffness of sole
increase toe spring
ground reaction point shifted posteriorly
AFO functional potential
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
list the four types of AFO
Solid AFO Posterior leaf spring AFO (PLS) Varus / Valgus control AFO Jointed AFO
AFO –How is it produced?
Assessment of patient’s functional loss Observation of gait Biomechanical assessment of gait deviations Identify functions required of orthosis Plaster wrap cast of patient’s lower leg
How can AFO characteristics can be altered?
Increasing/decreasing medial/lateral trimlines Increasing/decreasing material thickness Changing cross section shape Adding reinforcement/stiffeners Material choice
Functional Potential of a KO
Relieve pain Improve function Prevent structural deformity Correct mobile deformity Limit or prevent joint motion
KO Potential Motion Control
FlexionHyperextensionAnterior/Posterior InstabilityMedial/Lateral InstabilityRotation
Why would you fit a KO?
Osteoarthritis
Post surgical
Ligament injury
Mild Instability
Why must the deformity be mild in order for the knee orthosis to be mild?
short lever arms on the knee
Functional potential of a FAFO
Correction of the musculo-skeletal system Maintenance of position Assist motion about a joint/joints Resist motion about a joint/joints Protection Improve walking speed and cadence Reduce energy expenditure
considerations to determine what type of KAFO
patient age weight activity level occupation goals and expectations
what is a conventional calliper made out of?
what are the cons?
metal and leather
- heavy
- hard wearing
What are cosmetic KAFos made out of?
thermoplastics
- light
durable
improve cosmoses
Describe the two possible materials used for side bars of KAFOs
steel
- hard material
- heavy
- hard wearing
Dural
- aluminium alloy
- soft
- light
list the 7 types of knee joints used in a KAFO
Free Drop locks Manual Drop locks semi automatic locks bale locks polycentric locks spline joints
what is a quad top?
ischial tuberosity rests on a ledge outside the socket
Ischial containment
ischial tuberosity rests within socket
What is the aim of a HKAFO?
name an example
stabilise the hip and lower spine in cases where the patient is weak or paralysed
- Hip guidance orthosis (HGO)- basically a bilateral KAFO liked via specially designed low friction hip joints-allows for reciprocal ambulation
Upper lim orthotics FO HO WHO EO EWHO SO
Finger Orthosis Hand Orthosis Wrist Hand Orthosis Elbow Orthosis Elbow Wrist Hand Orthosis Shoulder Orthosis
Upper limb: Static orthosis
typically WHO
- holds wrist/hand in static position
- prevents movement at specific joints
- used to prevent contracture development
Upper limb: Dynamic orthosis
- springs and moving parts
- holds arm in corrected position while allowing active movement at specific joints
- aids rehab
