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Orthotics Flashcards

1
Q

What is orthotics?

A

The science that deals with the use of specialised mechanical devices to support or supplement weakened or abnormal joints or limbs

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2
Q

What is an orthosis?

A

An externally applied device (may also be called a brace, splint or orthotic)

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3
Q

Who is an orthotist?

A

A registered health care professiona who specialises in the assessment of the whole body for biomechanical problems and if appropriate may prescribe, measure, fit or review an orthosis

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4
Q

List the 6 types of lower limb orthotic

A 
Foot orthosis 
Footwear
AFO - Ankle Foot Orthosis 
KO - Knee Orthosis 
KAFO - Knee Ankle Foot Orthosis 
HKAFO - Hip Knee Ankle Foot Orthosis
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5
Q

What is a valgus deformity?

A

Everted position in the frontal plane

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6
Q

What is a varus deformity?

A

Inverted position in the frontal plane

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7
Q

What is an equinus deformity?

A

Plantarflexed position in sagittal plane

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8
Q

What is a foot orthosis?

A

A moulded walking base used inside footwear (insoles and heel cups)

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9
Q

What can foot orthoses be used for?

A 
Re-distribution and reduction of plantar pressure 
Relieve pain 
Improve function 
Prevent structural deformity 
Correct mobile deformity 
Accommodate fixed deformity 
Limit or prevent joint motion
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10
Q

What is a mobile foot deformity?

A

The foot can be manipulated into a ‘normal’ alignment

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11
Q

What is a fixed foot deformity?

A

The foot cannot be manipulated into a ‘normal’ alignment

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12
Q

How does the use of foot orthoses differ in mobile or fixed deformity?

A 
Mobile = foot orthosis to CORRECT deformity 
Fixed = foot orthosis to ACCOMMODATE deformity
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13
Q

What is involved in the physical assessment before prescribing an orthotic?

A 
ROM 
Muscle Powers 
Sensation 
Proprioception 
Circulation 
Muscle tone
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14
Q

How does a foot orthosis correct a valgus deformity?

A

Manipulate corrected position and hold foot by applying 3 point forces - MEDIAL wedge on insole or footwear

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15
Q

How does a foot orthosis accommodate a valgus deformity?

A

Accept foot position and accommodate to achieve greater stability - LATERAL wedge on insole or footwear

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16
Q

How does a foot orthosis correct a varus deformity?

A

Manipulate corrected position and hold foot by applying 3 point forces - LATERAL wedge on insole or footwear

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17
Q

How does a foot orthosis accommodate a varus deformity?

A

Accept foot position and accommodate to achieve greater stability - MEDIAL wedge on insole or footwear

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18
Q

What is an equinus deformity?

A

Plantarflexed position in the sagittal plane

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19
Q

How is an equinus deformity corrected with foot orthoses?

A

Manipulate corrected position and hold foot by applying 3 point forces

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20
Q

Is equinus normally a fixed or mobile deformity?

A

Fixed

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21
Q

What is it important to ensure when fixing an equinus deformity with a foot orthossi?

A

Ensure knee is not made unstable (can cause hyperextension)

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22
Q

How is an equinus deformity accomodated with foor orthoses?

A

Heel raise - following the contour of the foot and ensurring the knee is nto made unstable

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23
Q

What can happen if the equinus is not adequately accomodated?

A

Knee hyperextension

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24
Q

What additional treatment may be required alongside equinus foot orthosis?

A

Compensatory heel raise in contralateral shoe

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25
What footwear design features are good for an insensate foot?
``` Soft leather upper Few internal seams Padded tongues and cuffs Lace/velcro fastening Wide and deep toe box Rocker soles ```
26
Name 4 ways in which footwear can be adapted
Raises Wedges Flares Rocker soles
27
What is the purpose of a shoe/heel raise?
To accommodate fixed equinus foot or leg length discrepancy
28
What are the purposes of shoe wedges?
Correct mobile or accommodaye fixed varus/valgus foot
29
How can shoe wedges be fitted?
Can be added externally or internally in the heel and sole
30
What is the purpose of a shoe flare?
To increase stability from a varus/valgus foot
31
What effects does a rocker sole have on footwear?
Increase stiffness of sole Increase toe spring Ground reaction point shifted posteriorly
32
What is an AFO?
Externally applied device which extends from just below the knee, around the ankle and across the sole of the foot
33
What is an AFO used for?
Used for support and/or correction of foot/ankle deformities (can also have effect on knee)
34
What are the functional potential of an AFO?
``` Correction of the MSK system Maintenance of position Assist motion about a joint Resist motion about a joint Protection Improve walking speed and cadence Reduce energy expenditure ```
35
What are the 4 types of AFO?
Solid AFO Posterior leaf spring AFO (PLS) Varus/Valgus control AFO Jointed AFO
36
How is an AFO produced?
``` Assessment of patients functional loss Observation of gait Biomechanical assessment of gait deviations Identify functions required of orthosis Plaster wrap cast of patient's lower leg ```
37
Mechanically, how can the characteristics of an AFO be altered?
``` Increasing/decreasing medial/lateral trimlines Increasing/decreasing material thickness Changing cross-sec shape Adding reinforcements/stiffeners Material choice ```
38
What is the trimline of an AFO?
Border of the orthosis
39
Why must heel height be assessed?
Altering the heel height of shoes will influence the GRF around the knee and can increase or decrease stability
40
What is a knee orthosis?
Externally applied device worn on the leg extending from mid -thigh to mid-calf
41
What are the functional potentials of knee orthoses?
``` Relieve pain Improve function Prevent structural deformity Correct mobile deformity Limit or prevent joint motion ```
42
What motions can be controlled by a knee orthosis?
``` Flexion Hyperextension Anterior/Posterior instability Medial/Lateral instability Rotation ```
43
List 4 common reasons for fitting a knee orthosis
OA Post-surgical Ligament injury Mild instability
44
How many forces are required for knee orthosis use?
3
45
Why do knee orthoses only work for mild correctable deformities?
Due to the short lever arms on a knee orthosis
46
What is a KAFO (Knee Ankle Foot Orthosis) commonly referred to as?
A 'calliper'
47
What is a KAFO?
Custom made externally applied device worn on the leg extending from thigh to foot - used for support and/or correction of knee/ankle/foot deformities
48
What are the functional potentials of a KAFO?
``` Correction of the MSK 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 ```
49
What factors should be considered when choosing what type of KAFO?
``` Patient age, weight, activity level General health Occupation Lower limb function Goals and expectations Upper limb function ```
50
What is a conventional KAFO made from? What are the pros/cons?
'Calliper' typically made from metal and leather Heavy in weight Hard wearing
51
What is a cosmetic KAFO made from? Why are these good?
Typically made from thermoplastic Light in weight Durable Improved cosmesis
52
What 2 materials can side bars be made from?
Steel - hard material - heavy - hard weaing Dural - aluminium alloy - softer material - light weight
53
What is a drop locked knee brace?
When the knee is in extension, gravity causes a ring to drop and joint to lock
54
What is a manual drop lock knee brace?
When knee is in extension, a ring needs to be moved by hand to lock
55
What is a semi automatic lock knee brace?
When knee is in extension, the spring activates a ring to lock
56
What is a bale lock knee brace?
Bar or cord activated ring lock joint
57
What is a polycentric knee lock brace?
More than one joint centre
58
What is a spline lock knee brace?
Incremented joint to allow fixed setting - can be used in contracture management
59
Describe weight bearing in a KAFO?
KAFO requires to take body weight through the side bars, reducing weight through the leg
60
What is a quad top?
Ischial tuberosity rests on a ledge outside the socket
61
What is ischial containment?
Ischial tuberosity rests within socket
62
What is a HKAFO (Hip Knee Ankle Foot Orthosis)?
Basically a KAFO with the addition of a hip joint and pelvic band (provides control to selected hip motions as well as the leg)
63
What is the advantage of a HKAFO over a KAFO?
Can reduce or minimise the risk of the hip moving out of proper position or dislocating
64
What is the aim of HKAFO?
To stabilise the hip and lower spine in cases where the patient is weak or paralysed
65
Describe an example of a HKAFO
Hip guidance orthosis (HGO) HGO consist of bilateral KAFOs linked via specially designed low friction hip joint Used in conjunction with crutches the HGO allows reciprocal ambulation
66
What can be used alongside a HKAFO when greater trunk stability is required?
Spinal support instead of a simple pelvic band
67
Which is more common, upper or lower limb orthotics?
Lower limb
68
Name 6 examples of upper limb orthotics
``` Finger orthosis Hand orthosis WHO - Wrist Hand Orthosis Elbow Orthosis EWHO - Elbow Wrist Hand Orthosis Should Orthosis ```
69
Describe an upper limb static orthosis
Typically a WHO Holds wrist/hand in static position Prevents movement at specific joints Used to prevent contracture development
70
Describe an upper limb dynamic orthosis
Has springs and moving components Holds arm in corrected position while allowing active movement at specific joints Aids rehab

AY BMSc Lectures (8 decks)

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