ORTHOTICS

Question 1

Goals of orthotics?

Answer 1

• optimize alignment
• manage comfort/pain
• Optimize functions of the skin
• Optimize the ability to transfer
• Optimize mobility
• Optimize self care
• Optimize domestic life, vocational &/or education abilities
• Optimize participation in any other activity

Question 2

What are the 4 main areas of physical assessment of key findings in this area

Answer 2

Skin
Strength
PROM/AROM
Tone

Question 3

For skin, What are the key finding for a physical assessment?

Answer 3

• Sensation (Need lots of education)
• Integrity
• Edema
• Calluses

Question 4

For strength, What are the key finding for a physical assessment?

Answer 4

• Hip
• knee
• ankle

Question 5

For PROM/AROM, What are the key finding for a physical assessment?

Answer 5

• Hip and knee ROM

- Dorsiflexion

Question 6

For Tone, What are the key finding for a physical assessment?

Answer 6

• Normal, flaccid, or spastic?
• UPN vs LMN
• Muscle imbalances
• Spasticity vs Dystonia vs Hypotonic

Question 7

What are some functional tests for orthoses

Answer 7

• Joint alignment
• Instability/pain
• Contractures/Equinus compensation
• Functional hallux limitus
• Squats/stepping
• Toe/heel raises
• Balance/stork stand
• Forefoot/hindfoot align

Question 8

What are the 5 attributes of normal gait

Answer 8

1. Stability in stance
2. Foot clearance in swing
3. Appropriate swing phase prepositioning
4. Adequate step length
5. Energy conservation

Question 9

What is the systematic approach used for obersvational gait analysis

Answer 9

1. One joint at a time
2. When are deviations (swing vs. stance phase, etc)
3. Sagittal, coronal, or transverse coronal plane problem
4. Use a checklist to systematically break down process

Question 10

Orthotic treatment and design principles?

Answer 10

• Force
• GRF
• Torque
• Friction
• lever arm
• BOS
• COM
• Pressure relief/distribution
• Corrective pressure systems
• Vector realignment/proprioception
• interface and contours
• material choice

Question 11

The 3-point pressure system is to..

Answer 11

resist a movement

Question 12

Why do you want to control where the vector is acting

Answer 12

To manipulate for realignment purposes - if GRF is going behind or infront of knee and the result of this

Question 13

What do the properties of materials influence

Answer 13

• The forces exerted against the body from the ground and device

Question 14

AFO effect on balance

Answer 14

Facilitates static

compromises dynamic

Question 15

What AFO improves both static and dynamic balance and increase WB

Answer 15

Posterior leaf spring

Question 16

What measures are best for static balance? for dynamic?

Answer 16

Single leg stance

TUG

Question 17

Is there good evidence for the effects of AFOs on kids balance

Answer 17

no - poor evidence

Question 18

AFO ___ Gait velocity and functional mobility

Answer 18

improves

Question 19

AFO ___ energy

Answer 19

decrease

Question 20

What is the effect of control over ankle ROM on power generation in stance

Answer 20

impairs

Question 21

What is the evidence for AFO in hemiplegia

Answer 21

Moderate

• Encourage balanced standing
• Provide ankle stability
• Promotes postural alignment
• Maintain ROM at ankle

Question 22

What nerve do FES target

Answer 22

peronal nerve - tib ant and peroneal longus

Question 23

FES during conventional rehab improves… when compared to rehab alone

Answer 23

gait
balance
independence

Question 24

FES decreases

Answer 24

Fall frequency