Orthotics PT Perspective Flashcards
Shoe - what is important to consider
Need a deep toe box
Lacing - need to be able to open shoe enough to get orthotic in
Advantages of plastic vs. metal
lighter weight
can be more flexible
cosmesis
Disadvantages to plastic vs. metal
May not last as long
Fits closer to skin so need to be careful with breakdown
Weight gain or edema - need to be careful
Children and growth
Advantages of metal vs. plastic
Sturdy, more durable
More accomodative to edema
Disadvantages to metal vs. plastic
bulky
heavier
Posterior leaf spring AFO - need to be careful with
trim lines - thin so break easily
Usually don’t give someone an over the counter for permanent use
Klenzak does what
DF assist/PF stop
Pawl and bail lock vs. drop ring lock
Pawl or Bail - you don’t have to do it manually
Drop ring - need to manually do it, at least for the keeper
Craig Scott KAFO - set in
DF, anterior tibial band and no knee cap
Craig Scott KAFO - allows for
increased stability in ambulatory patients with SCI
Pts will use swing to or swing through gait pattern
THKAFO - parpodium often used for
kids with spina bifida to allow them to ambulate in classroom or home setting
Also allows them to stand at an earlier age
THKAFO - Reciprocal Gait Orthotic (RGO)
When you shift weight to one side, the cable will flex the hip to bring it forward and then keep reciprocating
Cant do what with RGO
stairs or curbs!
very bulky under clothes
HKAFO - typically put who in this one
paraplegics
maybe with crutches
this allows them control at the hip
THKAFO - who is typically put in this
cervical lesions - not very functional though
Also seen with spina bifida
Moved to doing what for paraplegics
AFOs with walkers - so that they can have reciprocal gait pattern
Orthotic checkout - what do you want to do first
just look at the orthotic itself - check the straps, check the inside, run hands along trim lines, check the joints for the motion or lack of that you wanted
Orthotic checkout - step after inspecting the orthotic itself
look at the patient and at their skin
Orthotic checkout - put the orthotic on and then what
what position are you in
In sitting, recheck the fit - go along the trim lines again, check fibular head space, run fingers along it and feel for space, look at joints
Orthotic checkout - after looking at orthotic on foot in sitting, do what?
Put the shoe on and make sure that it fits appropriately in there
Have them stand up and put weight through it
Check the toes and squeeze around the foot
What do we do for an orthotic checkout after checking the orthotic on the foot in the shoe
Have them ambulate with it and see how it functions
Amount of wear
depends on patient
inpatient maybe try 2 or 3 times of walking about 75 ft or whatever their comfortable distance is
If redness persists ___ ___ then you are calling the orthotist for adaptations to be made
20 minutes
Role of PT
Calcaneal alignment Navicular control Wearing time Skin condition OTC orthotics Medications Donning/Doffing NDT orthotics Fabrication of foot plates
PT role in prescribing orthotic
Deciding if we think we need an orthotic or not and what type of orthotic you want
MD will write the Rx for it PT gets in touch with the orthotist and then they will come cast, fit, and deliver it
