Orthotics SMO, IMO, AFO Flashcards
What motions does an SMO control
Probation, Supination, and plantar flexion*
Forces acting to control Supination with an SMO
Primary: L-M at the talus
Secondary: M-L at the medial malleoli/Superior timeline
Secondary: M-L at the 1st met head from shoe/Orthotic
Forces acting to control Pronation with a SMO
Primary: M-L at the talus
Secondary: L-M at the lateral malleoli
Secondary: L-M at the 5th met head
Forces controlling Supination at using an IMO
Primary: L-M at the talus
Secondary: M-L at the Calcaneus
Secondary: M-L at the 1st met head from shoe/Orthotic
Forces acting to control Pronation with a IMO
Primary: M-L at the talus
Secondary: L-M at the Calcaneus
Secondary: L-M at the 5th met head
When is a SMO recommended
When medial to lateral is not adequently controlled or PF needs controlling
How can an SMO control PF
If it has a heel back it controls PF similar to an AFO
Proper alignment of an SMO.
Post, late, med, ant
Posterior: Heel cup is vertical or slight virus
Lateral View: Hindfoot, midfoot, and forefoot are in neutral
Superior View: Forefront is neutral and bisecting heel. Line should pass between 2nd and 3rd met
Anterior: All metatarsal heads are level
What will a SMO for a flexible deformity look like
Will be aligned to neutral
What will a SMO for a rigid deformity look like
Not aligned to neutral but to the most optimal alignment possible in regards to the deformity
What is an indication for a full foot plate
Pt has no active toe extension
Toe Clawing
Benefit of a semi-rigid or flexible foot plate
Use for ambulation because it allows the mets to break
Indication for a rigid foot plate
Foot amputees, presence of a toe filler, they are not able to stand with neutral foot alignment
Where does a partial foot plate end and why use it
Proximal or at the met heads. If the patient can actively extend the toes for food swing in the gait phase
IMO vs shoe mods
IMO is closer to the anatomical shape of a foot
IMO is interchangeable that can be placed in multiple shoes
What are some functions of the foot and ankle
Shock absorber
Push of for gait
Mobility
Stability
Which side is structurally designed for mobility and which side for mobility
Medial side: Mobility
Lateral side: stability
Which motions are most favored at the Talocural joint
PF and DF
Which motions are favored at the subtalar joint
Inversion and Eversion
What motions occur at each joint for pronation of the foot
TC: DF
Subtler: Everson
Midtarsal: DF
Tarsal/Metatarsal: Forefoot abduction
What motions occur at each joint for Supination of the foot
TC: PF
Subtler: Inversion
Midtarsal: PF
Tarsal/metatarsal: Abdduction
What is occurring up the kinematic chain with foot pronation
Hip: Flexion, Abduction, IR
Tibia: IR
Knee Flex, valgus
Lumbar spine: extension
What is occurring up the kinematic chain with foot Supination
Tib: ER
Knee: Extends and Varus
Hip: Adduction, ER, Extended
Lumbar flexed
How can a shoe act as an Orthotics
Provides stability, alignment, and a shock absorber.
What are AFO’s made from
Plastic
Metal
Hybrid
What are the types of plastic foot Orthotics
SAFO: solid foot Orthotics
HAFO: hinged foot Orthotic.
(AAFO: articulated)
What is the purpose of a Posterior leaf spring Orthotics
Will act as a DF assist
Will not control any other motions
What is the purpose of a spiral Orthotics
Has a Dorsi flexion assist
Why use a metal AFO
Advised to use when pt weight fluxuates or there is edema
What motions does a SAFO control
PF, DF, Probation, Supination
Forces to control Plantar flexion in AFO
Primary: Posterior inferior direction coming from the top/tongue of shoe
Secondary: Going anteriorly from the posterior portion of the superior timeline of the Orthotic
Secondary: Going superiorly from the inferior surface of the Orthotics applied at the met heads
Forces to control DF in AFO
Primary: Superior and anterior applied from the heel of shoe/Orthosis
Secondary: Going post applied at the anterior superior Orthotics band
Secondary: Going inf applied at the met heads from the toe box of the shoe
What does a media flange do
Prevents pronation of the foot by controlling IR of the tibia on the talus
What does a lateral flange do
Prevents Supination by controlling ER of the tibia on the talus
What is the benefit of a hinged AFO
Allows varying degrees of movement at the ankle
What is a prerequisite for prescribing a HAFO to a patient
They must demonstrate fair hip and trunk control and emerging control at the knee
When prescribe a free ankle joint Orthosis
Pt with polio with intact mm’s but compromised hip or knee control
When prescribe posterior stop on a AFO
To limit plantar flexion for a pt who can’t clear toes in swing phase of gait
When prescribe a anterior stop on a AFO
When a person walks with a crouched (Knees flexed gait)
When prescribe a spring loaded DF assist Orthosis
DF facilitation needed at initial swing
When is a spring loaded AFO contraindicated
With spasticity
When to prescribe a spring loaded DF-PF assist AFO
To assist with both DF and PF in gait cycle
How to name Orthotics
Identify right or left Material: Plastic/metal/hybrid Name: SAFA Motions controlled and joint Additional features
