Practical 2 Flashcards
Indications for DAFO?
Flexible pes planus, mild to moderate spastic diplegic or hemiplegic CP, Hypotonic CP
Contraindications for a DAFO:
Toe walker, mod-high tone, ankle arthritis (rigid foot deformities)
What does a UCBL do?
Controls Mid foot and Hind foot (subtalar and tarsal joints)
Indications for UCBL:
Pronation control, flexible pes planus, OA of the hindfoot, posterior tib dysfunction, tarsal coalition, rearfoot valgus/varus,
Contraindications for UCBL:
Toe walker, mod-high tone, ankle arthritis (rigid foot deformities)
Indications for SMO or SMAFO:
Severe Pes Planus, Mild ankle instability, low (hypo) tone, Intermittent toe walkers, mild to moderate CP, tarsal coalition, post tib dysfunction
Contraindications for SMO or SMAFO:
high tone (hypertonicity) , sagittal plane, weakness deformity, dominate toe walkers, equinovarus/valgus
Contraindications for total contact AFOs:
edema fluctuations, insensitivity, wounds, or scars near trim lines
Bilateral Metal Upright (bars) AFO indications:
Foot drop, Post-Polio, Neuropathic feet Poor knee control in sagittal plane Ankle varus/valgus Foot drop with uncontrolled edema Poor skin below the knee
Bilateral Metal Upright (bars) AFO Contraindications:
Patient’s concerns with bulk/weight
Limits shoe wear
Free motion/articulated/hinge AFO indications:
Posterior tib tendon dysfunction
Subtalar or talar joint instabilities
Free motion/articulated/hinge AFO Contraindications:
Weak Quads, Sagital plane ankle weakness
High impact sports
Free motion/articulated/hinge AFO motion:
Allows sagittal plane motion free DF and PF
Limits coronal plane instabilities
Action of Dorsiflexion assist AFO:
Assist in clearance of the toes while allowing for some PF
Variable DF Assist
Allows for controlled foot flat stance phase
Indications for dorsiflexion assist AFO:
DF weakness
Contraindications for Dorsiflexion assist AFO
Contraindicated in moderate to severe tone levels or in individuals with altered knee control
Posterior Stops in AFO indications:
Structural collapse of the ankle foot, severe spacticity,
Posterior Stops in AFO contraindications:
inadequate hip strength, absent quads, fluctuating edema, fixed/contracted spastic gastrocs
SAFO=Solid Ankle Foot Orthosis=a non articulated AFO indications:
Ankle instability/weakness in more than one plane
Equino varus
Moderate-severe pes plano valgus
Mild-moderate genu recurvatum
SAFO=Solid Ankle Foot Orthosis=a non articulated AFO contraindications:
edema
skin issues
Indications for posterior leaf spring:
Mild –Moderate Foot drop (LMN flaccid paralysis of dorsiflexors) and knee hyperextension
Contraindications for posterior leaf spring:
moderate to severe spasticity, coronal plane ankle instability, ankle dorsiflexion limitations/fused joint, severe knee instability
Action of posterior leaf spring:
Limits plantar flexion to assist limb clearance in swing. Patient has to have adequate knee, hip, and ankle plantar flexor strength
Indication for spiral AFO:
Ankle dorsiflexion weakness and/or plantar flexors ALONG with mild-moderate medial-lateral instability
Contraindications for spiral AFO:
Inadequate hip strength, moderate to severe spasticity, severe medial lateral ankle instability, fluctuating edema
Ground/Floor Reaction AFO indications:
crouched gait, Foot drop with knee instability, quadriceps weakness, MS, Spina Bifida patients
Ground/Floor Reaction AFO contraindications:
Genu recurvatum, ACL, Severely ER Feet, patients that do not have adequate trunk control/balance or have flaccid/limited quad strength especially if used bilaterally
KAFO indicated for:
knee, ankle, and foot instability
Post polio syndrome (PPS), genu recuvatum, weakness proximal to knee,
SCI, CVA, Spina Bifida
quads less than 3+/5
Indications of stance control KAFO:
knee buckling flaccid paralysis of quads
Contraindiacation of stance control KAFO:
contractures of knee/ankle, insufficient hip musculature, DF ROM
