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Orthotics > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

which type of orthotic plastic can be reheated?

A

thermoplastics

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2
Q

what type of plastic can NOT be reheated?

A

thermosetting

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3
Q

what is considered when designing an orthotic?

A 
comfort
cosmesis
sensation
durability
weight
cost
ease of donning/doffing
size and contour
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4
Q

how is bending moment determined

A

by the location and magnitude of the sheer forces

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5
Q

how are shear forces controlled

A

by strap location, strap tightness and width of the straps

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6
Q

the longer the orthosis……

A

the greater the leverage

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7
Q

what are the disadvantages of orthotics

A
  • muscle atrophy
  • joint contractures
  • dependence
  • skin issues
  • poor cosmesis
  • respiratory difficulties
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8
Q

what are flexible trunk orthoses (belts and corsets) mainly used for?

A

used mainly for symptom management in people with back pain

corsets are used to decrease pain by unloading the spine via increasing intra-abdominal pressure
sacroiliac belts increase passive stability`

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9
Q

what are postural training orthoses intended for?

A

improve body awareness; NOT correct deformity

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10
Q

goal of rigid spinal orthoses

A

limit spinal movement
protect the spine
facilitate healing
*** it uses a 3 point counter force system to control movement in the desired plane

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11
Q

what is the 3 column concept

A

wedge fractures involve the anterior column
burst fractures involve both the anterior and middle column

a fracture is labeled unstable if 2 adjacent columns are involved. They usually require surgical fixation, bracing or both

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12
Q

what are the 3 kinds of rigid LSOs

A

chairback
knight
bodyjack

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13
Q

what motion does a chairback LSO control?

A

controls flexion and extension

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14
Q

what kind of motion does a knight LSO control

A

controls flexion/extension and lateral flexion

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15
Q

what motion does a body jacket LSO control

A

controls all planes of motion

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16
Q

what levels of the spine doe TLSOs control

A

T5 - L4

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17
Q

What motion are TLSOs more effective at controlling than LSOs

A

TLSOs are better at controlling rotation

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18
Q

why is the lumbosacral region hard to stabilize?

A

this region has the greatest range for flexion/extension and bears the most load making it difficult to control

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19
Q

what TLSO controls flexion

A

the Jewett and the CASH

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20
Q

What TLSO controls flexion and extension

A

taylor spinal

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21
Q

what motion does the taylor knight spinal TLSO control

A

flexion/extension/lateral flexion

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22
Q

what population uses hyperextension braces and why

A

patients diagnosed with osteoporosis who had a compression fracture. the 3 point counterforce system prevents flexion

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23
Q

what are the indications for use of an occian back

A

for critically ill patients that have poor skin assessment
for patients unsafe to turn due to instability
for those not awake or alert within 24-48 hours after admission
for those with pre-existing burns, skin injuries or lacerations
** patients who want improved nighttime comfort

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24
Q

what is significant about the Philadelphia collar

A

stabilizes pt immediately after trauma
gives access to trach and carotid
waterproof

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25
Q

what is an advantage of the aspen vista collar?

A

it is adjustable to 6 different settings which reduces the need for inventory and also reduces skin breakdown while slicking away moisture

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26
Q

what orthosis proves the best stability for both the lower cervical and upper thoracic spine

A

CTOs

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27
Q

what device gives the most stable immobilizaton

A

the halo

it is the only way to stabilize the occiput to C2

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28
Q

what gives the most effective method of immobilizing C1-C2

A

the minerva which is a halo that does not drill into the skull

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29
Q

what is the purpose of bracing

A

to prevent progression of curve to a level as the patient grows

it is not intended to be curative

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30
Q

what is the eligibility for bracing

A

skeletally immature adolescents

risser scale of 0-2

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31
Q

which is the most common brace

A

the boston
it is a combination of a active/passive orthosis
it encourages the wearer to actively pull away from the pads into the reliefs

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32
Q

what is the criteria for stopping bracing

A

until skeletal maturity

  • risser 4 status
  • unchanged height over 6 months
  • 18-24 months post menarche in females
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33
Q

skin instructions for orthosis

A

keep skin clean and dry
avoid lotions
wear fitted shirt underneath
inspect skin daily

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34
Q

donning and doffing

A

cervical need to be able to open mouth but not move head

lumbar should have it position as low as possible

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35
Q

Lists the goals of orthotics

A
  • assist or stabilize a joint
  • protect a joint
  • prevent or correct a deformity
  • improve function
  • decrease pain
  • control spasticity
  • provide sensory feedback
36
Q

extrinsic factors that affect knee stability

A

hip and ankle alignment
strength of the hip mm
ROM
varus/valgus moments during gait

37
Q

intrinsic factors that affect knee stability

A 
ligamentous instability
angular deformities (varus, valgus, recurvatum)
muscle imbalance (weak quads or hamstrings)
38
Q

what are the indications for use of a KAFO

A 
needed to achieve knee stability
malalignment
loss of ligamentous stabilit
offloading of the knee or ankle
pain reduction
39
Q

contraindications for KAFO

A

not able to meet energy demands
lack of hip, trunk and UE strength to maintain standing balance and use the device
open wounds that would possibly be in contact with the orthosis
swelling

40
Q

what motion is controlled in the sagittal plane by a KAFO

A

knee flexion

41
Q

what is controlled in the frontal plane by a KAFO

A

knee valgus

42
Q

what are the advantages to locking the orthotic

A

gives more stability and overall mobility

43
Q

what are the disadvantages to locking

A

it takes more energy for movement and causes gait deviations as well as compensatory motions

44
Q

what does the free motion knee joint allow

A

it allows flexion and extension while preventing hyperextension
it is good for people with adequate muscle strength but who have instability or recurvatum

45
Q

where is the knee component of an offset joint

A

it is posterior to the anatomical joint center which allows it to increased extension moment for stability in stance

also decreases pressure on the patella pad

46
Q

what is the most common type of knee joint

A

the drop lock

47
Q

what needs to happen for the drop lock to be in place

A

need to get full knee extension in standing first

48
Q

what type of knee joint is used when changes in condition are expected

A

an adjustable/dial lock

mainly used in patients with knee flexion contractures that have been improving with stretching

49
Q

what is the biomechanical design of a stance control orthotic

A

it locks the knee in extension at initial contact and unlocks the knee on heel rise in the transition from terminal stance to preswing

50
Q

advantages of stance control

A

stability during stance
provides knee flexion during swing
minimizes gait devations
less energy cost

51
Q

disadvantages of stance control

A

increased size of components
increased cost
criteria for selction of orthosis is specific
-knee flex contracture less than 10 degrees, no leg length discrepancy, must be less than 200 lbs

52
Q

what type of orthotic uses a swing to or swing through gait

A

the scott-craig KAFO

it is specific to SCI and has a PF stop

53
Q

what is the criteria to have a C- brace?

A

must have lower limb weakness of the quads and the inability to maintain knee extension during stance phase

usually used for someone with incomplete paraplegia or polio

54
Q

what are the indications for HKAFOs

A

complete or partial loss of hip, knee and ankle musculature
prevention of contractures
instability in standing

55
Q

contraindications for HKAFO

A

instability in meeting energy demands
inadequate trunk and UE strength to safely use orthotic
fixed hip or knee flexion contractures
(need extension to stabilize and lock orthotic)

56
Q

what are the benefits of a parapodium

A

used to meet the developmental needs of children
enables hands free standing
adjustable
hip and knee joints unlock for sitting
typically used for children with spina bifida

57
Q

disadvantages of HKFAOs

A

difficulty to don/doff
high strength and balance is needed
not the primary means of locomotion

58
Q

what is the primary use of a HKAFO

A

used for exercise and position change

59
Q

what does a RGO allow for

A

allows for reciprocal gait orthosis
the cable system enables a coupling mechanism at the hips
the cyclical tension and release is what creates the reciprocal gait

60
Q

what do you need for a reciprocal gait if you do not have functional hip flexor strength?

A

you need lateral trunk sway/shift with trunk extension/rotation to begin the process of reciprocal gait

61
Q

what is developmental hip dysplagia

A

a congenital condition which causes hip dislocation, subluxation and hip instability

62
Q

what can be used for hip dysplagia in children

A

a pavlick harness which allows the child to still kick and easily manage their diapers
puts them in 110 degrees of hip flexion

63
Q

what is the next step after the palvick harness if further correction is needed

A

a rhino cruiser is a rigid plastic hip orthosis that maintains hip abduction in an ambulatory toddler

it is used between 6-24 months of age

64
Q

what happens in legg-calve-perthes disease

A

there is a loss of blood supply to the femoral head

the current prescription it to contain the femoral head in the acetabulum as it reforms

65
Q

what is a SWASH and how is it significant

A

Standing Walking And Sitting Hip orthosis

used in children with CP who have excessive adductor tone and abductor weakness therefore it prevents scissoring

66
Q

what is a hip SPICA used for

A

limits excursion of the hip after muscular strains, bruises and hip pointers

67
Q

what is the most common knee joint orthosis

A

polycentric which is designed to decrease migration by mimicking the anatomical knee joint

68
Q

indications for a functional knee orthosis

A

severe instability of the ligaments in the knee
post reconstruction surgery control
provides proprioception

69
Q

what is the goal of patellofemoral orthoses

A

designed to centralized patellar tracking

70
Q

what are the indications for a infrapatellar strap

A

chondromalacia
patella tendonitis
osgood-schlatter disease

71
Q

what are the 3 overuse injury factors

A

training errors
footwear
biomechanical

72
Q

what causes faulty transverse plane movements in the lower extremity

A

the way the foot hits the ground effects the entire chaine

ex: faulty pronation can create abnormal transverse plane movements causing injury

73
Q

is pronation a normal part of gait

A

YES!!!! pronation is a normal component of gait

74
Q

what motion does the ankle joint allow

A

dorsiflexion and plantarflexion

75
Q

what motions does the subtalar and mid-tarsal joints allow

A

supination and pronation (tri-plane motions)

76
Q

what are the components of pronation

A

dorsiflexion
eversion
abduction

77
Q

what are the components of supination

A

inversion
plantarflexion
adduction

78
Q

what is the role of pronation

A

acts as a shock absorber

allows the foot to adapt to uneven surfaces by unlocking the midfoot joints

79
Q

what causes poor pronation

A

results from compensatory movement of the foot due to congenital malalignment of the subtalar joint

80
Q

how is subtalar neutral defined

A

by the position of maximum congruency of talonavicular joint

81
Q

what is the goal of a foot othotic

A

to bring the supporting surface (ground) up to the foot in its subtalar neutral position to reduce excessive or prolonged pronatory movement

82
Q

what is the overall purpose of orthotics

A

reduce the “snowball” effect in proximal joints and reduce any imbalances up the chain

83
Q

what motion occurs in the ankle to compensate for limited dorsiflexion

A

may cause increase in pronation at the subtalar and midtarsal joints

84
Q

when would you suggest foot orthotics

A

if a patients foot is overpronating from a foot structure issue

85
Q

what is the difference between semi-rigid and rigid foot orthotics

A

semi-rigid offers more comfort, has a quicker turn around and is more cost effective

rigid has precise control, greater accuracy and durability

86
Q

When is surgery required for a patient with scoliosis

A

when they have a curve of 45-50 degrees

Orthotics (4 decks)

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