S2 L6: Foot Orthosis (FO) Flashcards
3 function of foot in gait
- Shock absorption
- Adaptation to surface
- Propulsion
_____ ______ are appliances that apply forces to the foot. Whether immobilized, corrects, or makes the feet adjust to several environments during ambulation.
Foot Orthoses
Purposes of foot inserts
Pain relief & too improve the wearer’s transition during stance phase
Internal modifications inside the shoe made of resilient materials to reduce impact shock and shear, brought about by ambulation due to the ground reaction force.
Inserts
T/F: Foot inserts are recommended for pt who suffers from diabetic neuropathy.
True
This type of foot insert acts like a second skin. It tends to reduce gait unsteadiness by improving proprioception from the increased foot contact area.
Full-length insert (full length orthosis)
T/F: Full-length insert (full-length orthosis) is used to relieve pain and activity limitation particularly associated with PES PLANUS or individuals who have a very high arch deformity.
False.
Pes Planus —> Pes Cavus
An increased caved position of the longitudinal arch, most common is the Medial Longitudinal arch
Pes Cavus
Pt suffers from flat foot deformity.
Pes Planus
Internal modification inserted inside the shoe and is placed along the metatarsals.
Metatarsal Pad
The convex component protects the metatarsal pad from ______ during the ground-reaction force in _____.
- Heating too much
- Stance Phase
What does metatarsal pads reduce?
- Reduces plantar pressure especially for pt’s who suffers from insensitivities such as cases like diabetic neuropathy.
- Reduces tension on MT heads.
What are the main disadvantage of internal modifications?
Tt reduces shoe volume. Shoes can be tight especially if the insert is thick.
What is one advantage of internal modifications?
It does not affect the aesthetic appearance of the shoes, unlike external modifications.
Like the full-length insert, it is intended to prevent depression of the subtalar joint and flattening of the arch. Helpful for patients with Pes Planus.
Longitudinal Arch Supports
What is the difference of Longitudinal arch supports and full length supports?
Longitudinal arch does not cover the entire foot. It is only intended to assist the longitudinal arch if there is a flattened portion.
It is the primary keystone for the medial longitudinal arch.
Scaphoid
Presentation of the scaphoid when a pt has pes planus.
Depressed.
Modification given specifically if there is a depressed scaphoid bone. To correct a flat medial longitudinal arch.
Scaphoid Pad
Recommended support when pt does not only suffer from a depressed scaphoid, but also weakness of the plantar muscles and other structures of the MLA.
Longitudinal Arch Support
Much rigid type of an internal modification to address midfoot issue or a posterior tibial malfunction
UCBL Insert
Landmarks of the UCBL Insert
Heel cups extend to the inframalleolar area and distal to metatarsal heads
What could happen if there are deviations on the landmarks of the UCBL?
It can create deviations on the ambulation and cause pain or aggravate the present deformity.
What are the main uses of the UCBL insert?
- Used to realign a flexible flat foot
- Immobilize midfoot fracture
- Correct posterior tibial malfunction.
This wedge alters the alignment of the rearfoot.
A heel wedge
These wedge & heel are intended for flexible pes valgus in which the foot moves laterally in relation to a severely pronated positioning.
Medial heel wedge and Thomas Heel
The modification is attached to the medial part of the heel wherein it elevates the medial part of the foot so that the over pronation will be counteracted
Medial Heel Wedge
Modification to be used in cases that there is still presence of severe pronation in which medial heel wedge won’t be enough to correct over pronation
Thomas Heel
What border of the THOMAS HEEL extends forward on the medial side to augment the effect of the medial wedge in supporting the longitudinal arch
Anterior Border
This wedge tends to counteract a foot that is assuming an over supination. It could also compensate for a fixed foot valgus.
Lateral Wedge
T/F: Rigid foot deformities can be corrected even with the use of positional aids or modifications.
False. It cannot. The best way to approach this is to accommodate the foot deformities.
Medial Heel Wedge Indications for Corrections/Lateral Heel Wedge Indications for Accommodation
- Pronation
- Eversion
- Pes Valgus
- Pes Planus
Medial Heel Wedge Indications for Accommodations/Lateral Heel Wedge Indications for Corrections
- Supination
- Inversion
- Pes Varus
- Pes Cavus
Made of resilient material to absorb shock at heel contact. It is indicated when the patient wears an orthosis with a rigid ankle.
Cushion heel
In what gait phase does the cushion heel protect the heel?
Heel Strike - Shock absorption during heel contact
Alters the entire sole of the shoe to counteract/compensate for a shortened limb. Balances the GRF on both feet during ambulation.
Shoe Lift
Where is shoe lifts commonly used?
Used for leg length discrepancies
T/F: The goal of the shoe lift is to reduce stress or distribute pressure
False. It is to raise one foot in order to shift balance.
A flat strip of firm material placed posterior to the metatarsal heads; recommended for pts with metatarsal pain.
Metatarsal Bar
Since placed posteriorly, the metatarsal bar will tend to _____ the stress on the metatarsal heads and _____ the WB pressure on the shaft.
- Reduce
- Transfer
Where does the metatarsal bar transfer the stress from the metatarsophalangeal joints?
Metatarsal Shafts
A convex transverse band affixed to the sole proximal to the metatarsal heads. Tends to create a smoother transition from heel strike to foot flat.
Rocker Bar
The Rocker Bar is prescribed to which patients?
Pts who have difficulty in transitioning from heel strike to initial contact all the way to foot flat.
Type of Rocker Bar that inhibits demand for motion in the ankle joint; for pts with weak proprioception
Ankle Joint Rocker
Type of Rocker bar that reduces ground-reactive force to ball/head and improve total efficiency of initial stance all the way to the late stance.
Met-head Rocker
How is the metatarsal bar different from the met-head rocker?
MTTB merely removes the pressure on the MTT heads and shifts it to the MTT shaft.
Type of rocker bar that reduces ground-reactive force to the heel
Heel Rocker
To whom is the Heel Rocker indicated?
Pts who suffer from heel pain and has issues in transitioning from initial to late stance.
Type of Rocker Bar that reduces propulsive forces to midfoot.
Lisfranc Rocker
To whom is the Lisfranc Rocker indicated?
Pt who suffer from midfoot fracture, pesplanus/cavus, difficulty in transitioning from initial to late stance.
Type of Rocker bar that inhibits demand for dorsiflexion of toes especially during late stance.
MJP Rocker
To whom is the MJP Rocker indicated?
If pt has pain on the MTP joint and needs to improve from transitioning to initial to late stance.
Type of Rocker Bar that holds foot dorsiflexed especially during initial stance as well as during off-loading of forefoot. Indicated for pt’s with jack foot deformity
Healing Rocker
