S2 L7: Ankle Foot Orthosis (AFO)

Question 1

What are the components of AFO?

Answer 1

1. Foundation: the shoes/base
2. Ankle Control
3. Foot Control: used in cases when the pt has valgus or varus
4. Superstructure: entire skeleton of the orthosis

Question 2

What are the main advantages of the Insert Foot Plate?

Answer 2

1. Provides good control of the foot
2. There are AFOs used as the shoe itself; there are also inserts/footplate
3. Permits interchanging shoes
4. Lightweight
5. Limit footdrop

Question 3

What are the disadvantages of Insert Foot Plates?

Answer 3

1. Reduces interior shoe volume = tighter fitting shoe
2. More expensive

Question 4

U-shaped fixture, the center is riveted to the shoe through the shank; holds the shoe underneath

Answer 4

Stirrup

Question 5

Arms of the stirrup join the brace uprights at the level of _____, providing _____ between orthotic and anatomical joints

Answer 5

1. The anatomical neck
2. Congruency

Question 6

Ankle control that holds foot to 90° (neutral), assists during heel strike; indicated for patients with DF weakness / foot drop d/t common peroneal n. impingement

Answer 6

Posterior Leaf Spring

Question 7

How to checkout the Posterior Leaf Spring?

Answer 7

1. Posterior shell is behind the malleoli (malleoli are free)
2. Proximal shell is at midpart of the leg
3. Distal part should not extend toes
4. Only extend up to metatarsal shafts (there’s a primary basis for this)

Question 8

This ankle control is a DF spring assist; Coil spring compresses in stance and rebounds during swing

Answer 8

Klenzak Joint

Question 9

The ankle control that tends to impose a flexion force at the knee during early stance and prevents the lax knee from hyperextending or moving posteriorly

Answer 9

PF Resistance (Posterior Stop)

Question 10

For the PF Resistance: If the stop is set to allow slight PF of ~ 5°…

Answer 10

Knee extension results which can be used to control an unstable knee that buckles.

Question 11

Active Knee Flexion = ???

Answer 11

Passive DF

Question 12

Active Knee Extension = ???

Answer 12

Passive PF

Question 13

5° of PF using PF resistance = ???

Answer 13

Genu Rectuvarum

Question 14

Too much PF causes…

Answer 14

Severe knee recurvatum or foot drop

Question 15

Anterior stop that aids individual with paralysis of the tricep surae to achieve late stance

Answer 15

DF Resistance

Question 16

If the DF Resistance is is set to allow slight DF of ~ 5°, knee flexion results, can be used to:

Answer 16

Control Hyperextension

Question 17

Too much DF results to:

Answer 17

Knee buckling (flexion when WB or instance) results

Question 18

Orthoses that limits all foot and ankle motion

Answer 18

Solid AFO

Question 19

Where is the trimline of the Solid AFO and what is its purpose?

Answer 19

Trimline: Anterior to Mammeoli
Purpose: Immobilize entire ankle and restrict foot drop

Question 20

To which pts is the Solid AFO indicated?

Answer 20

Hemiplegia and Spastic Diplegia

Question 21

This orthoses can be adjusted whether you want DF or PF which allows for controlled mobility

Answer 21

Bi CAAL

Question 22

Identify the Function and Clinical Indication for the corresponding Channel and Pin: POSTERIOR PIN

Answer 22

Function: Limits plantarflexion
Clinical Indications: Plantar spasticity, toe drag, pain with ankle motion

Question 23

Identify the Function and Clinical Indication for the corresponding Channel and Pin: POSTERIOR SPRING

Answer 23

Function: Assists dorsiflexion
Clinical Indication: Flaccid footdrop, knee hyperflexion

Question 24

Identify the Function and Clinical Indication for the corresponding Channel and Pin: ANTERIOR PIN

Answer 24

Function: Limits dorsiflexion
Clinical Indication: Weak plantarflexors, weak knee extensors, pain with ankle motion

Question 25

Identify the Function and Clinical Indication for the corresponding Channel and Pin: ANTERIOR SPRING

Answer 25

Function: Assists plantarflexion
Clinical Indication: None

Question 26

T/F: In a Bi CAAL, you cannot combine a pin and spring posteriorly or anteriorly.

Answer 26

False. You can!

Question 27

This foot control (AKA Medial T Strap) arises from the shoe quarter covering the medial malleolus and buckles to the lateral upright, pushing laterally.

Answer 27

Valgus Correction Strap

Question 28

In a Valgus Correction Strap, it exerts a _____ force to restrain _____.

Answer 28

1. Laterally directed
2. Pronation (Valgus)

Question 29

This foot control (AKA Lateral T Strap) arises from the shoe quarter, covers the lateral malleolus, and buckles to the medial upright, pushing medially.

Answer 29

Varus Correction Strap

Question 30

The Lateral T Strap buckles around the medial upright, corrects _____ (_____ _____)

Answer 30

1. Varus
2. Hindfoot Supination

Question 31

A low-profile supramalleolar design for a subtalar joint control to limit varus or valgus.

Answer 31

Supramalleolar Orthosis (SMO)

Question 32

It is the proximal part of the orthosis or weight relieving orthosis.

Answer 32

Superstructure

Question 33

Parts of the Superstructure

Answer 33

Uprights & Shell/Band/Brim

Question 34

Superstructure that winds around the calf and controls but does not eliminate motion in all places.

Answer 34

Spiral AFO

Question 35

To whom are Spiral AFOs indicated?

Answer 35

Pts who are active

Question 36

Superstructure that reduces the amount of weight transmitted to the foot (d/t foot pain, ankle conditions) to the patella during amb

Answer 36

Patellar-tendon-bearing Brim

Question 37

Superstructure that ends beyond the toes to counteract severe PF spasticity

Answer 37

Tone Reducing Orthosis

Question 38

Plastic AFOs (Tone Reducing Orthosis) is designed for children with _____ and adults with _____.

Answer 38

1. Spastic CP
2. Spastic Hemipelgia

Question 39

Tone Reducing Orthosis Footplate: Design, Purpose, Application

Answer 39

Design: Broad and upright
Purpose: Modify reflex hypertonicity
Application: Constant pressure to the PFs and invertors to control the tendency of the foot to assume equinovarus posture

Question 40

To whom are the Tone Reducing Orthosis indicated for?

Answer 40

Pts who have mod spasticity with varus instability, but do not have fixed deformity