S2_L2.1: Intro to Orthotics & Prosthetics, Splinting, & Shoe Flashcards
Identification:
They provides care to persons with neuromuscular and musculoskeletal impairments that contribute to functional limitation and disability by designing, fabricating, and fitting orthoses or custom made braces for pts with functional limitations.
Orthotists
Identification:
Any externally applied device to an existing body part that improves function.
Orthoses
Enumeration:
5 goals of orthoses
- Stabilize weak or paralyzed segments or joints
- Support damaged or diseased segments or joints
- Limit or augment motion across joints
- Control abnormal or spastic movements
- Unload distal segments
Identification: It will fix the foot/ankle in a certain position and movement is not allowed.
LE Static Splint
Identification: It allows certain movement and limiting/restricting certain motions of the LE.
LE Dynamic Splint
Identification: It extends from the foot to the waist. It provides stability and aids in ambulation when LE muscles are weak.
Long leg braces
Identification: Brace that will cover the ankle and foot segment. It is primarily indicated for patients with weakness of ankle dorsiflexors as manifested or seen in stroke patients.
Short Leg Brace
Identification: An external modification is made on the sole. It is common. Aka corrective shoes. Orthotists fabricate these.
Orthopedic shoes
Identification: Internal modification that may be custom made or is readily available in the market. For flat foot & to correct the arches of the foot, this is used. Orthotists will also make this.
Moldable inserts
Identification: They provide care to patients with partial or total absence of limbs by designing, fabricating, and fitting pros theses or artificial limbs. They create the design, select the appropriate materials and components, and make all necessary casting, measurements, and
modifications (including static and dynamic alignment).
Prosthetists
Identification: Medical devices that are completely finished and are technically connected to the body; Designed to replace as much as possible the function, or appearance of a missing limb or body part
Prostheses
Analogy - Padding
Closed cell : (1)___ ::
Open cell : (2)___
- without holes
- with holes
TRUE OR FALSE: The primary purpose of dynamic splints are to mobilize areas of the body and have 1 or more movable parts.
True
Identification: Type of splint that is highly recommended for acute injuries so as not to aggravate the condition
Static splint
Identification: It performs the vital functions of transferring body weight to the floor during walking and of protecting the wearer from hazards in the environment
Shoes
Identification: Keystone of a good shoe
Its ability to absorb shock
Identification: Primary purpose of static splinting
To immobilize body structures
Identification: Actual material used in fabrication of splints
Orthoplast
Identification: Handling characteristic where it can be molded easily in whatever structure that is needed to be splinted
Memory
Enumeration: 7 members of the orthotic team
- Physiatrist
- Orthotist
- Physical therapist
- Occupational therapist
- Patient
- Rehabilitation counselor
- Social worker
Enumeration: 5 common goals for orthotic device
- pain relief
- immobilization and protection
- reduction of axial load
- prevention and correction of deformity
- improvement of function
Identification: Prosthesis recommended for pts who have a total absence of the entire UE
Body powered prosthesis
Matching Type:
- made of metal or titanium
- made of a durable shell
- bulkier, heavier
- could fit different shoe types
- lighter, pricier
Choices:
A. Endoskeleton LE Prosthesis
B. Exoskeleton LE Prosthesis
- A
- B
- B
- A
- A
Matching Type:
- Splinting was recognized to be important after injury in rehabilitation.
- Most splints were made of metal. Plaster of Paris (most commonly used material nowadays) was discovered.
- Splint was the most common first aid during WWII. Rehabilitation during WWII splints sold commercially.
Choices:
A. 1700
B. 1800
C. 1940s
- B
- A
- C
Fill in the blanks:
Temperature range for heat used in splinting is ___.
135°F - 180°F
Matching Type:
1. influences amplitude of the long extrinsic tendons on joint/s; mostly applicable to dynamic splints
2. provides single directional force, affecting motion at one or more joints within a segment in a similar manner
3. affecting motion at two or more joints within a segment in a dissimilar manner (opposing force system)
Choices:
A. Simple / static splint
B. Compound / dynamic splint
C. Long splint
- C
- A
- B
Identification: This determines the shape of the shoe.
Last
Matching Type:
1. directs the forefoot
medially
2. forefoot is directly slightly lateral to the midline
3. symmetric around the
midline
4. directs the foot much more
laterally
Choices:
A. Straight last
B. Conventional last
C. Outflared last
D. Inflared last
- D
- B
- A
- C
Matching Type:
1. inside piece of the external sole; primary structure of sole
2. situated next to the foot
3. piece that is most external, it should not contact the floor at the
distal end
4. Area between the heel and the ball of the shoe
5. Slight rise of the sole which allows a rocker effect at late stance
Choices:
A. Insole
B. Outsole
C. Welt
D. Toe spring
E. Shank
- C
- A
- B
- E
- D
Identification: Type of shoe indicated for a rigid pes equinus foot as it covers the malleoli
High-quarter shoe
Identification: This is indicated for patients with instability in the cervical spine 2º to fractures.
Halo Traction Brace
Identification: Duration for wearing a splint per day?
23 hrs/day
Identification: It is a common body brace. It is indicated for patients with scoliosis. A corrective brace.
Milwaukee Brace
Identification: It is a thoracolumbosacral
orthosis. It provides limitation
or stabilization for
movement.
Knight-Taylor Brace
Identification: For pts with rigid ankle orthoses, fixed deformity, spasticity, or fragile neuropathic feet, this type of shoe is recommended. These are high shoes which incase the malleoli, providing addition mediolateral stability
Lace-to-toe / Surgical style shoes
Identification: Shoes are most commonly made with this type of last, where the toe box is directed inward from the heel.
Medial last
Matching Type
- Orthotic heel wedge inside shoe
- Full length external lift mounted to the sole of the shoe
Choices:
A. > 3/8 inch leg length discrepancy
B. < 3/8 inch leg length discrepancy
- B
- A
FIll in the blanks:
For every (1)___ increase in heel, there is added weight-bearing to the (2)___.
- 1.5 inch
- metatarsal heads
Matching Type:
- Further confirm and check out if this pt will be comfortable or the device was able to achieve the ultimate function that the pt would want
- Primary lead of the rehabilitation team
- Convey appropriate information to the team
members.
Choices:
A. Physician
B. Patient
C.PT and/or OT
- C
- A
- B
TRUE OR FALSE: The 3 major events that served as an impetus for orthotists and prosthetists profession are:
1. WWI
2. WWII
3. Onset and spread of poliomyelitis in the 1950s
True
Identification: Splint that keeps the wrist raised upward to prevent flexion deformity
Cock-up Splint
Enumeration: 5 principles of orthotic application
- Pressure distribution
- Comfort
- Wearer independence
- Conservation of energy
- Simplicity and durability of materials
Fill in the blanks
In proper maintenance of orthotic application:
-Open (1)___ every week
-Place a drop of (2)___ in each joint every week
-Keep leather parts in (3)___ repair
-Keep (4)___ and (5)___ of shoes in good condition as not to touch any part of the brace on the floor
- locks
- machine oil
- good
4-5. Heels, soles
Fill in the blanks
In proper maintenance of orthotic application:
-Handle (1)___ with care and avoid injuring them
-Examine skin every night for (2)___
-Inspect (3)___ before putting on
- braces
- pressure marks
- braces
Identification: Most suitable metals for orthotic appliances.
Steel & aluminum alloys
Matching Type:
- Provides support to areas of the body and have no movable joint
- More complex
- Aid in fracture alignment and wound healing
- Prevent soft tissue contracture
- Substitute for loss of motor function
- Correct an existing deformity
Choices:
A. Static splinting
B. Dynamic splinting
- A
- B
- B
- A
- B
- B
Identification: Main mechanisms of a dynamic splint
Wires and screws
Identification: Splinting procedure that provides additional comfort for the wearer
Edge finishing
TRUE OR FALSE: If the splint has moisture and air permeability, there is a lesser tendency for skin irritability.
True
Matching Type:
- Drapability
- Conformability
- Moisture permeability and air
- Self finishing edges
- Bonding, adherence
Choices:
A. Performance characteristic
B. Handling characteristic
C. Both
- B
- A
- A
- B
- B
Matching Type:
- Durability
- Memory
- Rigidity
- Elasticity
- Flexibility
Choices:
A. Performance characteristic
B. Handling characteristic
C. Both
- C
- B
- A
- B
- A
Identification: This may be due to a fracture or congenital anomalies or biomechanically imbalance pelvic rotation, hip anteversion/retroversion, or lateral foot pronation
Leg length discrepancy
Identification: A consequence of loss of the longitudinal arch in conditions such as pes planus or of undue stresses created in the forefoot with tightness of the gastrocnemius and soleus muscles or an elevated longitudinal arch
Plantar fasciitis
Identification: Characterized by flattening of the longitudinal arch, causing a splaying of the forefoot and lateral deviation of the metatarsals. This deformity can be either flexible or fixed/rigid.
Pes planus / Flatfoot
Identification: It is a painful condition of the
foot characterized by neuronal degeneration and perineural fibrosis, most commonly seen between the third and fourth or the second and third metatarsals
Morton (Interdigital) Neuroma
Identification: Pain around the metatarsal heads that result from compression of the plantar digital nerve as it courses between the metatarsal heads
Metatarsalgia
Identification: Configuration of the foot in
which the second toe is either the same size as the great toe or slightly longer than the great toe. The increased length of the second ray causes lateral instability that affects the foot biomechanics
Morton Syndrome
Fill in the blanks: A (1)___ can be used to reduce
tension on the plantar fascia and Achilles
tendon and adequate length to minimize compression and promote (2)___
from midstance to toe-off.
- high heel / posterior heel elevation
- supination
Fill in the blanks - Plantar fasciitis shoe prescription:
● Control (1)___ from heel strike to heel stance
● Maintain the (2)___ joint in a neutral position
● (3)____ heel counter to limit heel valgus
- Pronation
- Subtalar
- Long medial
Fill in the blanks - Pes planus shoe prescription:
● (1)____ to reduce pronation from heel strike to midstance & correct (2)___
● Relieve tension on the (3)___ tendonitis
- Medial heel wedge
- Eversion
- Posterior tibial
TRUE OR FALSE: A shoe for pes planus should offer a long medial heel counter, a Thomas heel or a firm wedge sole, and a straight last.
True
Fill in the blanks - Metatarsalgia shoe prescription:
● Wide width to reduce pressure on the (1)___ arch
● Long fitting to eliminate (2)___ MTP joints
● (3)___ to enhance shock absorption
● A (4)___ toe box to allow forefoot flexion and extension
- transverse metatarsal
- plantarflexed
- cushion soles
- high
Fill in the blanks - Metatarsalgia shoe prescription:
● Reduce (1)___ by stabilizing the metatarsal phalangeal joint
● Stabilize the (2)___ and (3)___ to reduce
pressure on metatarsal heads
- friction
2-3. rearfoot, midfoot
Identification: It is used to alter lines of stress to facilitate a more normal gait pattern and to modify midfoot and forefoot positions
Wedging
Identification: Synthetic material that may be molded,
extruded, laminated into desired form. It is the most common orthotic material.
Plastic
Matching Type:
- Low endurance limit, corrosion resistant and high strength:weight ratio
- High strength:weight ratio
- More resistant to corrosion, durable, light weight, preferred by active users
A. Steel
B. Aluminum
C. Titanium & magnesium
- B
- A
- C
Fill in the blanks:
Thermoplastics (1)___ when heated and (2)___ when cool
- soften
- harden
Identification: Materials that develop a permanent shape when heat and pressure are applied and maintain a memory. Examples of these are polyesters, epoxies, and polyurethane foam
Thermosetting plastics
Identification: most weather resistant thermoplastics (high temperature)
acrylic
Identification: high temperature thermoplastics most commonly used in orthotics
Vinyl Polymers and Copolymers
Identification: The temperature of low temperature thermoplastics to become workable and may be shaped directly to the body
80ºC
Identification: Most essential element of clothing in any person’s wardrobe. This performs the vital functions of transferring body weight to the floor during walking (in response to
GRF) and of protecting the wearer from hazards in
the environment.
Shoe
Fill in the blanks:
Ill fitting shoes can create (1)__ force that leads to (2)___ —create and facilitate toe and foot deformities and lead to (3)___.
- shear
- skin breakdown
- falls
Fill in the blanks: A well-designed shoe provides a (1)___ heel base,
ankle (2)___, and (3)___-fitting heel counter
- broad
- collar
- close
Fill in the blanks:
Foot stability is important and critical regardless of reason for shoe—critical to minimize (1)___
injury, excessive (2)___, and (3)___ of the heel during the gait cycle
- ankle
- pronation
- slippage
Identification: Primary determinants of proper shoe fit
Shape and size
Identification: In this shoe type, the outside quarter is cut lower than the inside to avoid contact with the malleoli
Oxford (Balmoral) shoe
Identification: In this shoe type, forward edges of the quarters are on top of the vamp
Blucher (Derby) shoe
Identification: lace stays that permit substantial adjustability which is important for edematous patients. anterior margins of the lace stays are separated from the vamp
Blucher lace stay
Fill in the blanks:
In the blucher style shoe, the tongue is a/an (1)____, while the tongue is a/an (2)____ in the bal-type oxford shoe.
- extension of the vamp
- separate piece
Matching Type:
- Tends to position the foot into dorsiflexion thus minimizing abnormal plantarflexion
deformity - Promotes mobility than stability
- joined to the vamp which make up the side and back of the upper
A. Rear quarter
B. Low-quarter
C. High-quarter
- C
- B
- A
Identification: in individuals wearing orthoses and with moderate to severe foot deformity, this closure is preferred.
Blucher closure
D/t its construction. It allows a certain degree of flexibility and expansion during donning and doffing as it offers a wide inlet.
Identification: 2 important characteristics of a sole.
Thickness, rigidity/stiffness
Note: It should not be too rigid as to interfere with the
movement of the foot and toes at the MTP joint during the terminal stance and pre-swing phases of gait
Fill in the blanks: The traditional sole consists of (1)___ pieces of leather sewn together with a layer of (2)___ in
between.
- two
- compressible cork
Fill in the blanks: In athletic shoes, the sole is made of (1)___ to provide maximal (2)___.
- rubber
- traction
It would absorb shock thereby minimizing the heel impact forces especially in contact and high intensity sporting activities
Fill in the blank:
As heel height increases, a greater ___ range of motion is necessary for the forefoot to reach the floor.
Plantarflexion
TRUE OR FALSE: For some patients with neuromuscular dysfunction (e.g., hemiplegia, paraplegia, multiple sclerosis), a traditional metal double-upright lower extremity orthosis can be prescribed
True
Matching Type:
1. Places the ankle in greater PF range and forces tibia forward
2. reinforces the quarter to help secure the shoe to the anatomic heel
3. distributes force between the back and front of the foot evenly
4. relieve excessive pressure on the shank portion & causes subtalar neutral
5. Prevents collapse of the material between heel and ball of the foot to provide extra support
6. Found in the distal vamp which prevents the anterior portion of the vamp from losing
its shape
Choices:
A. Broad low heel
B. High heel
C. Toe box
D. Shank
E. Heel counter
F. Thomas Heel
- B
- E
- A
- F
- D
- C
Matching Type:
- Placed proximal to the metatarsal heads
- Create an eversion effect on forefoot
- Used when flexible valgus and calcaneus are present
- Supports the navicular bone and helps invert the calcaneus, shifting the body weight laterally
- Used for flexible varus of the calcaneus
- Prevents inversion of the ankle
- Produces an inversion effect on
the forefoot
Choices:
A. Lateral sole wedge
B. Lateral heel wedge
C. Lateral flared heel
D. Metatarsal bar
E. Medial heel wedge
F. Barton wedge
G. Medial sole wedge
- D
- A
- E
- F
- B
- C
- G
Fill in the blanks - Morton syndrome shoe prescription:
● Long medial counter
for (1)___ support and stability
● (2)__ or (3)__ last to accommodate foot shape
● High wide toe box to
reduce (4)___ across the transverse metatarsal arch
- rearfoot
2 - 3. Straight, flared - compression
Fill in the blanks - Morton syndrome shoe prescription:
● Accommodate the forefoot (1)___ and
(2)___ metatarsal
● Large enough shoe
size to accommodate
the long (3)___ toe
● (4)___ heel or
wedge sole to support
the medial longitudinal
arch
- varus
- dorsiflexed
- second
- thomas
Fill in the blanks - Morton Neuroma Shoe Prescription:
● Shoes should be wide enough to eliminate
transverse compression and have enough length to reduce (1)___ of the MTP joint
● A long (2)___ counter can help to reduce pronation
● A cushioned sole increases shock absorption and a (3)___ heel unloads pressure on the metatarsals
- plantarflexion
- medial
- low
Fill in the blanks:
A (1)___ mold is used as a template that touches the pt’s skin, while a (2)___ mold is the end-product or replica of the limb.
- negative
- positive
TRUE OR FALSE: Most leather used in orthotic fabrication are vegetable tanned
for texture and to prevent skin irritation
True
Additional: D/t animal extinction nowadays, straps
are used instead
TRUE OR FALSE: Rubber is an orthotic material seen as a basic component of shoes. It has tough resiliency and shock absorbing
qualities,
good resistance to cold, aging, tears, and abrasion.
True
TRUE OR FALSE: Plastics are radiolucent, have little to no toxicity, and are unaffected by fluids such as water, urine, and oils
True
TRUE OR FALSE: The compensation due to a high heel is to retain slight knee
and hip flexion or by extending the
knee and exaggerating lumbar lordosis
True
TRUE OR FALSE: Ill-fitting heel counters predispose the back of
the heel to abrasions
True
Identification: It redistributes body weight over the entire plantar surface, facilitating a smoother
and more normal gait pattern while reducing
stress and trauma in the forefoot
Rocker bottom
