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(2) Assistive Technology🦿 > S2_L2.2: LE Orthoses & Common Gait Dev'ns > Flashcards

S2_L2.2: LE Orthoses & Common Gait Dev'ns Flashcards

1
Q

Identification: A convex transverse band affixed to the sole proximal to the metatarsal heads. It also tends to create a smoother transition from heel strike to foot flat.

A

Rocker bar

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2
Q

Fill in the blanks: A rocker bar is specifically prescribed to pts who have difficulty in transitioning from (1)__ to (2)__ to (3)__.

A
  1. Heel strike
  2. Initial contact
  3. Foot flat
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3
Q

Identification: This protects the heel during heel strike.

A

Cushion heel

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4
Q

Matching Type for MEDIAL Heel Wedge

  1. Pes valgus
  2. Inversion
  3. Pronation
  4. Pes planus
  5. Supination
  6. Pes varus

Choices:
A. Correct flexible
B. Accommodate Rigid

A
  1. A
  2. B
  3. A
  4. A
  5. B
  6. B
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5
Q

Matching Type for LATERAL Heel Wedge

  1. Pronation
  2. Eversion
  3. Pes varus
  4. Pes cavus
  5. Pes valgus
  6. Supination

Choices:
A. Correct flexible
B. Accommodate Rigid

A
  1. B
  2. B
  3. A
  4. A
  5. B
  6. A
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6
Q

Fill in the blanks: (1)___ are given specifically if there is a depressed scaphoid bone. It is to correct a flat (2)___ longitudinal arch.

A
  1. Scaphoid pads
  2. Medial
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7
Q

Case: If a pt does not only suffer from a depressed scaphoid, but also weakness of the plantar muscles and other structures of the medial longitudinal arch, what is recommended for this pt?

A

Longitudinal arch support

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8
Q

Matching Type:

  1. Reduces ground-reactive force to the heel
  2. Reduces ground-reactive force to ball/head. Improves total efficiency of initial stance all the way to late stance
  3. Holds foot dorsiflexed especially during initial stance & during off-loading of forefoot
  4. Inhibits demand for DF of toes especially during late stance
  5. Inhibits demand for motion in the ankle joint.
  6. Reduces propulsive forces to midfoot

Choices:
A. Healing Rocker
B. Lisfranc Rocker
C. Met-head Rocker
D. Ankle Joint Rocker
E. Heel Rocker
F. MPJ Rocker

A
  1. E
  2. C
  3. A
  4. F
  5. D
  6. B
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9
Q

Identification: This is indicated for pt’s with jack foot deformity

A

Healing rocker

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10
Q

Identification: It is the proximal portion of the orthosis. It is a weight-relieving orthosis consisting of uprights, and a shell, band or brim.

A

Superstructure

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11
Q

Identification: It is commonly used for leg length discrepancies. The goal is not to reduce stress or distribute pressure, but to raise one foot in order to shift balance.

A

Shoe lifts

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12
Q

Identification: It is used to realign a flexible flat foot, immobilize
midfoot fracture and correct posterior tibial malfunction

A

University of California Biomechanics Laboratory (UCBL) Insert

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13
Q

Fill in the blanks: The longitudinal arch support, like the full-length insert, is intended to prevent (1)___ of the subtalar joint and (2)___ of the arch.

A
  1. depression
  2. flattening
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14
Q

Identification: It allows for alternate or reciprocal swiveling and simulates the reciprocal gait.

A

Swivel walker

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15
Q

Identification: It is prescribed for adults with paraplegia

A

Scott-Craig Knee-Ankle-Foot Orthosis

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16
Q

Identification: It is prescribed for patients who cannot achieve full knee extension due to a knee flexion contracture.

A

Serrated Knee Joint

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17
Q

Fill in the blanks: The off-set joint allows the mechanical axis to be (1)___ to the anatomical axis and thus improve (2)___.

A
  1. posterior
  2. stability
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18
Q

Identification: This is the most common knee control. It is also contraindicated for knee flexion contracture as it can only lock when the knee is in 0º.

A

Drop-Ring Lock

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19
Q

Fill in the blanks: Full-length insert / orthosis tends to reduce gait unsteadiness by improving (1)___ from the (2)___ foot contact area. It is used to relieve pain and activity limitation particularly associated with (3)___.

A
  1. proprioception
  2. increased
  3. pes cavus
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20
Q

Identification: It reduces plantar pressure especially for pt’s who
suffers from insensitivities such as cases like diabetic neuropathy

A

Metatarsal pad

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21
Q

Fill in the blanks: The metatarsal pad is a (1)___ component that may be incorporated in an insert or may be a resilient domed piece glued to the (2)___ sole so that its (3)___ is under the metatarsal (4)___.

A
  1. convex
  2. inner
  3. apex
  4. shafts
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22
Q

Identification: 3 functions of the foot in gait

A
  1. Shock absorption
  2. Adaptation to surface
  3. Propulsion
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23
Q

Identification: Appliances that apply forces to the foot. Whether it immobilizes, corrects, or makes the feet adjust to several environments during ambulation.

A

Foot orthoses

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24
Q

Identification: 2 purposes of foot orthosis

A
  1. pain relief
  2. inserts can improve wearer’s transition during stance phase
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25
Q

Fill in the blanks: Inserts are made of resilient materials to reduce impact (1)___ and (2)___, brought about by ambulation due
to the (3)___.

A
  1. shock
  2. shear
  3. ground reaction force
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26
Q

Identification: It acts like a second skin, if a pt has difficulty in identifying or positioning the foot in relation to its body position.

A

Full-length insert / Full-length orthosis

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27
Q

Identification: Its primary purpose is to protect the metatarsal
heads if there are painful phases and it shifts the weight/GRF under the metatarsal shafts.

A

Metatarsal pad

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28
Q

TRUE OR FALSE: Metatarsal pads reduces plantar pressure especially for pts who suffer from insensitivities such as cases like diabetic neuropathy.

A

True

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29
Q

Enumerate the advantage and disadvantage of internal modifications.

A

Advantage: Does not affect the aesthetic appearance of the
shoes

Disadvantage: Reduces shoe volume.

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30
Q

Identification: Helpful for pts who suffer from a flexible pes planus

A

Longitudinal arch support

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31
Q

Differentiate longitudinal arch support from a full-length insert.

A

The longitudinal arch support does not cover the entire foot.

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32
Q

Fill in the blanks: The navicular is also known as (1)____. It is directly in front of the (2)___. It is the (3)____ for the medial longitudinal arch.

A
  1. scaphoid
  2. talus
  3. primary keystone
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33
Q

Fill in the blanks: The scaphoid pad allows (1)___ support that is positioned at the (2)___ border of the insole with the apex between the (3)___ and the (4)___.

A
  1. minimum
  2. medial
  3. sustentaculum tali
  4. navicular tuberosity
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34
Q

Identification: It is a more rigid type of internal modification to address midfoot issues (e.g. fractures; flatfoot deformity, or more specifically, a posterior tibial malfunction)

A

University of California Biomechanics Laboratory (UCBL) Insert

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35
Q

Identification: The UCBL landmarks are heel cups extend to the (1)___ area and (2)___ to the metatarsal (3)___.

A
  1. inframalleolar
  2. distal
  3. heads
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36
Q

Identification: This ensures that the patient wears the appropriate shoes and does not reduce
shoe volume.

A

External modification

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37
Q

TRUE OR FALSE: The cushion heel is made of resilient material to absorb shock at heel contact. It is indicated for pts with heel pain and when the pt wears an orthosis with flexible ankle.

A

False

Rigid ankle

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38
Q

TRUE OR FALSE: The shoe lift alters the entire sole of the shoe to counteract / compensate for a lengthened limb. It balances the GRF on both feet during ambulation.

A

False

Shortened limb

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39
Q

Fill in the blanks: The metatarsal bar is a flat strip of firm material placed (1)___ to the metatarsal heads. At (2)___ stance, the metatarsal bar transfers stress from the MTP joints to the (3)___.

A
  1. posterior
  2. late
  3. metatarsal shafts
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40
Q

TRUE OR FALSE: The rocker bar increases the distance the wearer must travel during stance phase, improving early stance, as well as shifting load from the MTP joints to the metatarsal shafts.

A

False

Reduces the distance,
Improving late stance

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41
Q

Identification: It counteracts a foot that is assuming an over supination. It shifts WB to the medial side of the front of the foot. It compensates for fixed forefoot valgus allowing the entire distal foot to contact the floor.

A

Lateral Wedge / Reverse Thomas Heel

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42
Q

Fill in the blanks: The (1)___ border of the Thomas heel extends forward on the (2)___ side to augment the effect of the (3)___ wedge in supporting the longitudinal arch.

A
  1. anterior
  2. medial
  3. medial
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43
Q

Identification: It elevates the medial part of the foot so that the over pronation will be
counteracted and it will tend to automatically position the forefoot into neutral/midline.

A

Medial heel wedge

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44
Q

Fill in the blanks: (1)___ & (2)___ are intended for flexible pes valgus in which the foot moves laterally in relation to a severely (3)___ positioning.

A
  1. medial heel wedge
  2. thomas heel
  3. pronated
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45
Q

Identification: It alters alignment of the rearfoot.

A

Heel wedge

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46
Q

Enumerate the 4 components of AFO

A
  1. foundation
  2. ankle control
  3. foot control
  4. superstructure
47
Q

Enumerate the 4 stage procedure in a reciprocating gait orthosis. (L leg swings)

A
  1. Shift weight to R leg
  2. Tuck the pelvis by extending the upper thorax
  3. Press on the crutches
  4. Allow the L leg to swing through
48
Q

TRUE OR FALSE: A reciprocating gait orthosis is a THKAFO where the hips are joined by one or two more metal rods. The steel cables or rods prevent inadvertent hip extension on the supporting leg.

A

False

Prevents hip flexion

49
Q

Enumerate the 5 orthotic options for pts with paraplegia

A
  1. standing frame
  2. swivel walker
  3. parapodium
  4. scott-craig KAFOs
  5. reciprocating gait orthosis
50
Q

Match the orthosis with its features/description.

  1. Base has two distal plates that rock slightly to enable swivel gait.
  2. Swing to or swing through gait pattern with the aid of crutches or walker.
  3. Has joints that permit the wearer to sit
  4. Prescribed for children with myelodysplasia
  5. Indicated for physiologic standing

A. Standing frame
B. Swivel walker
C. Parapodium
D. Scott-Craig KAFOs
E. Reciprocating gait orthosis

51
Q

Match the orthosis with its feature/description

  1. For children and adults
  2. Has wheels for mobility & platform for UE use
  3. Articulated, has knee component
    to allow sitting
  4. For children only
  5. Prescribed for adults with paraplegia
  6. Integrates spinal orthosis, similar to parawalker

A. Standing frame
B. Swivel walker
C. Parapodium
D. Scott-Craig KAFOs
E. Reciprocating gait orthosis

A
  1. A
  2. A
  3. C
  4. C
  5. D
  6. E
52
Q

TRUE OR FALSE: Scott-Craig KAFOs include either a shoe reinforced with transverse and
longitudinal plates and BiCAAL ankle joints set in slight PF or a plastic solid ankle section, as well as pretibial band, a pawl lock with bail release, and a
single thigh band.

A

False

Reason: It should be slight DF

53
Q

TRUE OR FALSE: A standing frame consists of broad base, posterior non articulated uprights extending from a flat base to mid torso, chest band, a posterior thoracolumbar band, wheels, and platform for UE

54
Q

TRUE OR FALSE: The goals of orthoses for pts with paraplegia are standing to maintain skeletal, renal, respiratory, circulatory and GIT function and form of
ambulation.

55
Q

Identification: Entire skeleton of the orthosis

A

Superstructure

56
Q

TRUE OR FALSE: AFOs are made out of metal or plastic. Metal is rarely prescribed because it’s heavier. Both materials can be beneficial for the patient with the same goal.

57
Q

Determine whether a valgus or varus correction strap is being described.

  1. Exerts a laterally directed force
  2. Medial T Strap
  3. Pushes medially to correct inversion deformity
  4. Restrains pronation
  5. Pushes laterally to correct eversion deformity
  6. Corrects hindfoot supination
  7. Lateral T Strap

A. Valgus Correction Strap
B. Varus Correction Strap

A
  1. A
  2. A
  3. B
  4. A
  5. A
  6. B
  7. B
58
Q

Determine whether DF or PF resistance is being described.

  1. For too much PF
  2. Aids individual with paralysis of the tricep surae to achieve late stance
  3. Used for L4 SCI
  4. Deals with severe knee recurvatum or foot drop
  5. Deals with knee buckling, flexion in WB or stance

A. DF Resistance / Anterior Stop
B. PF Resistance / Posterior Stop

59
Q

Fill in the blanks: If the stop is set to allow slight DF of ~ 5°, knee (1)___ results, can be used to control knee (2)___.

A
  1. flexion
  2. hyperextension
60
Q

Fill in the blanks: If the stop is set to allow slight PF of ~ 5°, knee
(1)___ results, can be used to control an unstable knee that (2)___.

A
  1. extension
  2. buckles
61
Q

Analogy

Active knee (1)___ : Passive DF
Active knee (2)___ : Passive PF

A
  1. flexion
  2. extension
62
Q

Matching Type:

  1. DF assistance
  2. Permits interchanging shoes, limits footdrop
  3. Traditional foundation for AFO, U-shaped fixture
  4. Limits all foot and ankle motion
  5. Coil spring compresses in stance and rebounds
    during swing

A. Insert / Footplate
B. Stirrup
C. Posterior Leaf Spring
D. Klenzak Joint
E. Solid AFO

63
Q

Matching Type:

  1. Its center is riveted to the shoe through the shank; holds the shoe underneath
  2. For stability in cases of hemiplegia, spastic diplegia
  3. DF spring assist between the stirrup and bar strip
  4. Holds foot to 90° (neutral), assists during heel strike
  5. Provides good control of foot but reduces shoe volume

A. Insert / Footplate
B. Stirrup
C. Posterior Leaf Spring
D. Klenzak Joint
E. Solid AFO

64
Q

TRUE OR FALSE: The trimline of a solid AFO is anterior to malleoli to immobilize entire
ankle and restrict foot drop.

65
Q

Identification: The posterior leaf spring is indicated for patients with DF weakness / foot drop d/t what nerve impingement?

A

Common peroneal nerve

66
Q

Fill in the blanks: In the posterior leaf spring, the posterior shell is behind the (1)___, proximal shell is at (2)___ of the leg, & distal part should only extend up to metatarsal (3)___.

A
  1. malleoli
  2. midpart
  3. shafts

Additional: Metatarsal heads are excluded as they receive
the greatest pressure during forefoot contact

67
Q

Determine whether posterior pin or spring is appropriate

  1. Limits PF
  2. Knee hyperextension
  3. Toe drag, pain with ankle motion
  4. Flaccid footdrop
  5. Assists DF
  6. Plantar spasticity

A. Posterior pin
B. Posterior spring

A
  1. A
  2. B
  3. A
  4. B
  5. B
  6. A
68
Q

Determine whether anterior pin or spring is appropriate

  1. Pain with ankle motion
  2. Limits DF
  3. No clinical indications
  4. Weak plantarflexors
  5. Weak extensors
  6. Assists PF

A. Anterior pin
B. Anterior spring

A
  1. A
  2. A
  3. B
  4. A
  5. A
  6. B
69
Q

Matching Type:

  1. For subtalar joint control to
    limit varus or valgus.
  2. For active pts, controls but does not eliminate motion in all planes bc of its design
  3. Reduces the amount of weight transmitted to the foot
  4. Control the tendency of the foot to assume an equinovarus posture
  5. Allows for controlled mobility

A. BiCAAL
B. Spiral AFO
C. Patellar-Tendon-Bearing Brim
D. Tone Reducing Orthosis
E. Supramalleolar Orthosis

70
Q

Enumerate 4 types of superstructure

A
  1. Spiral AFO
  2. Tone Reducing Orthosis
  3. Patellar-Tendon-Bearing brim
  4. Calf band
71
Q

Fill in the blanks: The tone reducing orthoses are plastic AFOs designed for children with spastic (1)__ and adults with spastic (2)__.

A
  1. cerebral palsy
  2. hemiplegia
72
Q

TRUE OR FALSE: The tone reducing orthosis is useful for individuals
who have min
spasticity with varus instability, but do not have fixed deformity.

A

False

Reason: It should be mod spasticity

73
Q

Fill in the blanks: In the tone reducing orthosis, footplate and broad upright are
designed to modify reflex (1)__ by applying constant pressure to the (2)__ and (3)__.

A
  1. hypertonicity
  2. plantarflexors
  3. invertors
74
Q

Matching Type:

  1. Heavy and cumbersome
  2. Lumbosacral orthosis attached KAFOs
  3. From ankle & foot to midthigh to provide control in allowed motions of knee joint
  4. Addition of a pelvic band and hip joints
  5. Locked hip joints, restrict gait to swing-to or
    swing-through pattern

A. THKAFO
B. HKAFO
C. KAFO

75
Q

Identification: Primarily used for pediatrics. It May be achieved with plastic calf shells shaped to apply
corrective force for genu valgum or genu varum.

A

Frontal plate control

Additional: To reduce genu valgum, the medial portion of shell extends proximally to apply laterally directed force at the knee.

76
Q

TRUE OR FALSE: Hip joint is placed on the lateral side of brace until the axis of the joint is at the measured distance from knee joint axis to greater trochanter.

77
Q

Fill in the blanks: In hip joints, two-position lock stabilizes the pt in hip (1)__ for standing and walking, and (2)__ of hip flexion for sitting.

A
  1. extension
  2. 90º
78
Q

Fill in the blanks: Hip joints are attached to KAFO which allows (1)___ only. They prevent (2)__, (3)__, & (4)__.

A
  1. flexion-extension
  2. adduction
  3. abduction
  4. rotation
79
Q

Identification: A metal hinge that connects the lateral upright of the KAFO to a pelvic band.

80
Q

Matching Type:

  1. Applies a posteriorly directed force to complement
    the anteriorly directed forces from back of the shoe and thigh band
  2. Locks automatically when the knee is 0º.
  3. Allows mechanical axis to be posterior to
    anatomical axis, thus improve stability
  4. Provides simultaneous locking of both uprights
  5. Most common knee control, manual control at proximal uprights

A. Off-set joint
B. PAWL Lock with Bail Release
C. Knee Cap
D. Drop-Ring Lock

81
Q

Matching Type

  1. Does not hamper knee flexion during swing or sitting, only stabilizes during knee extension
  2. Joint may flex inadvertently or knee buckling when the wearer walks on ramps
  3. Contraindicated for knee flexion contracture
  4. When the client stands with the knee fully extended, the ring drops, preventing the uprights from bending
  5. Hinge placed posterior to the midline of the leg

A. Off-set joint
B. PAWL Lock with Bail Release
C. Knee Cap
D. Drop-Ring Lock

82
Q

Cause of excessive medial or lateral foot contact

A

Transverse plane malalignment

83
Q

Common gait deviation in late stance is the inadequate transition: delayed or (1)__ transfer of weight over the (2)__. Orthotic causes are (3)__ stop & (4)__ dorsiflexion stop.

A
  1. absent
  2. forefoot
  3. plantarflexion
  4. inadequate
84
Q

Determine which deviations occur in the phases of the gait cycle.

  1. Vaulting
  2. Foot slap
  3. Inadequate transition
  4. Anterior trunk bending
  5. Hip hiking

A. Early Stance
B. Late Stance
C. Swing

85
Q

Determine which deviations occur in the phases of the gait cycle.

  1. Toes first
  2. Toe drag
  3. Circumduction
  4. Hyperextended knee
  5. Flat foot contact

A. Early Stance
B. Late Stance
C. Swing

86
Q

Determine which deviations occur in the phases of the gait cycle.

  1. Wide walking base
  2. Excessive medial or lateral foot contact
  3. Posterior trunk bending
  4. Internal or external rotation
  5. Excessive knee flexion
  6. Lateral trunk bending

A. Early Stance
B. Late Stance
C. Swing

A
  1. A
  2. A
  3. A
  4. A
  5. A
  6. A
87
Q

Orthotic causes of wide walking base:
Excessive height of (1)__ upright of KAFO; Excessive (2)__ of hip joint of HKAFO; Insufficient lift on (3)__ shoe; Knee lock; Requires (4)__.

A
  1. medial
  2. abduction
  3. contralateral
  4. walking aid
88
Q

Lower extremity swings outward in a semicircular arc

A

Circumduction

89
Q

Lower extremity elevated at pelvis to enable the limb to swing forward

A

Hip hiking

90
Q

Exaggerated plantarflexion of contralateral lower extremity to enable the limb to swing forward

91
Q

Toes maintain contact with ground

92
Q

In a wide walking base, heel centers more than ____ apart.

A

4 inches (10 cm)

93
Q

Tiptoe posture may or may not be maintained throughout stance

A

Toes first

94
Q

Entire foot contacts ground initially

A

Flat foot contact

95
Q

Knee collapses when foot contacts ground

A

Excessive knee flexion

96
Q

In lateral trunk bending, the patient leans toward ____ as weight is transferred to LE.

A

Stance leg

97
Q

Conducted with the orthosis on the patient while standing and sitting, as well as examination of the device off the individual

A

Static examination

98
Q

TRUE OR FALSE: In dynamic examination, the gait pattern exhibited by the person who wears an orthosis reflects both the contribution of the wearer’s general health status and the orthotic motion control and assistance.

99
Q

TRUE OR FALSE: In LE Orthosis Examination, the fit and alignment of the shoe, ankle joint, calf band, shell or PTB brim, mechanical knee joint, knee lock, medial uprights, and pelvic joint must be checked.

100
Q

Anterior trunk bending is caused by inadequate (1)__ lock. Anatomical causes may be (2)__ muscles are weak, and hip and knee (3)__ contractures.

A
  1. knee
  2. quadriceps
  3. flexion
101
Q

In posterior trunk bending, the (1)__ muscle may be weak and there is (2)__ ankylosis. Orthotic causes are inadequate (3)__ lock and the (4)__ lock.

A
  1. gluteus maximus
  2. knee
  3. hip
  4. knee
102
Q

Wide walking base is anatomically caused by (1)__ contracture, (2)__ balance, and a (3)__ contralateral LE.

A
  1. abduction
  2. poor
  3. short
103
Q

Inadequte transition in late stance may be caused by weak (1)__, (2)__ sprain or rupture, pes (3)__, and (4)__ pain.

A
  1. plantarflexors
  2. achilles tendon
  3. calcaneus
  4. forefoot
104
Q

Anatomic causes of toe drag are weak (1)__, plantar flexor (2)__, pes (3)__, and weak hip (4)__.

A
  1. dorsiflexors
  2. spasticity
  3. equinus
  4. flexors
105
Q

Foot slap is anatomically caused by

A

Weak dorsiflexors

106
Q

TRUE OR FALSE: Toes first is anatomically caused by short LE, pes equinus, extensor spasticity, and heel pain

107
Q

TRUE OR FALSE: Poor balance and pes calcaneus can cause flat foot contact. Its orthotic causes are requiring a walking aid, and inadequate traction from sole and inadequate dorsiflexion stop.

108
Q

TRUE OR FALSE: Excessive medial or lateral foot contact is anatomically caused by weak invertors or evertors, pes valgus or varus, and genu valgum or varum

109
Q

TRUE OR FALSE: Internal or external rotation may be caused by weak or spastic internal or external rotators, anteversion or retroversion, and weak quadriceps (ER).

110
Q

TRUE OR FALSE: Hip hiking & circumduction may be caused by extensor synergy, while vaulting may be caused by extensor spasticity.

111
Q

Excessive knee flexion can be caused by inadequate knee lock, inadequate (1)__ stop, plantarflexion (2)__ and inadequate (3)__ shoe lift

A
  1. dorsiflexion
  2. restriction (stop)
  3. contralateral
112
Q

Hyperextended knee may be caused by excessively (1)__ calf band, inadequate knee lock, pes (2)__ uncompensated by contralateral shoe lift, and (3)__ inadequately controlled by plantarflexion stop.

A
  1. concave / deep
  2. equinus
  3. genu recurvatum
113
Q

Uprights incorrectly aligned in ___ plane and requires orthotic control are orthotic causes of internal or external rotation.

A

transverse

114
Q

TRUE OR FALSE: Lateral trunk bending may be caused by excessive height of medial upright of KAFO, excessive abduction of hip joint of HKAFO, requires walking aid, and insufficient shoe lift

(2) Assistive Technology🦿 (9 decks)

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