S2_L2.2: LE Orthoses & Common Gait Dev'ns Flashcards
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.
Rocker bar
Fill in the blanks: A rocker bar is specifically prescribed to pts who have difficulty in transitioning from (1)__ to (2)__ to (3)__.
- Heel strike
- Initial contact
- Foot flat
Identification: This protects the heel during heel strike.
Cushion heel
Matching Type for MEDIAL Heel Wedge
- Pes valgus
- Inversion
- Pronation
- Pes planus
- Supination
- Pes varus
Choices:
A. Correct flexible
B. Accommodate Rigid
- A
- B
- A
- A
- B
- B
Matching Type for LATERAL Heel Wedge
- Pronation
- Eversion
- Pes varus
- Pes cavus
- Pes valgus
- Supination
Choices:
A. Correct flexible
B. Accommodate Rigid
- B
- B
- A
- A
- B
- A
Fill in the blanks: (1)___ are given specifically if there is a depressed scaphoid bone. It is to correct a flat (2)___ longitudinal arch.
- Scaphoid pads
- Medial
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?
Longitudinal arch support
Matching Type:
- Reduces ground-reactive force to the heel
- Reduces ground-reactive force to ball/head. Improves total efficiency of initial stance all the way to late stance
- Holds foot dorsiflexed especially during initial stance & during off-loading of forefoot
- Inhibits demand for DF of toes especially during late stance
- Inhibits demand for motion in the ankle joint.
- 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
- E
- C
- A
- F
- D
- B
Identification: This is indicated for pt’s with jack foot deformity
Healing rocker
Identification: It is the proximal portion of the orthosis. It is a weight-relieving orthosis consisting of uprights, and a shell, band or brim.
Superstructure
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.
Shoe lifts
Identification: It is used to realign a flexible flat foot, immobilize
midfoot fracture and correct posterior tibial malfunction
University of California Biomechanics Laboratory (UCBL) Insert
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.
- depression
- flattening
Identification: It allows for alternate or reciprocal swiveling and simulates the reciprocal gait.
Swivel walker
Identification: It is prescribed for adults with paraplegia
Scott-Craig Knee-Ankle-Foot Orthosis
Identification: It is prescribed for patients who cannot achieve full knee extension due to a knee flexion contracture.
Serrated Knee Joint
Fill in the blanks: The off-set joint allows the mechanical axis to be (1)___ to the anatomical axis and thus improve (2)___.
- posterior
- stability
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.
Drop-Ring Lock
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)___.
- proprioception
- increased
- pes cavus
Identification: It reduces plantar pressure especially for pt’s who
suffers from insensitivities such as cases like diabetic neuropathy
Metatarsal pad
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)___.
- convex
- inner
- apex
- shafts
Identification: 3 functions of the foot in gait
- Shock absorption
- Adaptation to surface
- Propulsion
Identification: Appliances that apply forces to the foot. Whether it immobilizes, corrects, or makes the feet adjust to several environments during ambulation.
Foot orthoses
Identification: 2 purposes of foot orthosis
- pain relief
- inserts can improve wearer’s transition during stance phase
Fill in the blanks: Inserts are made of resilient materials to reduce impact (1)___ and (2)___, brought about by ambulation due
to the (3)___.
- shock
- shear
- ground reaction force
Identification: It acts like a second skin, if a pt has difficulty in identifying or positioning the foot in relation to its body position.
Full-length insert / Full-length orthosis
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.
Metatarsal pad
TRUE OR FALSE: Metatarsal pads reduces plantar pressure especially for pts who suffer from insensitivities such as cases like diabetic neuropathy.
True
Enumerate the advantage and disadvantage of internal modifications.
Advantage: Does not affect the aesthetic appearance of the
shoes
Disadvantage: Reduces shoe volume.
Identification: Helpful for pts who suffer from a flexible pes planus
Longitudinal arch support
Differentiate longitudinal arch support from a full-length insert.
The longitudinal arch support does not cover the entire foot.
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.
- scaphoid
- talus
- primary keystone
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)___.
- minimum
- medial
- sustentaculum tali
- navicular tuberosity
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)
University of California Biomechanics Laboratory (UCBL) Insert
Identification: The UCBL landmarks are heel cups extend to the (1)___ area and (2)___ to the metatarsal (3)___.
- inframalleolar
- distal
- heads
Identification: This ensures that the patient wears the appropriate shoes and does not reduce
shoe volume.
External modification
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.
False
Rigid ankle
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.
False
Shortened limb
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)___.
- posterior
- late
- metatarsal shafts
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.
False
Reduces the distance,
Improving late stance
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.
Lateral Wedge / Reverse Thomas Heel
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.
- anterior
- medial
- medial
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.
Medial heel wedge
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.
- medial heel wedge
- thomas heel
- pronated
Identification: It alters alignment of the rearfoot.
Heel wedge