Student Presentation Take Home Slides

Question 1

Gold standard for treating diabetic ulcers

Answer 1

total contact cast

but there are other options If cast is contraindicated

Question 2

what type of modifications should be made for diabetic footwear

Answer 2

should use external shoe modifications with rocker shoe or in-depth shoe

Question 3

what is the best method of plantar pressure redistribution for diabetic foot wear

Answer 3

shoe inserts and in-depth shoes are best to redistribute pressure

help prevent ulcers and correct/prevent deformities

Question 4

when/how/why to use braces with chronic ankle instability

Answer 4

should be used in conjunction with other interventions

Rx should be individualized to pt needs

braces do more than provide support (i.e. can use for pain, decreased RIM, poor positioning, etc)

Question 5

what improper mechanics can result in patellofemoral pain syndrome

Answer 5

IR of hip and/or overpronation of foot can lead to improper mechanics at knee

Question 6

what knee braces should be used with PFPS

Answer 6

knee braces, sleeves, and straps not recommended for PFPS

Question 7

what interventions provide best short term benefits with PFPS

Answer 7

prefabricated foot orthotics and patellar taping provide short term benefits when combined with exercise program (specifically posterolateral hip and weight bearing knee exercises)

Question 8

purpose of offloading orthoses for knee OA

Answer 8

pain relief

load redistribution

joint realignment

Question 9

types of off loading knee OA braces

Answer 9

rigid off loader knee brace

soft unloader brace

combined functionality knee brace

Question 10

clinical use of knee offloading braces

Answer 10

enhance function

delay/avoid sx

improve overall function

Question 11

is bracing effective post ACL sx

Answer 11

may not be physical advantages but it can provide psychological security

Question 12

is bracing post ACL necessary and what are some comparative interventions

Answer 12

depends on individual needs and goals

KT taping and brace free are also options

Question 13

what should be taken into account when choosing a knee brace for an ACL pt

Answer 13

desired activities

not all braces can withstand the same levels of activities

Question 14

main applications of FES for MS pts

Answer 14

foot drop
weakened grasp
decreased CV endurance

Question 15

what mm is FES applied to most commonly with MS pts, corresponding to what functional limits

Answer 15

foot drop = peroneous longs and anterior tibialis

grasp = flexor digitorum profundus, flexor pollicis longus/brevus, opponens pollicis

endurance: glutes, quads, HS, anterior tibialis, and gastroc

Question 16

benefits of FES with MS pts

Answer 16

improved ability to perform ADLs

slowed mm atrophy

improved cognitive processing

improved QOL

Question 17

what pts typically powered LE orthoses (exoskeletons)

Answer 17

paraplegic pts

T8 and below SCI

but still has been used with higher level injuries and stroke

Question 18

functional outcome measures used with pts using powered lower limb orthoses

Answer 18

10 meter walk

TUG

6MWT

gait speed

Question 19

effects of powered exoskeletons

Answer 19

have shown clinical improvements but struggle to have community impact

compared to powered lower limb orthoses, HNP does produce community gait speeds

Question 20

impact of MMT on use of hybrid neuroprostheses vs powered exoskeletons

Answer 20

powered exoskeletons not limited by MMT or mm fatigue like HNP

Question 21

how does an intrepid dynamic exoskeleton orthosis work, who gets them, and what is their purpose

Answer 21

custom designed for each pt

store energy when the foot hits the ground and used that energy to create a spring in the initial swing

prescribed to reduce pain/discomfort and increase soldiers activity level

originally made for wounded vets and now available for civilians in some locations

Question 22

use of RGOs

Answer 22

aids in walking for those with LE weakness or paralysis s

promotes ore natural and energy efficient reciprocal gait pattern

Question 23

indications for use of RGO

Answer 23

SCI and neuro conditions

must have good head, neck, and UE control

minimal knee contractures and flexible hips

neutral feet or correctable deviations

Question 24

benefits of RGOs

Answer 24

physical = overall mobility, respiratory function, urinary function, prevents contractures, pressure relief

Question 25

gold standard treatment for infants with developmental hip dysplasia

Answer 25

dynamic splints are the gold standard

Question 26

harnesses for developmental hip dysplasia are most effective when

Answer 26

kids under 6 months

Question 27

pavlik harness vs Von Rosen device for DHD

Answer 27

pavlik is good for DHD but has risk of developing AVN

Von Rosen had better results with no risk

Question 28

when should cervical collars be used

Answer 28

indicated for C/S fx, sx, and stabilizing spine from trauma if SCI is suspected

should only be used in acute phase

mot enough stability/limited ROM for WAD

Question 29

where do majority of spinal burst fxs occur

Answer 29

thoracolumbar region between T11 and L5

Question 30

how are burst fxs treated

Answer 30

burst fx w/o neuro involvement considered to be stable and can be treated conservatively with bracing

rigid TSLOs are most common used brace

evidence suggests no significant difference in outcomes with conservative treatment vs no treatment in burst fxs w/o neuro involvement

Question 31

how do cranial remolding orthoses work and what are the guidelines for wear

Answer 31

use a flexible pilypropylene outer shell lined with soft foam to mold flattened areas of skull into symmetrical shape

most effective if started at 4-6 months

should be worn for 23 hours/day (should gradually progress the first few days)

Question 32

main goal of using a shoulder orthotic post stroke

Answer 32

prevent GH sublet by eliminating the vertical and horizontal pull of gravity

Question 33

guidelines for shoulder orthosis use post stroke

Answer 33

combined with therEx leads to best benefits for strength, ROM, stability, pain relief, and more

should only be applied when pt is upright and only utilized until pt has regained proper stability for the shoulder joint

Question 34

guidelines for orthotic use for carpal tunnel

Answer 34

nighttime wear of neutral positioned wrist orthoses for short term relief

if no relief from night time, adjust wear time to include day time, symptomatic, or full time wear

one position/design not favorable over another

orthoses demonstrated improvement over sx in short term