Student Presentation Take Home Slides Flashcards
Gold standard for treating diabetic ulcers
total contact cast
but there are other options If cast is contraindicated
what type of modifications should be made for diabetic footwear
should use external shoe modifications with rocker shoe or in-depth shoe
what is the best method of plantar pressure redistribution for diabetic foot wear
shoe inserts and in-depth shoes are best to redistribute pressure
help prevent ulcers and correct/prevent deformities
when/how/why to use braces with chronic ankle instability
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)
what improper mechanics can result in patellofemoral pain syndrome
IR of hip and/or overpronation of foot can lead to improper mechanics at knee
what knee braces should be used with PFPS
knee braces, sleeves, and straps not recommended for PFPS
what interventions provide best short term benefits with PFPS
prefabricated foot orthotics and patellar taping provide short term benefits when combined with exercise program (specifically posterolateral hip and weight bearing knee exercises)
purpose of offloading orthoses for knee OA
pain relief
load redistribution
joint realignment
types of off loading knee OA braces
rigid off loader knee brace
soft unloader brace
combined functionality knee brace
clinical use of knee offloading braces
enhance function
delay/avoid sx
improve overall function
is bracing effective post ACL sx
may not be physical advantages but it can provide psychological security
is bracing post ACL necessary and what are some comparative interventions
depends on individual needs and goals
KT taping and brace free are also options
what should be taken into account when choosing a knee brace for an ACL pt
desired activities
not all braces can withstand the same levels of activities
main applications of FES for MS pts
foot drop
weakened grasp
decreased CV endurance
what mm is FES applied to most commonly with MS pts, corresponding to what functional limits
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
benefits of FES with MS pts
improved ability to perform ADLs
slowed mm atrophy
improved cognitive processing
improved QOL
what pts typically powered LE orthoses (exoskeletons)
paraplegic pts
T8 and below SCI
but still has been used with higher level injuries and stroke
functional outcome measures used with pts using powered lower limb orthoses
10 meter walk
TUG
6MWT
gait speed
effects of powered exoskeletons
have shown clinical improvements but struggle to have community impact
compared to powered lower limb orthoses, HNP does produce community gait speeds
impact of MMT on use of hybrid neuroprostheses vs powered exoskeletons
powered exoskeletons not limited by MMT or mm fatigue like HNP
how does an intrepid dynamic exoskeleton orthosis work, who gets them, and what is their purpose
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
use of RGOs
aids in walking for those with LE weakness or paralysis s
promotes ore natural and energy efficient reciprocal gait pattern
indications for use of RGO
SCI and neuro conditions
must have good head, neck, and UE control
minimal knee contractures and flexible hips
neutral feet or correctable deviations
benefits of RGOs
physical = overall mobility, respiratory function, urinary function, prevents contractures, pressure relief
gold standard treatment for infants with developmental hip dysplasia
dynamic splints are the gold standard
harnesses for developmental hip dysplasia are most effective when
kids under 6 months
pavlik harness vs Von Rosen device for DHD
pavlik is good for DHD but has risk of developing AVN
Von Rosen had better results with no risk
when should cervical collars be used
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
where do majority of spinal burst fxs occur
thoracolumbar region between T11 and L5
how are burst fxs treated
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
how do cranial remolding orthoses work and what are the guidelines for wear
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)
main goal of using a shoulder orthotic post stroke
prevent GH sublet by eliminating the vertical and horizontal pull of gravity
guidelines for shoulder orthosis use post stroke
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
guidelines for orthotic use for carpal tunnel
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
