248 Edm: Orthotics

Front 1

what is the 3 point princiople?

Back 1

single force applied at the area of deformity or angulation (force acting laterally is placed medially at knee to correct genu valgus)

-2 additional counterforces, each half the value of the single force, act in the opposite diretion (e.g. 2 forces acting medially located on the lateral thigh and calf.

Front 2

Blucher opening of shoes:

Back 2

Has vamps (the flaps contain the lace stays) that open wide apart from the anterior margin of the shoe for ease of application

Front 3

Bal (Balmoral) opening of shoes:

Back 3

Has stitched down vamps
Not suitable for orthotic wear

Front 4

what is a heel insert?

Back 4

reduces the pressure on the tender area with cutouts and sloping anteriorly
-Used for heel spurs, plantar fasciitis

Front 5

what is a scaphoid pad?

Back 5

usually supports longitudinal arch

used for pes planus

Front 6

what is a semirigid plastic insert? (UCBL)

Back 6

1. Encompasses heel and midfoot

2. applies medial or lateral force to calcaneus

3. used for subtalar (rearfoot) eversion or inversion abnormalities

Front 7

what is metatarsal pad?

Back 7

1. used for metatarsalgia

2. placed proximal to met heads/over met shafts

3. takes pressure off met heads

Front 8

what is metatarsal bar?

Back 8

1. flat strip of material

2. placed posterior to met heads

3. used for metatarsalgisaa

Front 9

Thomas heel wedge is what?

Back 9

aka medial heel wedge

Extended anteriorly along the medial side to augment the effect of the medial wedge in supporting the medial longitudinal arch

Front 10

Thomas or medial heel wedge is used for what?

Back 10

Pronation
Flexible pes valgus

Front 11

Lateral heel wedge does what?

Back 11

1. Provides support along the lateral side of the heel
2. Used for excessive pes varus (supination) or genu varum

Front 12

Medial/lateral sole wedges do what?

Back 12

1. Alter metatarsal alignment
2. Lateral wedge shifts weight bearing to medial side of the front of foot
3. Medial wedge shifts weight laterally
4. Used for fixed lateral forefoot valgus or varus problems

Front 13

Rocker bar does what?

Back 13

1. Builds up the sole proximal to the metatarsal heads
2. Allows more push off in weak or inflexible feet

3. shifts weight bearing load onto shafts

4. used for metatarsalgia and with weak PF

Front 14

what does the plastic foot plate do?

Back 14

1. provides best control of the foot

2. shoe must close high on dorsum of foot

3. allows for ease of donning orthosis

4. allows changing shoes of the same heel height

Front 15

Metal stirrup is what?

Back 15

1. U-shaped attachment riveted to the sole of the shoe
2. arms of the stirrup join the uprights at the level of the anatomic ankle
3. Solid stirrup is attached permanently to the shoe and provides maximum stability
4. Split stirrup has three segments and allows for shoe interchange by detaching the uprights from the shoes

Front 16

Free motion ankle joint allows for what?

Back 16

DF & PF while providing for medial and lateral stability

Front 17

Solid AFO allows what?

Back 17

No movement
Indicated with severe pain or instability

-to compensate for lack of PF in early stance, a hinged solid AFO may be utilized to provide slight sagittal motion

Front 18

Limited motion ankle control allows motion where?

Back 18

To be restricted in one or both directions

Front 19

Bichannel adjustable ankle lock (BiCAAL) is what?

Back 19

Consists of a pair of joints with anterior and posterior channels that can have either springs to assist motion or pins to reduce motion

Front 20

Posterior stop limits what?

Back 20

PF

Front 21

Posterior stop is used to correct for what?

Back 21

Knee recurvatum in stance
Toe drag during swing phase

Front 22

Anterior stop limits what?

Back 22

DF

Front 23

Anterior stop is used to prevent what?

Back 23

Knee buckling or excessive knee flexion during early stance

Front 24

Posterior leaf spring provides what?

Back 24

DF assistance from a plastic insert that lifts the foot during swing phase
Used for weak DF

Front 25

Spring assist (Klenzak joint) does what?

Back 25

-double upright metal AFO with single anterior channel for spring assist to aid DF

-coil spring is compressed in stance and rebounds in swing

-not appropriate if spasticity is a factor

Front 26

what can medial and lateral motion of the foot/ankle be controlled by?

Back 26

plastic AFO

or leather correction straps (valgus/varus straps)

Front 27

Varus or Valgus T-straps?

Back 27

1. Medial strap buckles around lateral upright and corrects valgus

-applies lateral force to restrain pronation

-control subtalar joint or rear foot

2. lateral strap buckles around medial upright and corrects varus

-exerts medial force to restrain supination of rear foot

Front 28

Molded plastic AFOs are what?

Back 28

-Have a single upright or shell that can:

1. limit mediolateral motion (e.g.,solid AFO)

2. assist with motion (e.g.,posterior leaf spring) or

3. control for motion in all planes (e.g.,spiral AFO)

Front 29

Molded plastic AFOs are contraindicated for patients with what?

Back 29

changing leg volume (e.g. dialysis or CHF)

Front 30

Conventional AFOs are what?

Back 30

Have one or two metal uprights that attach to the shoe and to a calf band (leather or plastic) that provides proximal stabilization on the leg

Front 31

Conventional AFOs provide for what?

Back 31

1. Maximal mediolateral support
2. Allow for lower limb volume changes
3. Usually contain an orthotic ankle joint to assist or restrict ankle motion (e.g., posterior PF stop)

Front 32

Floor reaction orthosis is what?

Back 32

Has an/anterior band that is part of a solid ankle AFO and imposes a posterior force near the knee, resisting knee flexion

Front 33

Patella tendon bearing brim is what?

Back 33

Resembles an below knee prosthetic socket that allows for weight distribution on the patellar shelf

-brim is used with a plastic solid AFO or a metal limited motion ankle joint

Front 34

Tone reducing orthoses are what?

Back 34

1. Plastic AFOs designed for children with spastic cerebral palsy and adults with spastic hemiplegia
2. They apply constant pressure to spastic muscles (PFs and inverters) and modify the reflex hypertonicity

Front 35

What does a hinge joint on a KAFO provide?

Back 35

1. Mediolateral support

2. hyperextension control

3. while allowing flexion/extension of the knee

Front 36

Offset knee joint is what?

Back 36

A hinge placed posterior to the midline of the leg (weight-bearing line)

Front 37

Offset joint assists in what?

Back 37

1. Knee extension during mid-late stance
2. Stabilizes the knee in early stance (minimizes external flexion moment)
3. May flex inadvertently when the wearer walks on ramps

Front 38

Offset knee joint is contraindicated with what?

Back 38

Knee flexion contracture

Front 39

Drop ring lock is what & does what?

Back 39

1. The most common knee control
2. Locks the knee in extension
3. Upon standing, the ring drops over the joint preventing the knee from bending
4. A spring loaded retention button is used to hold the ring up and unlock one hinge at a time

Front 40

Pawl lock with bail release is what?

Back 40

1. A spring-loaded posterior projection (lever or ring) that allows the patient to unlock the knee by pulling up or hooking the pawl on the back of a chair and pushing it up
2. May release unexpectedly with posterior knee pressure or if the patient is jostled against a rigid object
3. Bulkier than drop ring lock

Front 41

how is sagittal stability achieved in KAFO?

Back 41

-bands or straps that provide posteriorly directed force that complements the anteriorly directed forces from the back of the shoe & thigh band

-Anterior bands can be pretibial or suprapatellar as well and may interfere with sitting

Front 42

how is frontal plane stability achieved in KAFO?

Back 42

with plastic calf shells or straps to correct genu valgum or varum

Front 43

Craig-Scott KAFOs is what?

Back 43

1. Commonly used for individuals with paraplegia (T9-T12 lesions)
2. Consists of shoe attachments with reinforced foot plates, BiCAAL ankle join set in slight DF, pretibial band, pawl knee locks with bail release, and single thigh bands

Front 44

Oregon Orthotic System KAFOs is what?

Back 44

Uses rigid plastic AFOs or KAFOs to restrict motion in the transverse, frontal, and sagittal planes

Front 45

what is a reciprocating gait orthosis (RGO)

Back 45

1. specialized THKAFO

2. Uses solid-molded AFOs with knee locks, plastic thigh shells, a hip joint with pelvic band & metal cables connecting both hips
3. The cables allow for a reciprocating gait pattern by preventing inadvertent hip flexion on the supporting leg
4. The wearer uses a four-stage procedure to ambulate
5. Can be a four- or two-point gait pattern

Front 46

what is the procedure to ambulate with a THKAFO?

Back 46

1. shift weight to the R leg

2. tuck the pelvis by extending the upper thorax

3. press on the crutches

4. allow left leg to swing through

Front 47

Reciprocating gait orthosis (RGO) THKAFOs are used for patients with what?

Back 47

T9-12 level of spinal cord lesion or spina bifida lesion
Usually with children

Front 48

ParaWalker is what?

Back 48

1. very sturdy hip joints that limit hip flexion and resist hip abduction and adduction as the wearer shifts weight from side to side during ambulation
2. The gait pattern is the same as with an RGO

Front 49

ParaWalker is used for patients with what?

Back 49

Lower thoracic spinal cord lesions

Front 50

Lenox Hill Knee orthoses (KO) does what?

Back 50

Mediolateral
Multiple ligament
Rotatory

Front 51

Pro-Am Knee orthoses (KO) does what?

Back 51

Anteroposterior

Rotatory
Mediolateral

Front 52

Iowa Knee Orthosis Knee orthoses (KO) does what?

Back 52

Mediolateral
Collateral ligament
Postoperative

Front 53

Palumbo KO?

Back 53

Patellar

Front 54

what is a swedish knee cage

Back 54

controls excessive hyperext of knee

Front 55

function of knee wraps and soft supports.

Back 55

e.g. neoprene sleeves

-supports knee

-assists in stabilizing the patella

-temp use for soft tissue injuries

Front 56

Patellar knee support is used for what?

Back 56

Postoperative rehabilitation
Patellar tendinitis
Patellofemoral dysfunction
Dislocations

Front 57

what is the patellar knee support?

Back 57

neoprene sleeve with patellar cutout and rubber buttress that is horseshoe-shaped to aid patella in proper gliding

Front 58

Hip orthoses (HO) is usually used for what?

Back 58

Legg-Calve-Perth disease (avascular necrosis of he hip) in which the patient's affected hip is held in ABD & IR for proper centralization of the femoral head in the acetabulum (e.g. Toronto hip orthosis or Scottish Rite orthosis)

Front 59

what is a standing frame used for?

Back 59

aka swivel walker

-permit wearer to stand without crutch support, freeing hands for activities

-can move by rotating the upper torso to shift weight and rock the frame from side to side

Front 60

Parapodium is what?

Back 60

1. Differs from the standing frame because of the joints that permit the wearer to sit
2. The knees or hips can be unlocked as needed
3. For walking longer distances, crutches or a walker are used with a swing-to or swing-through gait pattern

Front 61

Corset provides what?

Back 61

1. Abdominal compression & increases intra-abdominal pressures
2. Assists respiration in patients with spinal cord injuries
3. Relieves pain in low-back disorders
4. Acts as a sacroiliac support (e.g.,pregnancy)

Front 62

Thoracolumbosacral flexion-extension-control-orthosis (TLS FE) is what?

Back 62

aka Taylor Brace

-Includes components of LS FEL (lumbosacral Flexion extension lateral control orthosis) with addition of axillary shoulder straps to limit upper trunk flexion

Front 63

Plastic thoracolumbosacral jacket does what?

Back 63

1. Provides maximum support and control of all motions
2. Used in individuals recovering from spinal cord injury
3. Allows for early mobilization out-of-bed and functional training

Front 64

Jewett (TLSO) does what?

Back 64

Limits flexion, but encourages hyperextension (lordosis)
Used for compression fractures of the spine

Front 65

Philadelphia collar provides what?

Back 65

A more rigid form of support than soft cervical collar & less cervical motion because it's made of plastic

Front 66

Four-poster orthosis is what?

Back 66

-Have two plates (occipital & thoracic) with 2 anterior & 2 posterior posts to stabilize the head
-Provides for moderate control of cervical motions

Front 67

Halo orthosis is what?

Back 67

Attaches to the skull by screws with 4 uprights that attach to a thoracic jacket
Provides maximal control for patients with cervical fracture/spinal cord injury

Front 68

Minerva orthosis is what?

Back 68

Provides for maximal control of cervical motion using a forehead band instead of screws

Front 69

what are scoliosis orthoses used for?

Back 69

preventing lateral curve from increasing

Front 70

Milwaukee orthosis is what?

Back 70

A cervical, thoracic, lumbosacral orthosis (CTLSO) used to control scoliosis

used for Scoliotic curves of 40° or less

Front 71

Boston orthosis (TLSO) is what?

Back 71

Low-profile, molded plastic orthosis for scoliosis
More cosmetic, can be worn under clothing

Front 72

Boston orthosis (TLSO) is used when?

Back 72

-curves of 40 degrees or less
-To treat spondylolisthesis
-Conditions of severe trunk weakness (muscular dystrophy)

Front 73

what is a resting splint (cock-up splint)?

Back 73

1. An anterior or palmar splint that positions the wrist and hand in a functional position
2. Wrist can be held in neutral or 12°-20° of extension
3. Fingers are supported and all phalanges are slightly flexed with the thumb in partial opposition and abduction

Front 74

when is a resting splint indicated?

Back 74

1. RA
2. Fractures of the carpal bones
3. Colles' fracture
4. Carpal tunnel syndrome
5. Stroke with paralysis

Front 75

Dorsal wrist splint does what

Back 75

1. Frees the palm for feeling/grasping by the use of grips that curve around & over the 2nd & 5th metacarpal heads
2. Allows for the attachment of dorsal devices (e.g.,rubber bands) to make it a dynamic device

Front 76

when is a wrist-driven tenodesis orthosis (flexor hinge orthosis) used?

Back 76

assist pt in using wrist extensors to approximate thumb and forefingers in absence of active finger flexion

-patients with quadriplegia (usually C6)