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97 Cards in this Set
- Front
- Back
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how should the axis of rotation of the device compare to the joint
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should be lined up .... if not pistoning will ride up the leg when walking
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what are the trimlines
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where the plastic is cut... dictates operation of the orthosis
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what is SAAFO
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solid axis AFO = rigid AFO
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what does a Rigid AFO do
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1) limits all foot and ankle motion
2) provides tibial control in stance 3) prevents DF or PF 4) facilitates clearance with swing and heel strike at initial contact 5) Controls M/L subtalar instability |
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what will the effect be on gait if a patient using a rigid AFO doesn't have good hip/knee control
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they will take shorter steps
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what is the negative to the rigid AFO
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it takes the knee with it, not allowing anterior translation of the tibia
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what does a Hinged AFO do
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1) provides M/L stability
2) hinge can allow for passive DF 3) Can be fitted with springs and stpos |
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what is the benefit to the hinge allowing for passive DF in a hinged AFO
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allows a longer step length
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what is the negative to the hinged AFO
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it will wear out on a very active person
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what does a hinged AFO do that a solid AFO or no AFO cannot do
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hinged AFO increases DF in terminal stance and increases ankle power in push-off
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Springs ____ motion and stops _____ motion
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springs assist motion, stops limit motion
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a patient with what type of contracture might not be appropriate for an AFO
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PL contracture
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what would a patient with Kennedy disease look like while walking
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- tend to invert
- knee tends to flex during stance |
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what does a dorsiflexion stop control
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it prevents uncontrolled knee flexion
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what are two things in an AFO that could prevent the knee from buckling
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1) DF stop
2) force applied posteriorly from materials in the front |
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A unistrut is made of what material allowing it to be very light and incredibly strong
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carbon fiber
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what would a metal double upright AFO be used for
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old school polio
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what are the characteristics of a metal double upright AFO
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1) attached to a shoe
2) Can add strap for inv/ev 3) hinged ankle, dorsi srping assist, stops are all possible |
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where should straps lying below the knee be placed
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below the fibular head so as not to pinch the peroneal nerve
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which AFOs should have a patient wearing socks
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ALL of them
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which AFO is the "off the shelf models" known for being cheap - why are they beneficial
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posterior leaf spring - good to try something like this first to see if you can fix the problem by using an AFO
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what is the function of a posterior leaf spring
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1) push-off assist provided by the elasticity of the plastic
2) light weight 3) fits inside shoe, under clothes |
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how is the posterior leaf spring shaped
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upright is bent slightly posterior
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what would a spiral AFo be used for
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to control but not limit motions in all planes
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who would not benefit from a spiral AFO
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excessive pronator/supinator
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how is a spiral AFO designed
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single upright spirals from medial aspect of foot to around leg to terminate medially
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what would a hemispiral AFO be better for (compared to a spiral AFO)
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better control pronation/supination
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what is the main function of the floor reaction AFO
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designed to harness GRF for sagital plane stability of the knee
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how does the floor reaction AFO work
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fixed, slightly pflex ankle creates extension moment at the knee
- so pushes tibia posterior so knees dont buckle |
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what would the primary AFO be for crouched gait pattern (knees flex too much)
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floor reaction AFO
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What is a DAFO
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dynamic ankle-foot orthosis
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what is a DAFO used for
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to modify reflex hypertonicity
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how does a DAFO reduce tone
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by applying pressure to the plantarflexors and invertors
- surrounds the whole foot so that all the proprioceptive input is supposed to shut down tone/spasticity in PF/DF |
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What is a supramalleolar orthosis used for (SMO)
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- ML stability than a foot orthosis
- allows some DF and PF |
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What is a UCBs
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Deep Heel component that controls heel, midfoot, transverse and longitudinal arch
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what is the point of an ankle stabilizing orthosis (look like volleyball braces)
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- prophylaxis!
- limit ROM - increase proprioceptive feedback to help control ankle |
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what is an aircast brace used for
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ankle fx
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how does an aircast brace work
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- it has 4 seperate air bags inside the shell that uses pneumatic compression to unload the tib/fib by stabilizing the surrounding musculature
- also increased hydrostatic pressure in tissue facilitates healing and contributes to Fx stability |
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how does an achilles orthosis work
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- compressive load on the tendon helps to unload the soft tissue
- decreasing tensile stress on the tendon |
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how does a plantar fascia stretching brace work
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- worn at night to apply a passive constant gentle stretch
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what is a sweedish knee cage used for
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control of hyperextension in the knee
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when is a sweedish knee cage not appropriate
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if the hyhperextension is from ankle (plantarflexion) rather than from the knee (weak quads)
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when are swedish knee cagtes commonly used
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short term post-stroke
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what is a KAFO
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knee-ankle-foot orthosis
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who is a KAFO used for
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someone who has a knee joint but has extreme LE weakness (polio, post stroke)
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what is the function of a KAFO
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locked in extension during ambulation, but allows flexion to sit
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what are the 3 types of joints that could be at the knee
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1) offset joint (either post or ant)
2) drop lock 3) bail lock |
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what does an offset joint do
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posteriorly offsets the joint so that the GRF is kept anteriorly allowing the knee to go into extension
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what does a drop lock do
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slider (at jt) slides up to sit, or can lock the knee into extension to walk
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what does a bail lock do
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locks into extension when standing but allows the person to back up into a chair and clock the lock off in order to sit down
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an offset joint requires the patient to have some ____
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quad strength
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a drop lock requires the patient to have some _____
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UE strength
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what is the purpose of a patellofemoral pain device
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- help achieve and maintain optimal patellar tracking to prevent abnormal compressive forces
- prevent excessive lateral shifting |
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how dos the patellar tracking type orthosis work (looks like a U shape under patella)
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- creates extension torque resisting hamstrings, thus unloading the quads with a spring
- realigns pelvic position |
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who is a KAFO used for
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someone who has a knee joint but has extreme LE weakness (polio, post stroke)
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what is the function of a KAFO
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locked in extension during ambulation, but allows flexion to sit
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what are the 3 types of joints that could be at the knee
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1) offset joint (either post or ant)
2) drop lock 3) bail lock |
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what does an offset joint do
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posteriorly offsets the joint so that the GRF is kept anteriorly allowing the knee to go into extension
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what does a drop lock do
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slider (at jt) slides up to sit, or can lock the knee into extension to walk
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what does a bail lock do
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locks into extension when standing but allows the person to back up into a chair and clock the lock off in order to sit down
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an offset joint requires the patient to have some ____
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quad strength
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a drop lock requires the patient to have some _____
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UE strength
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what is the purpose of a patellofemoral pain device
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- help achieve and maintain optimal patellar tracking to prevent abnormal compressive forces
- prevent excessive lateral shifting |
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how dos the patellar tracking type orthosis work (looks like a U shape under patella)
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- creates extension torque resisting hamstrings, thus unloading the quads with a spring
- realigns pelvic position |
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who is a KAFO used for
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someone who has a knee joint but has extreme LE weakness (polio, post stroke)
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what is the function of a KAFO
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locked in extension during ambulation, but allows flexion to sit
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what are the 3 types of joints that could be at the knee
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1) offset joint (either post or ant)
2) drop lock 3) bail lock |
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what does an offset joint do
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posteriorly offsets the joint so that the GRF is kept anteriorly allowing the knee to go into extension
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what does a drop lock do
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slider (at jt) slides up to sit, or can lock the knee into extension to walk
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what does a bail lock do
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locks into extension when standing but allows the person to back up into a chair and clock the lock off in order to sit down
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an offset joint requires the patient to have some ____
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quad strength
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a drop lock requires the patient to have some _____
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UE strength
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what is the purpose of a patellofemoral pain device
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- help achieve and maintain optimal patellar tracking to prevent abnormal compressive forces
- prevent excessive lateral shifting |
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how dos the patellar tracking type orthosis work (looks like a U shape under patella)
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- creates extension torque resisting hamstrings, thus unloading the quads with a spring
- realigns pelvic position |
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how does the infrapatellar strap work
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elevates the patella and facilitates optimal tracking
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what is important to acknowledge when using a patellofemoral pain decvice
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not to apply a ton of force to the patella because it can still probably dislocate
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what is the function of the ACL stability braces (return to sport braces)
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suppose to prevent varus/valgus torque, but the literature is 50/50
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what do the rehabilitation knee braces do
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limit/control motion
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how does a total hip replacement orthosis work
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- keeps the patient in 15 deg. abduction
- allows better contact |
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who would wear a total hip replacement orthosis
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patients that are prone to dislocate
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what is a pavlik harness used for
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developmental hip dysplagia, sublux and dislocation
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what does a pavlik harness do
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keeps the child in abduction and external rotation promoting growth of a stable hip joint
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what is a static hip abductor orthosis used for
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hip dysplagia
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what is a scottish-rite abduction orthosis used for
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legg-calve-perthes disease
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what is an HGO
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hip guidance orthosis
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what is an RGO
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reciprocating gait orthosis
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what are HGO's and RGO's used for
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paraplegics/CP/SCI to walk
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what are the characteristics of an HGO
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- freely moving hip joint (rely on the person to advance the limb
- heavier/less flexible - easier to put on |
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what are the characteristics of an RGO
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- dual cable system for reciprocal flex/ext between the legs
- molded plastic feet sections |
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a _____ is worn OUTside of clothes whereas a _____ is worn INside clothes
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HGO= outside
RGO= inside |
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a ____ is used with axillary crutches whereas a ____ is used with rolling or reciprocating walker
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HGO= axillary crutches
RGO= rolling/reciprocating walker |
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with a HGO you advance the limb by_____ whereas wtih a RGO you advance the limb by _____
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HGO= advance by hip hiking
RGO= extending on stance side |
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how do SI support belts decrease tensile stress
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compress tissue around the SI joint
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how do SI support belts decrease anterior shear forces created by the abdomen
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by placing an ant/inf. force through the sacrum facilitating sacral extension and posterior rotation of the ilia
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how do SI support belts provide stability
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by decreaseing available movemnt
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Si support belts increase cutaneous unput for
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spinal posture and movement
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what are cranial molding helmets used for
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plagiocephaly
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