Equipment, Devices, And Therapeutic Modalities (Backho)

Front 1

CRUTCHES

Measurement.
(1) In the standing position,
(2) If the patient is supine,

Back 1

a. Patient's height - 16 inches
b. Point 2 inches below the axilla to a point 6 inches in front and 2 inches lateral to the foot.

Measure from the axilla to a point 6-8 inches lateral to the heel.

Front 2

CRUTCHES

When the patient uses the crutches,

Elbow angle??

Back 2

20-30 degrees of elbow flexion

Front 3

CRUTCHES

(1) Have a forearm cuff and handgrip.
(2) Can be used for stair climbing.
(3) Provide slightly less lateral stability and free the hands for use without dropping the crutch that is secured by the cuff.

Back 3

Forearm (Lofstrand)

Front 4

CRUTCHES Gait Patterns

( ) point gait
One assistive device and the opposite extremity move together followed by the opposite assistive device and extremity.

Back 4

Two-point gait

Front 5

CRUTCHES Gait Patterns

( ) point gait
Both assistive devices and the involved leg are advanced together, and then the uninvolved leg is
advanced forward.
Indication : ( )

Back 5

Three-point gait

Use with the involvement of one extremity
(e.g., lower extremity fracture).

Front 6

CRUTCHES Gait Patterns

Swing (to / through) gait
Assistive devices are advanced forward together, the weight is shifted onto the hands for support and both legs are swung forward to meet the assistive devices.

Indication :

Back 6

Swing-to gait

Limited use of both lower extremities and trunk instability

Front 7

CRUTCHES Gait Patterns

Swing (to / through) gait
Assistive device is advanced forward, the body weight is shifted onto the hands for support and both legs are then swung forward beyond the point of the assistive device placement.

Indication :

Back 7

Swing-through gait

Bilateral lower extremity involvement and trunk
instability (e.g., patient with paraplegia or spina bifida)

Front 8

Canes

Unload the weight bearing forces at the hip by ( ) %.

Back 8

30%.

Front 9

CANES Measurement

(1) Elbow angle :

(2) From ~ To :

Back 9

(1) 20-30 degrees of elbow flexion

(2) Measure from the greater trochanter to a point 6 inches to the side of the toes

Front 10

DEVICES

Frequently prescribed for patients with debilitating conditions, poor balance or lower extremity injury'
when the use of crutches is not advisable
(e.g., elderly patients).

Back 10

WALKERS

Front 11

Walker Gait pattern

swing (to/through) and (three/four) point gait patterns

Back 11

swing-to and three point gait patterns

Front 12

GUARDING

On level surfaces, the therapist should stand slightly behind and to one side, typically on the more (involved / uninvolved) side, of the patient

Back 12

involved

Front 13

Specialized wheelchairs

Lightweight,
(rigid/folding) frames,
(low/high) seats,
(low/high) backs,
slanted drive wheels,
(small/large) push rims.

Back 13

Lightweight, rigid frames, low seats, low backs, slanted drive wheels, small push rims.

Front 14

Specialized wheelchairs

Entire seat tips backward as a unit maintaining a 90 degree angle between the seat and back.
Indication :

Back 14

Tilt-in-space.

Patients with trunk extensor spasms or for pressure relief.

Front 15

Specialized wheelchairs

Used with patients who are unable to independently maintain an upright posture.
May be electric and assist in pressure relief

Back 15

Pressure relief if a patient cannot do active push-ups or pressure relief maneuvers
(e.g. upper cervical quadriplegia).

Front 16

Foot orthoses (FO)

Usually supports the longitudinal arch.

Used for pes planus.

Back 16

Scaphoid pad.

Front 17

Foot orthoses (FO)

Provides support along the lateral side of the heel.

Used for excessive pes varus (supination) or genu varum.

Back 17

Lateral heel wedge.

Front 18

Foot orthoses (FO)

Takes the pressure off of the metatarsal heads by building up the sole proximal to the metatarsal heads over the metatarsal shafts.

Used for metatarsalgia.

Back 18

Metatarsal pad.

Front 19

Foot orthoses (FO)

Builds up the sole proximal to the metatarsal heads. Allows more push off in weak or inflexible feet. Shifts the weight-bearing load onto the shafts.

Used for metatarsalgia and with weak plantartlexion.

Back 19

Rocker bar.

Front 20

Foot orthoses (FO)

A flat strip of leather or other firm material placed posterior to the metatarsal heads.

Used for metatarsalgia.

Back 20

Metatarsal bar.

Front 21

Foot orthoses (FO)

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

Used for pronation and flexible pes valgus.

Back 21

Thomas or medial heel wedge.

Front 22

Foot orthoses (FO)

Encompasses the heel and midfoot, applying medial or lateral force to the calcaneus.

Used for subtalar (rear foot) eversion or inversion abnormalities

Back 22

Semirigid plastic insert (University of California Biomechanics Lab UCBL).

Front 23

Foot orthoses (FO)

Made of viscoelastic plastic or rubber that reduces the pressure on the tender area with cutouts and sloping anteriorly.

Used for: heel spurs, plantar fasciitis.

Back 23

Heel insert

Front 24

Ankle foot orthosis (AFO)

Ankle control : ( )
A plastic orthosis that limits all foot and ankle motion.

Used for severe pain or-instability.

Back 24

Solid AFO

Front 25

Ankle foot orthosis (AFO)

Ankle control : ( )
Metal posterior stop.
Incorporated into the stirrup to limit (dorsiflexion/ plantarflexion.)

Used to correct (1) for knee : (2) for toe :

Back 25

Plantarflexion

Used to correct for knee recurvatum in stance and toe drag during swing phase of gait.

Front 26

Ankle foot orthosis (AFO)

Ankle control
Metal anterior stop.
Limits (dorsiflexion / plantarflexion.)

Used to prevent knee (1) : , (2) :

Back 26

Dorsiflexion

Used to prevent knee buckling or excessive knee flexionduring early stance

Front 27

Ankle foot orthosis (AFO)

Ankle control : ( )
Provides dorsiflexion assistance from a plastic insert that lifts the foot during swing phase.
Used for weak dorsiflcxors.

Back 27

Posterior leaf spring

Front 28

Ankle foot orthosis (AFO)

Ankle control : ( )
Incorporated into each stirrup. Provides motion assistance with a coil spring that is compressed in stance and rebounds during swing. Not appropriate if spasticity is a factor.

Back 28

Dorsiflexion spring assist (Klenzak joint)

Front 29

Foot control

( ) strap
Attaches on the lateral side and exerts a medial force to restrain supination of the rear foot.

Back 29

Varus strap

Front 30

Foot control

( ) strap
Attached to the medial portion of the shoe, exerting a lateral force to restrain pronation. It controls the subtalar joint or rear foot.

Back 30

Valgus correction strap

Front 31

Knee ankle foot orthosis (KAFO).
Knee controls : ( )
(a) Provides mediolateral support and hyperextension control while allowing flexion and extension of the knee.
(b) KAFOs usually have two uprights.

Back 31

Hinge joint

Front 32

Knee ankle foot orthosis (KAFO).
Knee controls : ( )
(a) The most common knee control. Locks the knee in extension.
(b) Upon standing, the ring drops over the joint preventing the knee from bending.
(c) A spring-loaded retention button is used to hold the ring up and unlock one hinge at a time.

Back 32

Drop ring lock.

Front 33

Knee ankle foot orthosis (KAFO).
Knee controls : ( )
(a) A hinge placed posterior to the midline of the leg (weight bearing line).
(b) Assists in knee extension, stabilizes the knee in early stance and may flex inadvertently when the
wearer walks on ramps.
(c) Contraindicated with knee flexion contracture.

Contraindication : ( )

Back 33

Offset joint

Knee flexion contracture.

Front 34

Knee ankle foot orthosis (KAFO).
Knee controls : ( )
(a) 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.
(b) May release unexpectedly with posterior knee pressure or if the patient is jostled against a rigid
object. Bulkier than drop ring lock.

Back 34

Pawl lock with bail release

Front 35

Reciprocating gait orthosis (RGO).
(1) Uses :

(2) Used for patients with ( ) ~ ( ) level of spinal cord lesion or spina bifida lesion

Back 35

Solid molded AFOs with knee locks,
plastic thigh shells,
hip joint with pelvic band and metal cables connecting both hips.

T9-12

Front 36

Knee orthoses (KO).

Continuous metal piece making up sidebars and posterior cross member with anterior thigh and calf straps that provide control for excessive hyperextension of the knee (recurvatum).

Back 36

Swedish knee cage

Front 37

Orthotic options for paraplegia.

a. Permit the wearer to stand without crutch support, freeing the hands for activities.
b. The patient can move by rotating the upper torso to shift weight and rock the frame from side to side.

Back 37

Standing frame and swivel walker.

Front 38

Orthotic options for paraplegia.


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

Back 38

Parapodium.

Front 39

TRUNK (SPINAL) ORTHOSES : ( ) = (e.g.. ).
Control or limit lumbosacral motions.
Lumbosacral flexion, extension, lateral control orthosis (LS FEL).
Includes pelvic and thoracic bands to anchor the orthosis with two posterior uprights, two lateral uprights and an anterior corset.

Back 39

Lumbosacral orthoses (LSO)

(e.g.. Knight LSO).

Front 40

Jewett (TLSO).

Limitation motion :
Encourage motion :

Indication :

Back 40

Limits flexion and
Encourages hyperextension (lordosis) of the spine.

Used for compression fractures of the spine.

Front 41

Cervical orthoses (CO)

Soft Collar (foam).
Provides minimal levels of control of cervical motions (e.g., cervical pain, whiplash injury).

Back 41

Philadelphia collar

Front 42

Cervical orthoses (CO)

Attaches to the skull by screws with four uprights that attach to a thoracic jacket. Provides for maximal control of cervical motion.

Back 42

Halo orthosis

Front 43

Cervical orthoses (CO)

Have two plates (occipital and thoracic) with two anterior and two posterior posts tostabilize the head. Provides for moderate control of cervical motions.

Back 43

Four-poster orthosis.

Front 44

Scoliosis orthoses

A cervical, thoracic, lumbosacral orthosis (CTLSO) that is a molded jacket and one anterior and two posterior uprights extended to a superior neck or chest ring. Used for scoliotic curves of 40 degrees or less.

Back 44

Milwaukee orthosis

Front 45

Scoliosis orthoses

A low profile, molded plastic orthosis that is more cosmetic and can be worn under clothing. Can be used by athletes during competition. Used for scoliotic curves of 40 degrees or less, to treat spondylolisthesis and conditions of severe trunk weakness (e.g., muscular dystrophy).

Back 45

Boston orthosis (TLSO).

Front 46

UPPER LIMB ORTHOSES

a. An anterior or palmar splint that positions the wrist and hand in a functional position.
b. Wrist can be held in neutral or 12 to 20 degrees of extension.

Back 46

Resting splint (cock-up splint).

Front 47

UPPER LIMB ORTHOSES

Positions the patient's arm at 90 degrees of abduction, 90 degrees of elbow flexion. Used to immobilize the shoulder following fracture or injury when strapping to the chest is not desirable, or with burns.

Back 47

Airplane splint.

Front 48

Assists the patient in using the wrist extensors to
approximate the thumb and forefingers (grip) in the absence of active finger flexion (e.g., facilitates-tenodesis grasp in the patient with quaclriplegia (usually at the ___ level).

Back 48

Wrist-driven tenodesis orthosis
(flexor hinge orthosis).

C6

Front 49

Initial contact (early stance)

Foot slap;
Forefoot slaps the ground

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 49

(1) Inadequate dorsiflexion assist;
inadequate plantarflexion stop

(2) Flaccid or weak dorsiflexors

Front 50

Initial contact (early stance)

Toes first;
Tiptoe posture may be held through stance

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 50

(1) Inadequate heel lift, inadequate dorsiflexion assist; inadequate plantarflexion stop; inadequate
relief of heel pain

(2) Short leg, pes equinus, extensor spasticity, heel pain

Front 51

Initial contact (early stance)

Foot flat contact;
Entire foot contacts ground at heel strike

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 51

(1) Inadequate traction from sole; requires walking aid, (e.g., cane); inadequate dorsiflexion stop

(2) Poor balance; pes calcaneus

Front 52

Initial contact (early stance)

Excessive medial foot contact;
medial border contacts the floor

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 52

(1) Transverse plane malalignment

(2) Weak inverters (evertors); pes valgus (varus); genu valgum (varum)

Front 53

Initial contact (early stance)

Excessive knee flexion;
knee flexes or buckles as foot hits the ground

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 53

(1) Inadequate knee lock;
inadequate dorsiflexion stop;
plantarflexion stop;
inadequate contralateral shoe lift

(2) Knee pain; short contralateral leg;
knee or hip flexion contracture;
weak quadriceps: flexor synergy

Front 54

Initial contact (early stance)

Excessive lateral foot contact;
Lateral border contacts the floor

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 54

(1) Transverse plane malalignment

(2) Weak evertors;
pes varus; genu varum

Front 55

Initial contact (early stance)

Hyperextended knee;
Knee hyperextends as weight is transferred to leg

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 55

(1) Genu recurvatum inadequately controlled by plantarflexion stop;
excessively concave calf band;
pes equinus uncompensated by contralateral shoe lift; inadequate knee lock

(2) Weak quadriceps;
lax knee ligaments; extensor synergy; pes
equinus; short contralateral leg;
contralateral knee or hip flexion contracture

Front 56

Initial contact (early stance)

Forward trunk lean;
Patient leans forward as leg accepts weight

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 56

(1) Inadequate knee lock

(2) Compensation for quadriceps weakness; hip and knee flexion contractures

Front 57

Initial contact (early stance)

Backward trunk lean;
Patient leans backward as leg accepts weight

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 57

(1) Inadequate hip lock; knee lock

(2) Weakness of the gluteus maximus on the stance leg; knee ankylosis

Front 58

Initial contact (early stance)

Lateral trunk lean;
Patient leans toward stance leg with weight

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 58

(1) Excessive height of medial upright of KAFO;
Excessive abduction of hip joint of HKAFO;
Insufficient shoe lift; requires walking aid

(2) Weak gluteus medius; Abduction contracture; Dislocated hip; Hip pain; Poor balance; Short leg

Front 59

Initial contact (early stance)

Wide walking base;
Heel centers more than 10 cm (4 inches) apart

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 59

(1) Excessive height of medial upright of KAFO; Excessive abduction of hip joint of HKAFO; Insufficient shoe lift; (e.g., cane; knee lock)

(2) Abduction contracture;
Poor balance; short contralateral leg requires walking aid

Front 60

Initial contact (early stance)

Internal rotation of limb

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 60

(1) Uprights incorrectly aligned in transverse plane; requires orthotic control (e.g., rotation control straps, pelvic band)

(2) Internalhip rotators spastic; External hip rotators weak; Antetorsion; retroversion;
weak quadriceps,
external rotation

Front 61

Late stance

Inadequate transition;
Delayed or absent transfer of weight over the forefoot

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 61

(1) Plantarflexion stop; inadequate dorsiflexion stop

(2) Weak plantarflexors;
Achilles tendon sprain or rupture; Pes calcaneus; Forefoot pain

Front 62

Swing

Toe drag: toes maintain contact with ground

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 62

(1) Inadequate dorsiflexion assist;
inadequate plantarflexion stop
Knee lock;

(2) Weak dorsiflexors; plantarflexor spasticity;
pes equinus; weak hip flexors Extensor;
extensor synergy; knee or ankle ankylosis;

Front 63

Swing

Circumduction: leg swings outward in a semicircular arc

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 63

(1) inadequate dorsiflexion assist;
inadequate plantarflexion stop

(2) weak dorsiflexors; pes equinus

Front 64

Swing

Hip hiking:
Leg elevated at pelvis to enable the limb to swing forward

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 64

(1) Knee lock; inadequate dorsiflexion assist; inadequate plantarflexion stop

(2) Short contralateral leg;
contralateral knee or hip flexion contracture;
weak hip flexors; extensor synergy;
knee or ankle ankylosis; weak dorsiflexors

Front 65

Swing

Vaulting:
Exaggerated plantarflexion of the contralateral leg to
enable the limb to swing forward

(1) Orthotic Cause :
(2) Anatomical Cause :

Back 65

(1) Knee lock; inadequate dorsiflexion assist; inadequate plantarflexion stop

(2) Weak hip flexors; extensor spasticity; pes equinus; short contralateral leg; contralateral
knee or hip flexion contracture; knee or ankle ankylosis; weak dorsiflexors

Front 66

Amputation : ( )

a. For a long below-knee amputation (BKA), more than 50% of tibial length is spared.
b. For a standard BKA, 20-50% of the tibial length is spared.
c. For a short BKA, less than 20% of the tibia is spared.

Back 66

Transtibial

Front 67

Amputation : ( )

a. Long above-knee amputation (AKA), more than 60% of the femoral length is spared.
b. Ideally an AKA has 35-60% of the femoral length spared.
c. Short AKA has less than 35% of the femoral length spared.

Back 67

Transfemoral

Front 68

Amputation : ( )

a. Ankle disarticulation with attachment of the heel pad to the distal end of the tibia for weight bearing.
b. May include the removal of the malleoli and distal tibia and fibular flares.

Back 68

Syme's.

Front 69

Postoperative dressings : ( )

Use of an immediate postoperative dressing greatly limits the development of residual limb edema,
reduces postoperative pain, enhances wound healing, allows for earlier ambulation with attachment of a pylon and foot, reduces time to shrink residual limb.

Back 69

Rigid dressing

Front 70

Temporary prosthesis

Advantage :

Back 70

(1) Shrinks residual limb more effectively than elastic wrap.
(2) Allows for early bipedal ambulation and early return to normal functioning.
(3) A positive motivational factor by providing an early replacement for the missing body part. Generally used for younger candidates whose amputation was not a result of vascular disease.
(4) Reduces the need for complex exercises. Many people return to full active daily life.

Front 71

Non-articulated feet : ( )

Most common foot, non-articulating, variety of cosmetic colors to match skin, durable, easy to use, rollover at terminal stance.
Contains energy absorbing cushion heel and internal wooden keel that terminates at a point corresponding to the metatarsophalangeal joints.

※ Disadvantages :

Back 71

SACH foot (solid ankle cushion heel).

Not used over uneven terrain for long distance ambulation, or if energy conservation is needed.

Front 72

Non-articulated feet : ( )

A version of the SACH foot.
Allows for walking on moderately uneven terrain because of the greater range of mediolateral motion permitted in the rear-foot.

※ Disadvantages :

Back 72

SAFE foot (stationary attachment flexible endoskeleton)

Heavier, more expensive and less durable than SACH foot

Front 73

Non-articulated feet : ( )

(a) Slightly flexible plastic keel bends at heel contact.
(b) Keel stores energy and recoils in late stance releasing energy for springy termination to stance.

Back 73

Seattle foot

Front 74

Above-knee prostheses

Quadrilateral socket :
The medial wall is the same height as the posterior wall while the anterior and lateral walls are
( ) to ( ) inches higher.

Back 74

2.5 to 3

Front 75

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
BELOW-KNEE AMPUTATIONS

Initial contact (early stance)
Excessive knee flexion

(1) Prosthetic Causes :
(High/Low) shoe heel; insufficient (plantarflexion/dorsiflexion); (soft/stiff) heel cushion;
socket too far (anterior/posterior); socket excessively (flexed/extended); cuff tabs too (anterior/posterior)

(2) Anatomic Causes :

Back 75

(1) High shoe heel; insufficient plantarflexion;
stiff heel cushion; socket too far anterior; socket excessively flexed; cuff tabs too posterior

(2) Flexion contracture; weak quadriceps

Front 76

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
BELOW-KNEE AMPUTATIONS

Initial contact (early stance)
Insufficient knee flexion
(1) Prosthetic Causes :
(High / Low) shoe heel;
excessive (plantarflexion/dorsiflexion);
(soft/stiff) heel cushion;
socket too far (anterior/posterior);
socket insufficiently (flexed/extended)
(2) Anatomic Causes :

Back 76

(1) Low shoe heel; excessive plantarflexion;
soft heel cushion; socket too far
posterior; socket insufficiently flexed

Front 77

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
BELOW-KNEE AMPUTATIONS

Mid stance
Excessive lateral thrust : ( )
Excessive medial thrust : ( )

Back 77

Excessive foot inset

Excessive foot outset

Front 78

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
BELOW-KNEE AMPUTATIONS

Early knee flexion:
Drop off

(1) Prosthetic Causes : (High/Low) shoe heel;
Insufficient (dorsiflexion/plantarflexion);
keel too (short/long); dorsiflexion stop too (soft/stiff); socket too (anterior/posteror)
socket excessively (flexed/extended); cuff tabs too (anterior / posterior)

Back 78

(1) High shoe heel; insufficient plantarflexion;
keel too short; dorsiflexion stop too soft; socket too anteriorsocket excessively flexed; cuff tabs too posterior

(2) Flexion contracture

Front 79

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
BELOW-KNEE AMPUTATIONS

Delayed knee flexion:
Walking up hill

(1) Prosthetic Causes : (Low/High) shoe heel; excessive (dorsiflexion / plantarflexion);
keel too (short/long); dorsiflexion stop too (soft/stiff);
socket too (anterior/posterior); socket not (flexed/extended) enough

(2) Anatomic Causes :

Back 79

Low shoe heel; excessive plantarflexion; keel too long; dorsiflexion stop too stiff; socket too posterior; socket not flexed enough

Extensor hyperreflexia

Front 80

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Stance

Deviation : Abduction

(1) Prosthetic Causes
(2) Anatomic Causes

Back 80

(1) Long prosthesis; abducted hip joint;
inadequate lateral wall adduction;
sharp or high medial wall

(2) Abduction contracture; weak abductors; laterodistal pain; instability

Front 81

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Swing

Deviation : Circumduction

(1) Prosthetic Causes : (Short/Long) prosthesis; locked knee unit; (loose/rigid) friction; inadequate suspension; (small/large) socket; (loose/rigid) socket; foot (dorsiflexed/plantarflexed)
(2) Anatomic Causes :

Back 81

(1) Long prosthesis; locked knee unit; loose friction; inadequate suspension; small socket; loose socket; foot plantarflexed

(2) Abduction contracture; poor knee control

Front 82

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Stance

Deviation : Lateral bend
(1) Prosthesis Causes : (Short/long) prosthesis; inadequate lateral wall (adduction/abduction); sharp or high medial wall
(2) Anatomical Causes : (Adduction / Abduction) contracture; weak (adductors/abductors); hip pain; instability; (short/long) amputation limb

Back 82

(1) Short prosthesis; inadequate lateral wall adduction; sharp or high medial wall

(2) Abduction contracture; weak
abductors; hip pain; instability; short amputation limb

Front 83

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Stance

Deviation : Forward flexion

Prosthetic Causes :

Back 83

Unstable knee unit; short walker or crutches

Front 84

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Stance

Deviation :

(1) Prosthetic Causes :
(2) Anatomic Causes :

Back 84

(1) Inadequate socket flexion

(2) Hip flexion contracture; weak extensors

Front 85

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Heel off

Deviation : Medial whip
(1) Prosthetic Causes :
(2) Anatomic Causes :

Back 85

(1) Faulty socket contour; knee bolt externally (internally) rotated; foot malrotated; prosthesis donned in malrotation

(2) With sliding friction unit; fast pace

Front 86

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Heel contact

Deviation : Foot rotation
Prosthetic Causes : (Soft / Stiff) heel cushion; malrotated foot

Back 86

Stiff heel cushion; malrotated foot

Front 87

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Early swing

Deviation : High heel rise

Prosthetic Causes : Inadequate friction; (slakc / taut) extension aid

Back 87

Inadequate friction; slack extension aid

Front 88

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Late swing

Deviation : Terminal impact

(1) Prosthetic Causes : Inadequate friction; (slakc / taut) extension aid
(2) Anatomic Causes :

Back 88

(1) Inadequate friction; taut extension aid

Front 89

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Swing

Deviation : Vaulting

(1) Prosthetic Causes :
(2) Anatomical Causes :

Back 89

(1) See above: circumduction

(2) With sliding friction unit; fast pace

Front 90

PROSTHETIC GAIT ANALYSIS AND DEVIATIONS
ABOVE-KNEE AMPUTATIONS : Swing

Deviation : Hip hike Uneven step length
(1) Prosthetic Causes :
(2) Anatomical Causes :

Back 90

(1) See above: circumduction Uncomfortable socket; insufficient socket flexion

(2) Hip flexion

Front 91

THERAPEUTIC MODALITIES

Hot packs.

Immersing in water between ( ) to ( ) degrees

Back 91

165-170 degrees

Front 92

Paraffin bath

Treatment temperature :

Back 92

125F°-127 F°.

Front 93

THERAPEUTIC MODALITIES : ( )

Use alternating hot and cold immersion to help decrease pain, increase circulation and decrease swelling.

Temperatures :

Time ratio :

ending in (hot/cold) immersion.

Back 93

40C° (104F°) for the hot
15C° (59F°) for the cold.

3~4 min (Hot) / 1min(cold)

Hot

Front 94

Ultrasound (US).

(Lower/Higher) intensities and (pulsed/continuous) US are used for acute conditions or thin tissue.

(Lower/Higher) intensities and (pulsed/continuous) US may be used for chronic conditions or thick tissue.

Back 94

Lower intensities and pulsed

Higher intensities and continuous

Front 95

Mechanical spinal traction

Degree
(1) To increase intervertebral space at CI -C4 :
(2) For C5-C7 :
(2) For disc dysfunction :

Back 95

(1) 0-5 degrees of flexion

(2) 20-30 degrees of flexion

(3) 0 degrees

Front 96

Lumbar spine positions

Degree
(1) For spinal stenosis :

(2) For posterior herniated disc :

Back 96

(1) hip and knee are placed in 90 degrees of flexion (90/90 position).

(2) prone position without a pillow is preferred position.

Front 97

Intermittent compression

Recommendation that the setting

Back 97

Never exceed the patient's diastolic blood pressure

Front 98

Iontophoresis.

cathode (negative pole) : ( 4 )

Back 98

salicylate (pain relief)

acetate (calcium deposits)

dexamethasone (anti-inflammation)

iodine (softens scars)

Front 99

A form of pulsed direct current (DC) stimulation using high voltage twin spikes with pulse widths in
microseconds.
The chemical, polar and thermal effects of DC are minimized because of the extremely short duration (pulse
width) of the stimulus.

Back 99

High voltage pulsed monophasic stimulation.

Front 100

Russian current

Uses high frequency ( ) current, which is modulated to ( ) for comfort

Indications :

Back 100

2500 Hz

70 pps

Used for strengthening of normal muscle by assisting with the muscle contraction during volitional activities such as isometric exercises and short arc joint movements.

Front 101

Functional electrical stimulation (FES)

(1) innervated muscle for general stimulation :

(2) denervated muscle

Back 101

(1) Alternating current (AC at 80-100Hz)

(2) Direct current (DC) that is interrupted with a long pulse

Front 102

FES ratio

(1) Minimal or no atrophy or weakness
(2) Moderate atrophy
(3) Severe atrophy

Back 102

(1) 1:1 or 1:2

(2) 1:3 or 1:4

(3) 1:5 to 1:10

Front 103

Hot packs

There should be ( ) - ( ) layers of toweling between
the hot pack and the patient.

Back 103

6-8 layers

Front 104

Paraffin bath

paraffm wax and mineral oil mixture ratio :

Treatment temperature of paraffin:

Back 104

6:1 or 7:1

125F° -127_F.

Front 105

Physics related to hydrotherapy

Heat-absorbing capacity of water. The amount of heat a gram of water absorbs or gives off to change the temperature 1°C.

Back 105

Specific heat

Front 106

Physics related to hydrotherapy

Capability of a liquid, gas, or solid to conduct heat.

Back 106

Thermal conductivity

Front 107

Physics related to hydrotherapy

Upward force of the water on an immersed or partially immersed body or body part which is equal to the weight of the water that it displaced (Archimedes' principle).

Back 107

Buoyancy

Front 108

Physics related to hydrotherapy

Fluid molecules move with respect to one another. High temperature
lowers the viscosity of the fluid.

Back 108

Viscosity

Front 109

Physics related to hydrotherapy

Circumferential water pressure exerted on an immersed body part. A pressure gradient is established between the surface water and deeper water caused by the increase in water density at deeper levels.

Back 109

Hydrostatic pressure

Front 110

Physics related to hydrotherapy

Tendency of water molecules to adhere to one another.

Back 110

Cohesion

Front 111

Whirlpool

Used for patients with burns, wounds, or those
who are infected with blood-borne pathogens
(human immunodeficiency virus or hepatitis-B
virus)

Back 111

Whirlpool liners

Front 112

Treatment temperature:

(1) whirlpool.
(2) Hubbard tank.
(3) Peripheral vascular disease.
(4) open wounds.

Back 112

(1) 103°F-110°F

(2) 100°F

(3) 95°-100°F

(4) 92°-96°F

Front 113

Ultrasound (US)

Transducer size :
Area of the faceplate (crystal size) which is smaller relative to the soundhead.
Transducer size should be selected relative to the size of the treatment area (I cm2 = wrist; 5 cm2 = shoulder, leg).

Back 113

Effective radiating area (ERA)

Front 114

Ultrasound (US)

The reduction of acoustical energy as it passes through soft tissue.

Back 114

Attenuation

Front 115

Ultrasound (US)

Reflection and refraction effect attenuation.

Back 115

Absorption