Kineosiology Upper-Limb Orthotics

Front 1

What is the most important/most influential force on the upper limb?

Back 1

gravity

Front 2

Give relative (percent) weights fo the arm and hand (of total body weight)

Back 2

- arm 5%
- hand 0.6%

Front 3

Kinesiology definition of orthotics

Back 3

Application of forces to correct abnormal forces acting on the limb - often to protect tissues, prevent abnormality or promote function

Front 4

General purpose of upper limb orthotics

Back 4

provide stability to PROXIMAL structures for increased function at distal structures

Front 5

Give an example of redundant and uniques forces in the upper limb

Back 5

- redundant: tenodesis for wrist extention
- unique: shoulder abduction (if deltoid is weak, not much can substitute)

Front 6

List four purposes of therapeutic orthotics

Back 6

- stabilize
- mobilize
- aid in healing
- prevent or reduce contractures

Front 7

List five purposes of functional orthotics

Back 7

- stabilize proximally
- enhance or maximize muscle action
- assist movement
- substitute for muscle action
- serve as a base for attaching functional tools

Front 8

List five types of therapeutic orthotics

Back 8

- static
- drop-out (gravity)
- articulated
- dynamic
- static progressive/serial

Front 9

Give general description of the wrist cock-up splint

Back 9

- stabilize the wrist in about 20 degrees of extention
- goal is more effective finger function

Front 10

List typical differences in materials used for permanent vs. temporary splints

Back 10

- permanent: metals, high temp plastics; usually start with plaster molding
- temporary: plaster of paris, low temperature thermoplastics

Front 11

General description of first order lever

Back 11

- balance around a fulcrum
- fulcrum in the middle

Front 12

General description of second order lever

Back 12

- mechanical advantage
- force over long lever arm
- load in the middle
- provide a supporting force

Front 13

General description of third order lever

Back 13

- mechanical disadvantage
- force over short lever arm
- supportive force in the middle

Front 14

Give the general rule for pressure tolerance for UE orthotics

Back 14

Cover 2/3 of the available space

Front 15

How should you adjust the surface area of a splint if a patient has increased tone?

Back 15

increase the surface area (more tone = more force)

Front 16

General guideline for length in the hand to allow functional finger movement

Back 16

Don't go distal to the palmar crease

Front 17

Give and example of upper limb orthosis for 1st, 2nd and 3rd degree levers

Back 17

- 1st degree: wrist cock-up
- 2nd degree: mobile arm support
- 3rd degree: shoulder sling

Front 18

General features of a long opponens splint

Back 18

- wrist in about 15 degrees of extention
- ideally contours to palm
- c-bar allows thumb to slide if there is function
- material is light to minimize extra forces

Front 19

General features of a short opponens splint

Back 19

- lumbrical bar
- locks thumb for prehension

Front 20

General features of a RIC tenodesis splint

Back 20

- used to train for tenodesis splint
- provides 5-6# of tenodesis pinch pressure
- short opponens component
- cord from fingers to foarearm piece for pinch

Front 21

General features of a wrist driven flexor hinge splint

Back 21

- uses more mechanical advantage
- provides more options in terms of wrist position, etc
***only UE splint with longevity of use over 18 months

Front 22

What is the only UE splint that has shown longevity of use over 18 months?

Back 22

wrist driven flexor hinge splint

Front 23

General features of a radial nerve palsy splint

Back 23

- asist with wrist and finger extention (pt still has active flexion)

Front 24

4 Key features to remember about the upper limb

Back 24

- complex tool
- open kinetic chain
- proximal stability for distal mobility
- assits with balacing of body

Front 25

Describe hand position and vascular flow

Back 25

Maintaining the contours/arches of the hand allows for maximal venous and lymphatic flow

Front 26

General features of an articulated therapeutic UE orthosis

Back 26

Usually have locking mechanisms to guide a specific plane of movement

Front 27

Most important feature of dynamic therapeutic UE splints

Back 27

Use LOW load forces for a prolonged period of time (no more than 100-300 grams)