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28 Cards in this Set
- Front
- Back
Why do we order LE orthotics (5)
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-to promote biomechanical alignment
-to aid in foot clearance during swing -to aid in hip &/or knee stability in stance -to promote increased hip & knee flexion @ terminal stance/preswing -to influence tone? |
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What types of orthotics are there (the joints they cross over) (5)
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-THKAFO
-HKAFO -KAFO -AFO -SMO |
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what materials are used for orthotics (5)
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-metals
-plastics -leather -rubber -carbon fiber |
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in order to prescribe an orthotic, what needs to be assessed (7)
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-joint mobility
-limb length -motor function -sensation -general mobility - functional status -psychological status |
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what considerations do you take for a type of orthotic (7)
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-what joints need to be controlled
-how much does the patient weigh -is there abnormal tone? High or low? -Are there sensory/skin issues -What is the prognosis for recovery of function? -Do you anticipate a decline in function -is cost an issue |
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what purpose does a HKAFO have
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functional standing
exercise ambulation |
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decribe the reciprocating gait orthosis
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-stabilizes over the hip. High energy demand. mechanically or power driven, when shift weight on one foot, other foot will advance forward. Will need loftstrand crutches in order to use
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describe a hybrid KAFO
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will be a combination of types of locks and materials
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what is a drop lock
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2 lateral locks that have a pin and ring system when need to sit down, must unlock in order to flex
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what is an offset knee
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it is set up so that when weight is anterior, will be stable when the weight is posterior, will unlock
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describe double metal upright KAFO
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stirrup goes into shoe that has stirrup adapter that has two metal pieces on the outside of the leg
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what is pre-fabricated AFO good for
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-"simple" foot drop
-intact sensory status -knee stability is not an issue -pt is not overweight |
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when will you probably need a custom made orthosis
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-abormal tone
-significant medial-lateral instability of the ankle -knee instability is an issue -pt has sensory deficits |
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what is the thickness associated with plastics
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-3-16", 1/8 (prefab)
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describe polyproplene
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most rigid plastic, but brittle, has a poor life cycle; used in solid ankle AFOs
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describe polyethelene
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wont support body weight, but good for positioning splints and anterior shell of AFO
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where does the trimline for a AFO need to be
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-2" below the fibular head
-ankle/malleolar trim lines can be anterior or posterior to malleoli depending on medial-lateral stabiity -footplate/metatarsal trim line can extend to MT heads or distal toes |
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what is the main purpose for the posterior leaf spring AFO for
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JUST FOOT DROP
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what do you need to consider for articulating vs nonarticulating
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-ankle articulation allows for more biomechanically appropriate actions during gait
-can lock articulating brace in a stable position of start with articulating brace that is not cut, and cut once pt gains stance control |
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what do you need to consider about AFO in regards to ankle ROM
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-ankle joint angle in solid AFO
-limits of ankle joint ROM in articulating AFO -need to STOP or ASSIST in DF or PF |
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what does the following do for the ankle:
Dual channel |
-DF stop/assist and PF stop/assist or free motion
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what does the following do for the ankle:
Gilette |
-PF stop but no DF assist
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what does the following do for the ankle:
Oklahoma |
Both PF stop & DF assist but bulky
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describe double metal upright AFO, what population is good for
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-good for pts with skin issues or volume fluctuations
-offer good stability, but not the intimate fit of custom molded plastic -heavier than plastic, although carbon fiber materials have created a much lighter breed of double upright brace |
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what are some considerations for AFOs in regards to tone
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-may need to enhance foot support to counteract equinovarus posture(can alter trim lines, use figure 8 strap)
-constant pressure to PF may influence tone -poistion of toes in extension may influence tone (length of foot plate is important) |
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Describe Ossur "AFO Dynamic"
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-carbon fiber technology: strong and durable
-energy storing -medial strut for arch support and cosmesis |
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describe Supramalleolar orthotics
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-can be fabricated by PT
-good temporary solution (not intended as permanent/long term brace) -can be used with or without straps |
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on a supramallolar orthotic what does not using straps allow
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without allos free movement of tibia to roll over foot in stance
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