Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
Why Do We Need Orthoses?
Support/Control Cushion |
ok
|
|
|
Orthoses
Prior to the 1970’s primarily composed of rubber, cork and leather Since that time the introduction of thermoplastics has allowed for advantages in design, versatility and application. They are hypoallergenic, moisture and bacteria resistant, and heat moldable |
ok
|
|
|
Orthoses Classification
1. Custom 2. Customizable Prefabricated 3. Over the Counter |
ok
|
|
|
Orthoses
2 main types: 1. Corrective/functional, which supports the foot in the ideal position 2. Accommodative, which allows for cushioning of the foot and relieving pressure in certain areas With the advent of materials such as plastics, these categories are not as clearly delineated. |
ok
|
|
|
___ Orthoses
Reduce pressure Tend to be thicker and require a deeper shoe or more grinding Most common used soft material today is ___- It is a cross linked closed cell polyethylene thermoplastic which means it will soften every time heated Comes in different grades of firmness (1-3 with 1 being medium and 3 being rigid) Disadvantages is that it retains heat from the foot Foam is another soft material. It is smoother than Plastazote and is used as an orthotic liner Pelite and Polyurethane are also soft products |
Soft Orthoses
Most common used soft material today is Plastazote- It is a cross linked closed cell polyethylene thermoplastic which means it will soften every time heated |
|
|
Semi-___ Orthoses
Made of firmer materials that are soft and incorporate posting techniques Made of a combination of materials that are glued or melted together Used to improve weight transfer, to support and stabilize deformities of the foot and lower extremity and to relieve pressure ___ frequent used orthoses |
Semi-Rigid Orthoses
Most frequent used orthoses |
|
|
Semi-___ Materials (continued)
Made of Plastazote, Aliplast and Pelite in firmer grades. Nickelplast is also very common in this category. EVA which is found in the midsoles of certain running shoes has also been used in this category as a posting material or as an all in one orthotic. Cork has also been used in the past. |
Semi-Rigid Materials (continued)
|
|
|
___ Materials
Advantages: Thin ¾ length (may be disadvantage) Most controlling Useful in dress shoes |
Rigid Materials
|
|
|
Rigid Materials
Disadvantages: limited impact reduction increased pressure areas highly skilled fabrication process materials often crack with high forces ___ for participation in high impact sports and running may result in stress fractures, impingement and neuromas |
contraindicated for participation in high impact sports and running
|
|
|
Choice of Materials
Biocompability Ease of use/Amount of control needed Activities to be performed Foot type Medical indications Type of shoe to go in/sport Ease of fabrication Availability Durability cost Comfort Simulation of soft tissue |
ok
|
|
|
Molding Techniques
1. Plaster casting in neutral position 2. Foam impression 3. Direct mold A full foot and ankle evaluation is important before taking the mold. Know how the foot looks ___ and functions ___ |
A full foot and ankle evaluation is important before taking the mold. Know how the foot looks statically and functions dynamically
|
|
|
Molding Techniques
1. Plaster Casting in Neutral Position: Very accurate (Most accurate of the 3 talked about here) Time ___ Messy Can be expensive |
Time consuming
|
|
|
Molding Techniques
2. Foam Impression: ___ accurate as plaster casting in neutral Quicker Inexpensive |
Not as accurate as plaster casting in neutral
|
|
|
Molding Techniques
3. Direct Mold Not as accurate as Plaster casting in neutral Inexpensive Time consuming |
ok
|
|
|
Key Terms
Durometer/Iron Shell Post (RF 3-5 deg normal) Forefoot extension/Morton’s extension Flanges Schaphoid pad (increase arch height) Met pad/Met bar (metatarsalgia) Cutout (plantar flexed first) |
ok
|
|
|
Are Orthoses Appropriate
Arch tape OTC inserts Is a better shoe enough Don’t forget the foot is supposed to move and pronate (in most cases) |
ok
|
|
|
Be Careful!!
Orthoses should not (in most cases) be a death sentence. Foot will ___ with extended use Be aggressive at first but try to wean from later (get athlete on field) Think about sports specific movements and orthoses interactions |
Foot will atrophy with extended use
|
|
|
Starting Recommendations
Modify OTC insert Start with taking the mold and then send out In office fabrication |
ok
|
|
|
Shoes
Shoe selection Heel counter - posterior stabilizer, shouldn’t be able to crush Achilles collar - minimal contact and friction, check for position in extreme DF Shock absorption - hydroflow, gel, air, hexalite, grid, sorbothane, polyurethane, EVA MTP - stiff supportive for hallux rigidus Forefoot width and length - proper fitting, fit for the longest toe Toe Box depth - especially important in orthotics that extend the length of the foot. |
ok
|
|
|
Shoe Selection (continued)
Shape of the shoe Straight lasted, 8-10 degrees, for the more ___ foot Curve lasted - approximately 15 degrees for a more ___ foot or for runners with a lot of rotation Stitch lasted - allows for more ___ Board lasted - allows for more ___ |
Straight lasted, 8-10 degrees, for the more pronated foot
Curve lasted - approximately 15 degrees for a more supinated foot or for runners with a lot of rotation Stitch lasted - allows for more flexibility Board lasted - allows for more stability |
|
|
Shoe Selection Suggestions
___ Pronator: Stitch lasted - allows for more flexibility Curve lasted - approximately 15 degrees for a more supinated for or for runners with a lot of rotation Neutral heel cup Moderate to soft cushioning Lateral flex in the midfoot |
Under Pronator:
|
|
|
Shoe Selection Suggestions
___ Pronator: Board lasted - allows for more stability Straight lasted - 8-10 degrees, for the more pronated foot Wide forefoot Moderate to firm cushioning Stiff midfoot |
Over Pronator:
|
