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AY BMSc Lectures > Orthotics > Flashcards

Orthotics Flashcards

1
Q

What is orthotics?

A

The science that deals with the use of specialised mechanical devices to support or supplement weakened or abnormal joints or limbs

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2
Q

What is an orthosis?

A

An externally applied device (may also be called a brace, splint or orthotic)

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3
Q

Who is an orthotist?

A

A registered health care professiona who specialises in the assessment of the whole body for biomechanical problems and if appropriate may prescribe, measure, fit or review an orthosis

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4
Q

List the 6 types of lower limb orthotic

A 
Foot orthosis 
Footwear
AFO - Ankle Foot Orthosis 
KO - Knee Orthosis 
KAFO - Knee Ankle Foot Orthosis 
HKAFO - Hip Knee Ankle Foot Orthosis
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5
Q

What is a valgus deformity?

A

Everted position in the frontal plane

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6
Q

What is a varus deformity?

A

Inverted position in the frontal plane

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7
Q

What is an equinus deformity?

A

Plantarflexed position in sagittal plane

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8
Q

What is a foot orthosis?

A

A moulded walking base used inside footwear (insoles and heel cups)

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9
Q

What can foot orthoses be used for?

A 
Re-distribution and reduction of plantar pressure 
Relieve pain 
Improve function 
Prevent structural deformity 
Correct mobile deformity 
Accommodate fixed deformity 
Limit or prevent joint motion
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10
Q

What is a mobile foot deformity?

A

The foot can be manipulated into a ‘normal’ alignment

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11
Q

What is a fixed foot deformity?

A

The foot cannot be manipulated into a ‘normal’ alignment

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12
Q

How does the use of foot orthoses differ in mobile or fixed deformity?

A 
Mobile = foot orthosis to CORRECT deformity 
Fixed = foot orthosis to ACCOMMODATE deformity
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13
Q

What is involved in the physical assessment before prescribing an orthotic?

A 
ROM 
Muscle Powers 
Sensation 
Proprioception 
Circulation 
Muscle tone
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14
Q

How does a foot orthosis correct a valgus deformity?

A

Manipulate corrected position and hold foot by applying 3 point forces - MEDIAL wedge on insole or footwear

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15
Q

How does a foot orthosis accommodate a valgus deformity?

A

Accept foot position and accommodate to achieve greater stability - LATERAL wedge on insole or footwear

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16
Q

How does a foot orthosis correct a varus deformity?

A

Manipulate corrected position and hold foot by applying 3 point forces - LATERAL wedge on insole or footwear

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17
Q

How does a foot orthosis accommodate a varus deformity?

A

Accept foot position and accommodate to achieve greater stability - MEDIAL wedge on insole or footwear

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18
Q

What is an equinus deformity?

A

Plantarflexed position in the sagittal plane

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19
Q

How is an equinus deformity corrected with foot orthoses?

A

Manipulate corrected position and hold foot by applying 3 point forces

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20
Q

Is equinus normally a fixed or mobile deformity?

A

Fixed

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21
Q

What is it important to ensure when fixing an equinus deformity with a foot orthossi?

A

Ensure knee is not made unstable (can cause hyperextension)

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22
Q

How is an equinus deformity accomodated with foor orthoses?

A

Heel raise - following the contour of the foot and ensurring the knee is nto made unstable

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23
Q

What can happen if the equinus is not adequately accomodated?

A

Knee hyperextension

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24
Q

What additional treatment may be required alongside equinus foot orthosis?

A

Compensatory heel raise in contralateral shoe

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25
Q

What footwear design features are good for an insensate foot?

A 
Soft leather upper 
Few internal seams 
Padded tongues and cuffs
Lace/velcro fastening 
Wide and deep toe box 
Rocker soles
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26
Q

Name 4 ways in which footwear can be adapted

A

Raises
Wedges
Flares
Rocker soles

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27
Q

What is the purpose of a shoe/heel raise?

A

To accommodate fixed equinus foot or leg length discrepancy

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28
Q

What are the purposes of shoe wedges?

A

Correct mobile or accommodaye fixed varus/valgus foot

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29
Q

How can shoe wedges be fitted?

A

Can be added externally or internally in the heel and sole

30
Q

What is the purpose of a shoe flare?

A

To increase stability from a varus/valgus foot

31
Q

What effects does a rocker sole have on footwear?

A

Increase stiffness of sole
Increase toe spring
Ground reaction point shifted posteriorly

32
Q

What is an AFO?

A

Externally applied device which extends from just below the knee, around the ankle and across the sole of the foot

33
Q

What is an AFO used for?

A

Used for support and/or correction of foot/ankle deformities (can also have effect on knee)

34
Q

What are the functional potential of an AFO?

A 
Correction of the MSK system 
Maintenance of position 
Assist motion about a joint 
Resist motion about a joint 
Protection 
Improve walking speed and cadence 
Reduce energy expenditure
35
Q

What are the 4 types of AFO?

A

Solid AFO
Posterior leaf spring AFO (PLS)
Varus/Valgus control AFO Jointed AFO

36
Q

How is an AFO produced?

A 
Assessment of patients functional loss 
Observation of gait 
Biomechanical assessment of gait deviations 
Identify functions required of orthosis 
Plaster wrap cast of patient's lower leg
37
Q

Mechanically, how can the characteristics of an AFO be altered?

A 
Increasing/decreasing medial/lateral trimlines 
Increasing/decreasing material thickness
Changing cross-sec shape 
Adding reinforcements/stiffeners 
Material choice
38
Q

What is the trimline of an AFO?

A

Border of the orthosis

39
Q

Why must heel height be assessed?

A

Altering the heel height of shoes will influence the GRF around the knee and can increase or decrease stability

40
Q

What is a knee orthosis?

A

Externally applied device worn on the leg extending from mid -thigh to mid-calf

41
Q

What are the functional potentials of knee orthoses?

A 
Relieve pain 
Improve function 
Prevent structural deformity 
Correct mobile deformity 
Limit or prevent joint motion
42
Q

What motions can be controlled by a knee orthosis?

A 
Flexion 
Hyperextension 
Anterior/Posterior instability 
Medial/Lateral instability 
Rotation
43
Q

List 4 common reasons for fitting a knee orthosis

A

OA
Post-surgical
Ligament injury
Mild instability

44
Q

How many forces are required for knee orthosis use?

A

3

45
Q

Why do knee orthoses only work for mild correctable deformities?

A

Due to the short lever arms on a knee orthosis

46
Q

What is a KAFO (Knee Ankle Foot Orthosis) commonly referred to as?

A

A ‘calliper’

47
Q

What is a KAFO?

A

Custom made externally applied device worn on the leg extending from thigh to foot - used for support and/or correction of knee/ankle/foot deformities

48
Q

What are the functional potentials of a KAFO?

A 
Correction of the MSK system 
Maintenance of position 
Assist motion about a joint/joints 
Resist motion about a joint/joints 
Protection 
Improve walking speed and cadence 
Reduce energy expenditure
49
Q

What factors should be considered when choosing what type of KAFO?

A 
Patient age, weight, activity level
General health 
Occupation 
Lower limb function 
Goals and expectations 
Upper limb function
50
Q

What is a conventional KAFO made from? What are the pros/cons?

A

‘Calliper’ typically made from metal and leather

Heavy in weight
Hard wearing

51
Q

What is a cosmetic KAFO made from? Why are these good?

A

Typically made from thermoplastic

Light in weight
Durable
Improved cosmesis

52
Q

What 2 materials can side bars be made from?

A

Steel

  • hard material
  • heavy
  • hard weaing

Dural

  • aluminium alloy
  • softer material
  • light weight
53
Q

What is a drop locked knee brace?

A

When the knee is in extension, gravity causes a ring to drop and joint to lock

54
Q

What is a manual drop lock knee brace?

A

When knee is in extension, a ring needs to be moved by hand to lock

55
Q

What is a semi automatic lock knee brace?

A

When knee is in extension, the spring activates a ring to lock

56
Q

What is a bale lock knee brace?

A

Bar or cord activated ring lock joint

57
Q

What is a polycentric knee lock brace?

A

More than one joint centre

58
Q

What is a spline lock knee brace?

A

Incremented joint to allow fixed setting - can be used in contracture management

59
Q

Describe weight bearing in a KAFO?

A

KAFO requires to take body weight through the side bars, reducing weight through the leg

60
Q

What is a quad top?

A

Ischial tuberosity rests on a ledge outside the socket

61
Q

What is ischial containment?

A

Ischial tuberosity rests within socket

62
Q

What is a HKAFO (Hip Knee Ankle Foot Orthosis)?

A

Basically a KAFO with the addition of a hip joint and pelvic band (provides control to selected hip motions as well as the leg)

63
Q

What is the advantage of a HKAFO over a KAFO?

A

Can reduce or minimise the risk of the hip moving out of proper position or dislocating

64
Q

What is the aim of HKAFO?

A

To stabilise the hip and lower spine in cases where the patient is weak or paralysed

65
Q

Describe an example of a HKAFO

A

Hip guidance orthosis (HGO)

HGO consist of bilateral KAFOs linked via specially designed low friction hip joint
Used in conjunction with crutches the HGO allows reciprocal ambulation

66
Q

What can be used alongside a HKAFO when greater trunk stability is required?

A

Spinal support instead of a simple pelvic band

67
Q

Which is more common, upper or lower limb orthotics?

A

Lower limb

68
Q

Name 6 examples of upper limb orthotics

A 
Finger orthosis
Hand orthosis 
WHO - Wrist Hand Orthosis 
Elbow Orthosis 
EWHO - Elbow Wrist Hand Orthosis 
Should Orthosis
69
Q

Describe an upper limb static orthosis

A

Typically a WHO
Holds wrist/hand in static position
Prevents movement at specific joints
Used to prevent contracture development

70
Q

Describe an upper limb dynamic orthosis

A

Has springs and moving components
Holds arm in corrected position while allowing active movement at specific joints
Aids rehab

AY BMSc Lectures (8 decks)

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