Extra Flashcards by sophia carrasco

What is a static orthotic design

Immobilizes a joint

Provides stabilization , protection and support to. A body segment

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What are consideration when choosing an outcome measure

what do they measure
purpose
psychometric properties
-clinical utility
type of measure

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What are the psychometric properties to consider with a outcome measures

-validity
- reliability (interrater vs intrarater)
- minimical detectable change/ minimal clinically important difference
- ceiling vs floor
Sensitivity

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What are the 2 types of outcome measures

Generic and disease specific

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What does a. Generic outcome measure reflect

Reflect for patients w varying conditions and varying levels of function (so everyone

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What are advantages and disadvantages for a generic outcome measures

Advantage: normative data for specific groups , easy to compare

Disadvantage: ceiling and floor effect likely

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What are examples of generic outcome measures

10 meter
6 min
TUG
FGA
4 square

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What does teh disease specific outcome measure reflect

A specific heal condition and items related more to the disease

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What is advantages and disadvantages for disease specific outcome measures

Advantage: more specifically reflects a certain condition and then relations between domains and ICF models

Disadvantage: does not allow comparisons across different groups

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What are examples of disease specific outcome measures

L test for functional mobility (LE amputation)
DGI and FGA (vestibular prob)
Modifies Emory functional ambulation profile (stroke)
HiMAT (TBI)

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Ceiling vs floor effect

To hard
To easy

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What outcome measures are included in the core set of outcome measure by ANPT and which are the GAIT core set

berg
FGA (gait)
10 m (gait)
6 min(gait)
-5x STS
activities specific balance. Condifcen scale )(gait )

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What does the FGA assess as a gait core outcome measure

Balance during walking

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What does teh 10m assess as a gait core outcome measure

Assesses gait speed (6th vital sign)

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What does teh 6 min assess as a gait core outcome measure

Assesses endurance testing post stroke anf SCI

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What does the activities specific balance confidence scale assess as a gait core outcome measure

Self report on level of self confience w multiple task related to walking

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What the cut off scores for the 10 m test for

Household ambulator
Limited community ambulator
Community ambulator

<.4 m/s
.4-.8 m/s
>.8 m/s

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How much time do u need to cross teh street for a slow light , average light and fast light

Slow: .71m/s
Average: 1.21 m/s
Fastest: 1/38 m/s

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What are teh 6 goals for casting

increased PROM
decreased tone/spasticity
improve positioning
improve hygiene
increased function of extermity
block an unwanted movement

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What interventions should u do before the next cast after u take the first one off

Soft tissue and joint mobs
WB and forced used

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If a patient has excess PF in WA (IC and LR) what is weak

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If a patient has excess PF in SLS (MSt and TSt) what is weak

quads

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If a patient has excess PF in SLA (swing) what is weak

Weak DF

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If a patient has excess DF in SLA (swing) what is weak

Weak calf w strong quads

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If a patient has excess DF in SLS (MSt , TSt) what is weak

Weake calf w strong quads

If a patient has excess DF in WA (IC , LR ) what is weak

Weak hip extensors

If a pateint demonstrates decreased knee flexion/stiff knee gait pattern in seing gait what is most likely the causes

Weakness in PF

If a patient has **excessive PF** during **swing** what could be the cause

Weak pre tibialis

If someone has contralateral hip drop what is weak

Abductors

If the knee is in hyperextension during loading response what is weak

PF or quads

If a pateint has no ankle rockers what is lacking and excessive

Lack of DF and excessive PF

If a patient has **hyperextension** in **midstance/terminal stance** what is the cause

Weak PF not allowing for controlled tibial advancement

If someone has **foot flap** in LR or IC what is the cause

Weak pre tibialis

How would u know if a patient was not tolerating casting

Increased BP Increased ICP Constantly diaphoretic Agitiation and/or inability to sleep

Which UE orthotics have a direct attachment of elastic components

High profile

Which UE orthotic has **more tension force**

Low profile

How should the outriggers of the UE orthotic be positioned

Must be perpendicular to bone

Position of function for hand position Wrist MP PIP DIP Thumb

Wrist: 20-30 extension MP : 35-45 flexion PIP: 45 flexion DIP: relaxed flexed Thumb: palmar abduction

Postion of rest/anti deformity for the hand Wrist MP PIP DIP Thumb

Wrist: 30-40 extension MP : 60-90 flexion PIP: extensions DIP: extension Thumb: palmar abduction

Pressure=

Force / area

Which UE orthotics archive tissue mobilization by applying a LOW load to the tissues END RANGE in one direction over a long period of time

Static progressive

What is the main difference between static and dynamic orthotics

Force is static vs elastic load

What kind of force is a dynamic orthotics

Elastic type of force —> increase ROM

What does a static orthotic do

Immobilizes a joint , provides stabilization , protection and support to bony segment

Qhat orthotic design is applied with the joints, soft tissues or musculothendious units they cross in a lengthened position and are worn for a extended period of time , removed during therapy

Serial static

What knee joint is the only one with **stumble recovery** due to control mechanisms for both **stance and swing**

Microprocessor (C lEG)

What does the **variable position knee joint** do

Accommodate knee flexion contractures

What knee joint is used for a pt w excessive hyper extension due to quad weakness

Posterior offer

What would indicate you to do us a metal KAFO

Need strength Obesity Fluctuating edema

What would indicate you to do us a plastic KAFO

Initimate/totla control Control of transverse plane When energy conservation is important

If a patient has a swing phase drop foot control bc of weak PF and they need assistance with DF what orthotic would u use

Ankle metal double upright , klenzak ankle

If u add a spring to the posterior side of the a metal double upright klenzak ankle what would that assist with

DF in swing to help w the foot control

What is the primary function of a metal soluble upright , double action ankle

Assist , resist or block PF and DF Pin in front of —> block DF in stance Spring in back—> asssit DF in swing and PF in stance

If a patient has an at risk or edematous foot what AFO would u use

Metal double upright , double action ankle

What rocker do u still have if u use an ground reaction + rear entry

First rocker - heel rocker

What is the primary and secondary action of the ground reaction AFO

Primary- external extension moment to the knee Secondary- good mid and read foot control

If a patient has weak quads and weak PF

Ground reaction

If the patient has absent quads or balance problems what AFO should u not use

Articulated ankle

What is the primary goal for articulated ankle AFO

- control ankle motin - allows ankle rocker in stance - DF restraint : controls tibial translation - PF stop: decrease amount of PF ; decreased tibial recline

What is the primary function of the posterior leaf spring AFO

- support weight in foo during swing - clears toes - assist w controlled lowering the food during LR in stance ; heel rockers

When is posteior leaf spring contraindicated

When control in stance , inversion and supination is needed

Which AFO is most effective for low tone and flaccid paralysis

Posterior leaf spring

Where is the trim line for posterior leaf spring

Posterior to midline of medial and laterla malleoli

What is the primary and secondary goasl for **solid ankle AFO**

Primary: blocked movement of ankle in ALL planes (loss of all rockers) Secondary: impact movements and position of the knee —> forces tibia back

If a patient needs control of stance phase (closed chain) to help with knee HE or knee flexion and also need help w DF assist and patient has mod hypertonciity what AFO would u used

Solid ankle AFO

When would u not use an solid ankle AFO

Open chain problems when ankle movement in stance should be preserved

What AFO gives u the highest level of control below the knee

Solid ankle AFO

When would u used supramalleolar orthosis

If a pt has severe pes plant/ valgus root , intermittent toe walking or low tone or mild hypertonic tone

What is the supramalleolar orthosis facilaitate in swing

Foot clearance

What is the primary and secondary affect of SAFO

Primary: control rear foot , midfoot Secondary: mild control of ankle inversion/eversion

When would u used UCBL

- flexibile pes Plano/ valgus foot , plantar fasciitis/ heel pain

When would u not use a ICBL

- mod to high tone - toe walker - athletic

What does the UCBL help

Pronation and supination not INV or EV

What does the vertical shank overstabilzie and destabilize

Knee Hip

**Excessive** shank inclination destabilizes what

Knee

Which rocker initiates swing limb advancement

Toe rocker

What will be increased w a crouch gait for peds

Increased hip flexion , knee flexion , DF

What type of outcome measure is easy to compare across patients

Generic outcome measure

What type of measures is reflecting a specific health condition and items relate more to a disease

Disease specific outcome measure

Ceiling and floor effects are more likely to be seen with what kind of outcome measure

Generic

Is a patient has a LE amputation and want s to see with and without use of prosthesis how they walk what outcome measure would u do

Amputee mobility predictor

What phase of gait are the 4 rockers of the foot in

Heel rocker:LR Ankle rocker: MDs Forefoot rocker:terminal stance Toe rocker: pre swing

What is the critical event in IC , LR , MidS , TmS

IC: heel contact LR: hip stability , controlled knee flexion , ankle PF (heel rocker) MidS: controlled tibial advancement (good PF to control) Term: calf mm control DF to have heel off and trailing limb

What is the critical event in PreSW, ISW, MidSW, TermSW

Pre: PASSIVE knee flexion , ankle PF assist w passive knee flexion ISW: hip flexion 15°, knee flexion 60° MD: neutral foot, increased hip flexion Term: knee extension

If a patient has foot slap what mm is weak

Pre tibialis bc it cant not on control PF

What does the UCBL block

Forefoot abduction/adduction

What does the postieorr leaf spring assist in controlling

Lowering of foot during loading response

Where is the trim line for a solid ankle ADO

Middle of malleoli so helps control mediolateral stability

Which AFO will Impact movement and position of the knee secondary

Solid ankle

Adding a DF restrain to articulate AFO helps controls what

Tibial translation

What knee joint helps assist in standing/stragitening the knee

Ratchet lock

What kind of ankle AF would u give a patient that is demonstrating weak anterior ribs and drop foot , so cant control PF

Posterior left spring

If someone has weak PF and is wearing a posterior left spring what will happen

They will buckle thru .. so dont give them if they have excessive DF

What is the primary effect of the ground reaction fore AFO

Applies an external extension movement to the knee

If there is excess knee flexion u want to block what

The DF bc when the knee goes into more flexion then DF increased also … prob have increased knee flexion due to weak PF or weak quads

How much percent is single limb support and double limb support

80% 20%

How mcuh % is stance ohase vs swing phase

62% stance 38% swing

What is the difference between ceiling and floor effect

Ceiling is when it is to easy Floor is when it is to hard - u fall to the floor bc it is to hard balhhhh

What is a single axis knee KADO

* free knee * unrestricted flexion * extension locked at 180°

What is a single axis locking knee KADO

* fall with gravity or are manual locked * drop lock * requires each side to be unlocked to sit

What is the basic goals of orthotic treatment

* prevent deformity * provide stability (block aberrant Motion and assist or resist joint motin) * facilitate function

What is the goals of casting

* increase PROM * decrease tone/spasticity * improve positions * improve hygiene * increased function of extremity * block an unwanted movement

What are the indications for casting

* correct deformity * lengthen mm * reduce spasticity * prevent loss of joint ROM

Extra Flashcards

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