Introduction to Upper Extremity Orhotics

Question 1

the four goals of UE splinting

Answer 1

1. protective
2. supportive
3. corrective/progressive
4. functional

Question 2

is “splint” an outdated term

Answer 2

yes

Question 3

is “orthosis” an outdated term

Answer 3

no

Question 4

two general types of splints

Answer 4

static and dynamic

Question 5

Static of Dynamic:

moveable parts are incorporated into the design of the brace and may include hinges, rubber bands, outriggers, or finger slings

Answer 5

dynamic

Question 6

Static or Dynamic:

no moveable parts and the involved part of the UE are positioned in a functional posture

Answer 6

Static

Question 7

are static splints worn intermittently or constantly

Answer 7

intermittently

Question 8

when are dynamic splints generally used

Answer 8

frequently used to maintain function and mobility while specific joints are supoprted

Question 9

type of sling where there is an “X” on the back

Answer 9

Figure 8 Sling

Question 10

what is the typical UE position in an arm sling

Answer 10

adduction

IR

slight flexion

Question 11

3 indications for arm sligns

Answer 11

1. humeral fracture
2. bone repair
3. rotator cuff injury

Question 12

when might an arm abduction orthosis be indictated

Answer 12

for patients with chronic GH dislocation

Question 13

what is another name for an arm abduction orthosis

Answer 13

adduction control orthosis

OR

airplane orthosis

Question 14

what is the typical design of an arm abduction orthosis

Answer 14

support medial arm, weight borne on iliac crest or lateral trunk

Question 15

what is the purpose of a balanced forearm orthosis (3)

Answer 15

1. supports arm
2. assists weak proximal mesculature (weak/low tone)
3. dampen control for increased tone

Question 16

what are the functional benefits of using a balanced forearm orthosis

Answer 16

improve functional independence in performing tabletop skills (eating, writing, operating keyboard)

Question 17

how does the balanced forearm orthosis work

Answer 17

uses shoulder or scapular movement to control elbow

Question 18

what does BFO stand for

Answer 18

Balanced Forearm Orthoses

Question 19

who is BFO appropriate for

Answer 19

individuals with SCI, polio, brachial plexus injury, MD, Guillian Barre

Question 20

what is the appropriate placement of an epicondylar strap

Answer 20

applied circumferentially to forearm, distal to epicondyles

Question 21

how does the epicondylar strap work

Answer 21

provides compression over muscle/tendon, reducing muscular forces on osteotendinous junction by redirecting the line of pull

Question 22

what are indications for an epicondylar strap

Answer 22

inflammation at junction of flexor or extensor tendons at osteotendinous attachment

Question 23

the hand is a two part unit… the ____ and ____ side

Answer 23

radial and ulnar side

Question 24

the radial part of the hand includes…

Answer 24

the thumb, index, and middle fingers

Question 25

the ulnar part of the hand includes

Answer 25

the ring and little finger

Question 26

what part of the hand is designed for mobility and functional grasp

Answer 26

radial

Question 27

what part of the hand is designed for stability

Answer 27

ulnar

Question 28

the three types of prehension graps

Answer 28

1. pinch 2. lateral pinch 3. three-jaw chuck

Question 29

what prehension is 60% of all ADL skills

Answer 29

three-jaw chuck

Question 30

what are the two types of grasp

Answer 30

1. spherical | 2. cylindrical

Question 31

throwing a ball is most like this type of grasp

Answer 31

spherical

Question 32

holding groceries is most like this type of grasp

Answer 32

cylindrical

Question 33

what is the functional position of the wrist/hand ``` wrist MCP PIP DIP thumb ```

Answer 33

wrist 30 extension MCP 45-50 flexion PIP 30-45 flexion DIP slight flexion thumb opposition and abduction

Question 34

what is the resting position of the wrist/hand ``` wrist MCP IP thumb CMC thumb MCP ```

Answer 34

wrist 20 extension MCP 70-90 flexion IP 30-45 extended thumb CMC abducted thumb MCP extended

Question 35

what is the purpose in a resting hand orthosis

Answer 35

protect, support, correct alignment

Question 36

what is the alignment in a resting hand orthosis

Answer 36

wrist and hand positioned in resting position

Question 37

three indications for resting hand orthoses

Answer 37

1. arthritis 2. hemiparesis 3. polio 4. burns 5. contractures

Question 38

what is the position of the wrist in wrist cock-up splint

Answer 38

extension

Question 39

what is the general characteristics of the MPs in a wrist cock-up splint

Answer 39

MPs are supported bu allow some movement

Question 40

what is the general characteristics of the IP joints in a wrist cock-up splint

Answer 40

IP joints are allowed unrestricted movement

Question 41

what is the purpose of a wrist cock-up orthosis (2)

Answer 41

1. support wrist during acute phase of healing | 2. increase functional independence secondary to weakness by improving hand function

Question 42

three indications for a wrist cock-up splint

Answer 42

1. carpal tunnel 2. flex/extension tendonitis 3. lat/med epiconylitis 4. wrist strain/sprain 5. brachial plexus injury

Question 43

what is the purpose of a tone reduction orthosis (3)

Answer 43

used to: - decrease flexor tone - increase ROM - prevent skin breakdown

Question 44

where is the thumb placed in a short opponens orthosis

Answer 44

thumb placed in abduction to promote function

Question 45

what is the length of the short opponens orthosis (anatomically)

Answer 45

IP joint of thumb to base of thumb

Question 46

what is cleared in the short opponens orthosis

Answer 46

the thenar crease

Question 47

what are 3 indications for short opponens orthosis

Answer 47

1. CMC/MCP arthritis 2. fracture 3. subluxation 4. dislocation of thumb 5. ligament repair

Question 48

what is the design of a long opponens orthosis-thumb spica

Answer 48

same design as short opponens but extends across wrist to forearm

Question 49

for long opponens orthosis-thumb spica, what is the position of the wrist

Answer 49

some extension

Question 50

what are general indications for a long oppenens orthosis

Answer 50

when the pathology involves thumb and wrist

Question 51

how does a tenodesis orthosis work

Answer 51

with active wrist extension, wrist flexors are put on stretch causing finger flexion

Question 52

for tenodesis orthoses, individuals learn to use the finger flexion movement for...

Answer 52

function

Question 53

what is a way to correct a swan neck or boutonniere deformity

Answer 53

ring orthosis

Question 54

what is the purpose of a dynamic orthosis

Answer 54

used to promote motion of certain segments while protecting or limiting motion at other segments

Question 55

what are three indications for elbow or wrist mobilization orthoses

Answer 55

1. maintain/protect range, improve ROM 2. flexion contractures at elbow, wrist, hand 3. scar release, trauma, burns