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Orthotics (mine) > KOs and KAFOs > Flashcards

KOs and KAFOs Flashcards

1
Q

What movements does a Supracondylar shell KAFO/FRO control at the knee?

A

Hyperextension, Valgus, and varus

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2
Q

What movements does a supracondylar shell KAFO control at the ankle?

A

DF, PF, Supination, and pronation

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3
Q

Describe the knee force systems for hyperextension from a supracondylar shell AFO

A

an anterior directed force originating at the posterior/superior margin of the orthosis is balanced by posterior directed forces originating at the anterior superior and inferior portions of the orthosis.

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4
Q

Describe the knee force system for valgus and varus from a supracondylar shell AFO?

A

Valgus: a laterally directed force originating from the central portion of the medial aspect of the orthosis near the knee is balanced by medially directed forces originating from the superior and inferior lateral aspect of the orthosis.

Varus is opposite

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5
Q

What is unique about the ankle joint set up in a supracondylar shell KAFO? How does this affect alignment?

A

The ankle joint is set in PF and supported by a heeled shoe

Being set in plantar flexion, the weight is on the ball of the foot and the force is shifted anterior. The knee is biased towards flexion and the hip towards extension

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6
Q

When would you prescribe a supracondylar shell KAFO?

A

when a patient has a flexed gait

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7
Q

What is a the makeup of a conventional KAFO?

A

double metal upright with knee locks and a shoe

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8
Q

How much clearance should a conventional KAFO have in the groin area?

A

3-4 inches

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9
Q

In a conventional KAFO - where should the superior portion of the lateral thigh area fall?

A

below the greater trochanter

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10
Q

In a conventional KAFO - where should the calf bands be placed?

A

2-3 inches below popliteal fossa and sit inferior to the fibular head

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11
Q

What motions are restricted in a conventional KAFO?

A

When the knee joint is locked - hyper extension, flexion, valgus, and varus.

If t straps are present - foot supination and pronation

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12
Q

What is a single axis knee joint used for?

A

single axis designed to be locked in a stationary extension position or move freely (most have full knee extension)

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13
Q

what is the point of an adjustable design knee joint?

A

allows the knee to be locked even thought the patient may not possess full knee extension

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14
Q

What is a spring loaded pull rod or bale release used for?

A

someone that may not be able to bend over and unlock orthosis without falling over (think rigid deformities)

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15
Q

What kind of locks are used with bale releases?

A

pawl lock

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16
Q

What are the advantages and disadvantages of a drop lock?

A
  • inexpensive and simple
  • is difficult to release from standing
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17
Q

When would you use a bale release attached to a pawl lock?

A

a dual locking mechanism is necessary on both the medial and lateral side

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18
Q

What are the typical indications for a KAFO?

A

when there is compromised motor control at the foot, ankle, knee, and hip.

Spinal cord injury, spina bifida, polio or post-polio syndrome

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19
Q

What is a craig-scott orthosis?

A

a specific metal KAFO that the ankle is set in 10 degrees DF

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20
Q

What happens when a KAFO is put in 10 deg of dorsiflexion?

A

the GRF is moved posterior to the knee and anterior to the hip so the knee is in flexion and the hip is able to maintain extension

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21
Q

What motions does a plastic custom molded KAFO control?

A

when the knee is locked, hyperextension, flexion, valgus, and varus

as well as supination and pronation at the ankle

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22
Q

Where should the thigh shell extend to in a plastic KAFO?

A

3-4 inches from groin

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23
Q

where should the posterior inferior trimline of the thigh shell fall in a plastic KAFO?

A

a minimum of 1.5 inches from the popliteal crease

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24
Q

Compare and contrast a metal KAFO to a plastic KAFO

A
  • metal KAFOs may be cooler and can easily accommodate growth
  • plastic KAFOs are lightweight and more cosmetically acceptable as well as they come in closer contact with the extremity surface and are thought to provide better control
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25
Q

What are the benefits of a plastic metal hybrid KAFO?

A

best of both works - flexible, can be worn under clothes, more cosmetically acceptable, and lightweight

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26
Q

Is an elastic knee orthosis flexible, semi rigid, or rigid?

A

Flexible

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27
Q

does an elastic knee orthosis control any movements? what is its function?

A

No - used as a compressive design to hold heat, reduce edema, and provide proprioceptive feedback

28
Q

What patients would you give a flexible knee orthosis?

A

patients with arthritis as well as edema or minor sprains

29
Q

Is an elastic knee orthrosis w/ M-L support flexible, semi rigid, or rigid? Why?

A

semi-rigid, because it has M-L bars

30
Q

Are any motions controlled in an elastic knee orthosis?

A

valgus and varus may be limited but nothing actually controlled

31
Q

What is the function of an elastic knee orthosis?

A

same as KO, compressive design that retains heat, reduces edema, and gives proprioceptive feedback

32
Q

What patients would you give an elastic knee orthosis?

A

patients with arthritis as well as edema or minor sprains

33
Q

is a knee immobilizer flexible, semi rigid, or rigid?

A

semi rigid

34
Q

Where should the inferior portion of a knee immobilizer extend in relation to the malleoli?

A

1-1.5 inches above

35
Q

Where should the superior portion of a knee immobilizer extend?

A

upper third of the thigh

36
Q

Are any movements controlled in a knee immobilizer?

A

no - just general kinesthetic awareness provided

37
Q

What is the function of a knee immobilizer?

A

used to decrease movement at the knee after surgery or post trauma

can also assist with upright posture control when there is weakness at the knee (think post stroke)

38
Q

Why would you choose a knee immobilizer over an elastic KO?

A

longer leverage and vertical bars = more support to the knee

39
Q

is an adjustable knee immobilizer flexible, semi-rigid, or rigid?

A

semi-rigid

40
Q

Does an adjustable knee immobilizer control an movements?

A

not fully control, but used for kinesthetic awareness

41
Q

What is the point of having an adjustable knee joint in a knee immobilizer?

A

Used to change the varying degrees allowed in motion (like with acl surgery)

42
Q

What are the advantages of an adjustable knee immobilizer over the elastic KOs?

A

the knee immobilizer is more restrictive than other KOs because of increased length and rigid construction

43
Q

Is a resting splint flexible, semi rigid, or rigid?

A

rigid

44
Q

Where should a resting splint extend to on the thigh?

A

upper 1/3 of the thigh

45
Q

where should a resting splint extend to inferiorly on the leg?

A

1-1.5 inches above the malleoli

46
Q

Are there any motion controlled in a resting splint?

A

all of them!! extension, flexion, valgus, varus

47
Q

What is the function of a resting splint?

A

maintain or increase ROM at the knee - may also only be worn at night

48
Q

When would you give a patient a resting splint?

A

any pathology that may cause knee flexion contractures (stroke, cp, ms, md, als, scleroderma, tbi)

49
Q

Is a swedish knee cage flexible, semi-rigid, or rigid?

A

rigid

50
Q

What movements are controlled in a swedish knee cage?

A

hyperextension

51
Q

when would you prescribe a swedish knee cage?

A

used for a patient with mild hyperextension (could be used with pts that have arthritis, stroke, hypotonia, etc)

52
Q

What is a disadvantage to a swedish knee cage?

A

cosmetic looks are poor because the orthosis is bulky and tends to protrude vertically in sitting

53
Q

is a three way knee stabilizer flexible, semi rigid, or rigid?

A

rigid

54
Q

what motions are controlled by a three way knee stabilizer?

A

varus, valgus, hyperextension

55
Q

when would a three way knee stabilizer be given to a patient?

A

similar to swedish knee cage but valgus and varus deficits too

56
Q

Why would you choose a three way knee stabilizer over a swedish knee cage?

A

more cosmetically acceptable and also controls varus and valgus

57
Q

Is a molded plastic solid knee orthosis flexible, semi rigid, or rigid?

A

rigid

58
Q

what motions are controlled with a molded plastic solid knee orthosis?

A

hyperextension, valgus, and varus

59
Q

When would you give a molded plastic solid knee orthosis to a patient?

A

mild to moderate knee hyperextension, valgus, and varus present (stroke, arthritis, etc)

60
Q

Why would you use a molded plastic solid knee orthosis over a swedish knee cage or 3 way knee stabilizer?

A

it is custom so it fits better and can be more restrictive as well as it is more cosmetically appropriate

HOWEVER it is expensive and doesnt account for growth

61
Q

Knee orthosis with hyperextension, varus, valgus, and rotary control is flexible, semi rigid, or rigid?

A

rigid

62
Q

what motions does a knee orthosis with hyperextension, varus, valgus, and rotary components control?

A

its in the name lol

63
Q

Where does a knee orthosis with rotary control extend to in the thigh?

A

middle third of the thigh

64
Q

where does a knee orthosis with rotary control extend to in the lower leg?

A

middle third of the lower leg

65
Q

what type of knee joint is in a KO with rotary control?

A

a polycentric knee joint to allow for flexion and extension along an instantaneous axis

66
Q

when would you give a patient a knee joint with rotary control?

A

usually indicated when there is significant damage to ligaments in the knee and the individual still wants to stay active - usually post surgical patient in long term phase of rehab

Orthotics (mine) (4 decks)

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