L6 Orthotics

Question 1

purpose of orthotics

Answer 1

control abnx movement compensations by bringing foot to the floor
biomechanical balanced kinetic chain
maintain subtalar neutral position

Question 2

Why does the alignment of the foot matter?

Answer 2

foot position affects GRF, mechanical chain changes when the foot is in a different position and GRF are different

Question 3

function of the subtalar joint in initial contact

Answer 3

shock absorber
pronation, rotation of the tibia to absorb?

Question 4

function of the subtalar joint in midstance`

Answer 4

loading response moves joint to pronation
over pronation can rotate tibia and affect the knee

Question 5

function of the subtalar joint in terminal stance

Answer 5

joint supinates to become rigid for toe off

Question 6

What issues can be created by over pronation in closed chain

Answer 6

anterior pelvic tilt
IR of femur
valgus knee
med rotation tibia/fibula
medial rotation talus
adduction/PF talus

Question 7

what issues can be created by over supination in closed chain?

Answer 7

posterior pelvic tilt
femur ER
knee varus
lat rotation tibia/fibula
abduction/DF talus

Question 8

how to measure varus and valgus

Answer 8

varus: ankles together, measure distance between knees
valgus: knees together, measure distance between ankles

Question 9

knee adduction moment (KAM)

Answer 9

during walking, GRF goes up and medial towards midline
places knee into varus
compresses medial knee
contributes to knee OA
this force is increased if the knee is in valgus

Question 10

types of shoe orthotics

Answer 10

heel cup
heel lift
wedge
stability//control, soft tissue protection

Question 11

principles required for orthotics

Answer 11

easy for patient
soft tissue
at risk patient
tolerate compression and shear
consider functional level of patient

Question 12

shoe inserts function

Answer 12

modifies heel/midfoot/forefoot
padding for pain
heel lift for leg length
wedge for supination/pronation

Question 13

correct pronation to reduce medial OA with what orthotic?

Answer 13

valgus wedge orthotic insole

Question 14

navicular drop test

Answer 14

over pronation test
measure midfoot collapse
measure navicular in seated on paper, stand and measure distance it drops
positive > 10mm

Question 15

considerations to assess the need of ankle orthotic

Answer 15

1. gait deviation: swing/stance
2. protect from injury like pressure/joint instability

Question 16

AFO prescription for what conditions?

Answer 16

weakness
stroke
CP
head injury
peripheral neuropathy
alignment
spinal cord injury
progressive diseases

ankle foot orthotic

Question 17

leaf spring AFO

Answer 17

gives energy to patient’s foot to bring it back into dorsiflexion
used for foot drop
support weight of foot in swing phase to clear floor

Question 18

causes of foot drop

Answer 18

peripheral neuropathy
Fx knee or fibular head
knee dislocation
cross ing legs
losing weight - they can cross legs now and stress nerve
bed rest
MS
stroke/cva
myositis

Question 19

solid afo

Answer 19

used in neuro pts with lots of spasticity for more control of tibia, support calcaneus
reduce PF

Question 20

static/rigid AFO

Answer 20

holds foot in biomechanical neutral

Question 21

disadvantages of solid AFO

Answer 21

interferes with transitions of all ankle rockers due to fixed ankle position
prevents controlled lowering of foot