LE orthotics Flashcards
(25 cards)
Indications for an orthotic treatment
support and alignment
Prevent or correct deformity
Substitute or enhance muscle function
Decrease pain
what can therapist influence with orthotics?
joint malalignment
Limp length discrepancy
Decrease flexibility
Muscle imbalance and weakness
Poor neuromuscular skills
Kinetic chain dysfunction
Foot orthosis indications
plantar fasciitis
Ankle sprain
Stress fracture
Metatarsalgia
Tendinitis
First MP joint sprain
Pes planus cavus
hallux valgus
Mortons neuroma
Tarsal tunnel
Rear foot valgus
forefoot adduction,abduction
AFO indications
cerebral palsy
Muscular dystrophy
stroke
Multiple sclerosis
Trauma
-Brain injury, peripheral nerve injury, spinal cord, injury, ankle injury, post surgical support
KAFO indications
less than 3- MMT score for quadriceps
Ligamentous laxity
Maximum knee control needed
KO indications
Ligamentous laxity
ACL PCL MCL LCL
unilateral compartment unloading
AFO pathologies
cva
Cerebral palsy
Brain injury
guillan barre syndrome
Ataxia
Parkinson’s disease
Multiple sclerosis
Muscular dystrophy
Results in muscular imbalances - acquired deformity or altered gait
AFOs help to control
pf or df
coronal stability of the subtalar joint
Midfoot positioning
-transverse arch
-longitudinal arch
-forefoot abduction/adduction
secondary benefits for AFOs
mild knee alignment and function
Most successful with sagittal plan involvement
3 point pressure system
Apex force used for correction or control
Two counterpressure forces applied for stability and control of the affected joint
ideal for off the shelf
May be stocked in left and right and diff sizes
corrects mild instability or strength deficits
temporary use in acute setting
Diagnostic use by therapist
Limited scope
custom molded indications
Chronic conditions
Progressive deficits
Moderate weakness or instability
Spasticity
Maximal control of the joint necessary
Combine DF and PF weakness
solid ankle AFO
Creates moments on knee that require minimal quad strength to control
Solid ankle AFO indications
weak or absent strength <3+
absent proprioception
Berg balance <43
coronal instability of the ankle
coronal ankle instability
look at free motion joints
-posterior tibialis deficiency
-hindfoot valgus
-over pronation
-pf/df strength is normal
mild dorsiflexion weakness
DF grade 4 or less
DF strength is maintained throughout activity
coronal control about the ankle is present
Progressive df weakness and coronal instability is present
orthotic that…
Induces immediate knee flexion moment
Eliminates foot slap
Prevent drop foot
Requires 4 quad strength
When rapid DF fatigue occurs
Articulated AFO with PF stop and DF assist
plantarflexion weakness
dorsiflexion stop
Allow controlled tibial progression
Prevent drop off in TS due to lack of PF strength
Articulated AFO with DF stop
use DF stop when
PF < or =4
use PF stop when
<43 Berg
spasticity
Poor proprioception
use DF assist when
DF < or =4
Worse with fatigue
ground reaction AFO used for
quads and pf weakness
3+ quad strength
Provides knee extension against the tibial cuff during midstance
Must have DF stop to prevent progression
When is a KAFO indicated
when there is less than three quad strength
To control valgus, varus, recurvatum
offset knee joints
-CoM is anterior to the joint axis
-Knee forced into extension during stance
KAFO drop locks are used to
Maximize stability
Require balance and hand dexterity
