Orthoses: Considerations for the Knee and Hip

Question 1

what factors influence the prescription of an orthosis (4)

Answer 1

• motor function
• goals
• impairments
• prognosis

Question 2

two types of custom fabrication of an orthosis

Answer 2

1. negative mold

2. positive mold

Question 3

difference between negative and positive mold

Answer 3

negative - the shell of the limb

positive - when it is the shape of the limb

Question 4

three parts of final orthotic check-out

Answer 4

1. fit
2. function
3. patient education

Question 5

regarding patient education when prescribing an orthosis, what is considered a red flag

Answer 5

redness from the orthosis lasting more than 15-20 minutes

Question 6

True/False: the PT should watch the patient put on and take off the orthosis before they go

Answer 6

true

Question 7

wearing schedule days 1-2

Answer 7

30 minutes, 2x/day

Question 8

wearing schedule days 3-6

Answer 8

60 minutes, 2x/day

Question 9

wearing schedule days 7-10

Answer 9

2 hours, 2x/day

Question 10

wearing schedule days 10-14

Answer 10

4 hours, 2x/day

Question 11

wearing schedule past day 14

Answer 11

all day use

Question 12

with an orthosis, what else generally needs to be worn

Answer 12

a sock

Question 13

when cleaning an orthosis, what should be avoided

Answer 13

submersion in water

Question 14

should the patient place their foot into the orthosis then shoe, or straight orthosis into shoe then place their foot in

Answer 14

always foot –> orthosis –> shoe

Question 15

three potential indications for knee orthoses

Answer 15

1. surgery
2. DJD
3. recurvottum

Question 16

what does KO stand for

Answer 16

Knee Orthosis

Question 17

three types of KOs

Answer 17

1. rehabilitative orthoses
2. functional orthoses
3. prophylactic orthoses

Question 18

what is a prophylactic orthosis

Answer 18

an orthosis that prevents injury

Question 19

why are there suspension considerations with KOs

Answer 19

as you move distally, the leg gets thinner, so the orthosis may slide down the leg

Question 20

three GENERAL types of KOs

Answer 20

1. flexible
2. semirigid
3. rigid

Question 21

potential motions controlled with KOs

Answer 21

hyperextension, flexion, varus, valgus, translation

Question 22

benefits of a polycentric KO

Answer 22

it changes the instantaneous axis of rotation

Question 23

two types of joint KOs

Answer 23

1. single axis

2. polycentric

Question 24

what does KAFO stand for

Answer 24

Knee Ankle Foot Orthoses

Question 25

difference with offset knee joint

Answer 25

it is more posterior to knee

Question 26

three types of knee joint KAFO

Answer 26

1. single axis 2. post/offset 3. adjustable

Question 27

what is a Pawl-lock Bale release

Answer 27

it sits posterior to the lock, when it hits the front of a chair, it unlocks the knee

Question 28

what type of knee joint is present with Pawl-Lock Bale releases

Answer 28

single axis knee joint

Question 29

overall, what does the Pawl-Lock Bale Release allow

Answer 29

knee flexion for sitting

Question 30

what does a Floor Reaction Orthosis do (KAFO)

Answer 30

positions the foot into plantar flexion

Question 31

where is the COG for the Floor Reaction Orthosis

Answer 31

anterior to knee

Question 32

the Floor Reaction Orthosis places the knee into...

Answer 32

extension

Question 33

what does the Craig-Scott KAFO place the ankle into

Answer 33

dorsiflexion

Question 34

because the Craig-Scott KAFO places the ankle into dorsiflexion, what happens to the knee

Answer 34

extension

Question 35

who generally uses the Craig-Scott KAFO

Answer 35

patients with SCIs

Question 36

what does the Craig-Scott KAFO allow people with SCIs to do

Answer 36

stand

Question 37

what else needs to be used with Craig-Scott KAFOs

Answer 37

some sort of an assistive device

Question 38

what does HKAFO stand for

Answer 38

Hip Knee Ankle Foot Orthosis

Question 39

what needs to be used with HKAFOs

Answer 39

assistive device

Question 40

indications for HKAFOs

Answer 40

significant weakness throughout the trunk and LEs

Question 41

for HKAFOs, the body needs to be stabilized in what position to allow for engagement in other activities involving UE function

Answer 41

body needs to be in upright standing posture

Question 42

three disadvantages/contraindications of HKAFOs

Answer 42

1. high energy expenditure 2. lack of necessary neck and UE strength and coordination 3. hip flexion contraction greater than 30 degrees

Question 43

two types of hip joints on HKAFOs

Answer 43

1. single axis | 2. dual axis

Question 44

what motions are allowed by dual axis HKAFOs

Answer 44

- flexion/extension | - abduction/adduction

Question 45

two general indications for hip orthoses for adults

Answer 45

1. proximal femur fracture | 2. total hip arthroplasty

Question 46

for developmental hip dysplasia, what hip orthosis may be indicated for babies

Answer 46

Pavlik Harness

Question 47

age appropriate for Pavlik harness

Answer 47

birth-6 months

Question 48

what position is the child held in with the Pavlik Harness

Answer 48

Abduction and ER

Question 49

does the Pavlik Harness control adduction?

Answer 49

no