Orthotics

Question 1

“P.T.G”

Answer 1

Patient / Task / Goal

OR

“Prioritize the goals”

Question 2

What is this measuring?

Answer 2

Ankle Angle

Question 3

What is this measuring?

Answer 3

Shank to Vertical Angle

Question 4

T or F: If a patient is lacking DF, you should set the Ankle Angle to neutral.

Answer 4

F

Do not set AA to neutral if pt does not have the ROM range

Question 5

What are the two basic categories of AFOs?

Answer 5

Non-Articulating / Solid

Articulating (w/ joints)

Question 6

What are the “tasks” associated with an Ambulatory AFO?

Answer 6

5 Attributes of Ambulation

Question 7

What are the “tasks” associated with a Non-Ambulatory AFO?

Answer 7

Contracture management

Wound healing / protection / prevention

Positioning

Question 8

Application of a force within an orthosis may help to ___.

Answer 8

Resist motion

Assist motion

Transfer force

Protect a body part

Question 9

What is an example of an orthosis that serves to resist motion?

Answer 9

Quad paralysis

KAFO with mechanical lock

Stabilizes knee - prevents knee flexion at IC and limits it during LR

Question 10

What are some examples of orthoses that serves to improve alignment?

Answer 10

Pavlik Harness (DHD)

Hip orthosis to keep femoral head in Acetabulum (Legg-Calve-Perthes Disease)

Cranial shaping orthosis

WHO to minimize ulnar deviation (RA pt)

Question 11

What are some examples of orthoses that serve to assist motion?

Answer 11

Peroneal Nerve Injury - prevent foot drop or toe drag

Gastroc stretch - nighttime orthoses

Question 12

What is an example of an orthosis that serves to transfer force?

Answer 12

FO that includes pad underneath metatarsal shafts

Shifts force from painful metatarsal heads (pt with metatarsalgia) to less sensitive shafts

Question 13

Do NOT put on a nighttime AFO in a way that ___.

Answer 13

elicits an intense stretch

Question 14

In what two ways can you improve patient’s comfort in an orthosis?

Answer 14

Maximize area covered by orthosis (minimizes pressure)

Lengthen longitudinal element of an orthosis (provide sufficient leverage)

Question 15

What is the common Pressure System for most orthoses?

Answer 15

3-Point Force System

Principal force acting in one direction and two counter-forces acting in the opposite direction

Question 16

What orthotic device exerts a Four-Point Pressure System?

Answer 16

Thoracic Hip Knee Ankle Foot Orthosis (THKAFO)

Question 17

What orthotic devices do NOT apply a Three-Point Pressure System and instead surround the body segment to apply a circumferential or total contact pressure?

Answer 17

Elastic sleeve (burn pt)

Sure Step SMO

Sensory Dynamic Pressure Garment

Theratogs

Question 18

What are some common compensations in the gait of children with hemiplegia?

Answer 18

Hemi-pelvis retraction

Increased push-off on unaffected side

Early firing of fibularis longus

Question 19

What are some OMs used in the context of Hemipolymicroglia?

Answer 19

Gait Deviation Index (GDI)

Salfort Gait Tool (SF-GT)

Visual Gait Assessment

GMFM

Question 20

Midfoot “Break”

Answer 20

DF coming from midfoot rather than TCJ

Question 21

Surestep SMOs are designed for children with ___ ___.

Answer 21

Down Syndrome

Question 22

Surestep SMOs are designed to address a STJ issue in which plane?

Answer 22

Frontal (Coronal)

Question 23

How does a Surestep SMO differ from that of a typical SMO?

Answer 23

Wrap around design

Shorter toe-plate and trimlines

Designed to promote / improve high level activities (jumping) and subtalar joint alignment

Question 25

What orthotic is this?

Answer 25

SMO w/ a PLS extension

Question 26

SMOs w/ PLS extensions are designed for who?

Answer 26

Sagittal plane Talocrural Joint issues and coronal Subtalar Joint issues ITW / Spastic Hemiplegic CP (GMFCS Level II)

Question 27

Label 1 / 2 / 3

Answer 27

1: Solid Ankle trimlines 2: Semi-Solid Ankle trimlines 3: PLS trimlines

Question 28

A *Ground Floor Reaction AFO* is designed for patients with ___. What does it do?

Answer 28

Duchenne Muscular Dystrophy Provides knee extension moment during ambulation

Question 29

What kind of orthotic is this?

Answer 29

Posterior Entry AFO

Question 30

Spinal Muscular Atrophy

Answer 30

Inherited (vs. DMD which is often not) Gene disruption Characterized by degeneration of anterior horn cells / muscle atrophy / widespread weakness / absent DTRs

Question 31

Spinal Muscular Atrophy Classifications

Answer 31

Type 1: Most severe / most common / manifests before 6 months / death typically by 2 years of age Type 2: Onset between 7 and 18 months / may live into adulthood with proper treatment and monitoring of pulmonary function Type 3: Mildest / onset after 18 months / children may walk independently or with AD into late adolescence or early adulthood

Question 32

All 3 types of SMA are characterized by:

Answer 32

Significant limb and trunk weakness Muscle atrophy (more pronounced in proximal muscles and LEs) Hypotonia and Areflexia Progressive MSK issues

Question 33

T or F: Scoliosis is associated with both DMD and SMA.

Answer 33

T

Question 34

What kind of orthotic is this?

Answer 34

*Multi-Podus or Pressure Relieving AFO (PRAFO)* This is a resting / non-ambulatory AFO

Question 35

Articulating AFOs have a joint that ___ motion.

Answer 35

allows

Question 36

What kind of joint is this?

Answer 36

Overlap

Question 37

What kind of joint is this?

Answer 37

Tamarack

Question 38

What kind of joint is this?

Answer 38

Oklahoma