Orthotics

Question 1

4 factors for making decision for orthosis

Answer 1

-advantages
-disadvantages
-indications it will be useful
-characteristics of individual

Question 2

What are 3 advantages of orthosis

Answer 2

Improve mobility
Influence tone
Protect limb

Question 3

What are 3 disadvantages of orthosis

Answer 3

Affect ADL/mobility
Expense
Energy cost

Question 4

2 important ways to protect skin

Answer 4

-wear socks that cover orthotic
-check brace 20 mins after first wear

Question 5

5 structures/things to check for skin protection after first wear

Answer 5

-med and lat mall
-1st ray
-calc
-edges of orthotic
-REDNESS on orthotic, don’t wear and see orthotist

Question 6

What are 3 issues that require orthosis?

Answer 6

-gait deviation
-protection from injury
-muscular adaptation

Question 7

What gait deviation occurs during swing phase? What type of orthosis would be beneficial?

Answer 7

Drop foot

Leaf spring or DF assist

Question 8

What 3 gait deviations occurs during stance phase

Answer 8

-ankle instab
-ankle PF wk or neuromuscular fxn
-knee hyperext

Question 9

What type of orthotic would be beneficial for ankle instability

Answer 9

Solid or hinged AFO

Question 10

What orthotic would be beneficial for ankle PF weakness

Answer 10

Solid AFO with support strap, hinged

Question 11

How will an AFO affect STS

Answer 11

Decrease DF

Question 12

How would an orthotic affect gait

Answer 12

Improve gait mechanics

Question 13

4 considerations when making a decision for orthotic (criteria etc.)

Answer 13

-stable disease, improve/degen
-6 to 8 hours a day (prolong wear w/o skin damage)
-cosmesis
-consider job and recreation

Question 14

What 3 stances are critical to consider for orthotic

Answer 14

-mid stance**
-mid swing
-terminal swing**

Question 15

What are 3 importances for custom-molded orthoses

Answer 15

-impaired sensation
-hypotonicity
-risk of progressive deformity

Question 16

What is an orthosis constructed around? What does it ensure?

Answer 16

Rectified model of limb

Adequate pressure relief over vulnerable areas

Question 17

3 types of orthosis materials

Answer 17

-thermoplastic
-custom
-carbon fiber

Question 18

5 dx/impairments that require AFO

Answer 18

-peripheral neuropathy
-stroke
-CP
-SCI
-head injury

Question 19

What are the 3 force principles? Where on AFO? KAFO?

Answer 19

Posterior, primary, plantar

Post calf, TC jt, under ball of ft

Post knee, patella tendon, post calc

Question 20

Equation for pressure

Answer 20

Force/area

Question 21

How to ensure orthosis is most effective (think forces)

Answer 21

Control direction of primary and direction of counter forces

Question 22

2 benefits of carbon fiber

Answer 22

Light weight and durable

Question 23

4 conditions/dx for KAFO

Answer 23

SCI, polio, spina bifida, MD

Question 24

What are mass manufactured orthosis

Answer 24

Off the shelf, based on shoe size

Question 25

What are cons for mass manufactured orthosis

Answer 25

-problematic with ft deformity and sensory impairment -lg calves -wide/narrow ft

Question 26

3 benefits of commercial DF assist orthotic designs

Answer 26

-prepositions ft for heel strike in IC -limited med/lat stab during stance allows tibial advancement during stance -contributes to push off

Question 27

What is commercial DF assist orthotic design not used for? Why

Answer 27

CNS issues w/ spasticity, doesn’t control rear foot

Question 28

What impairment is the leaf spring orthotic used for

Answer 28

Drop foot

Question 29

3 descriptions of lead spring (make of it)

Answer 29

-shallow trim lines (less support and control) -mass produced -dynamic thermal plastic AFO

Question 30

What does leaf spring assist with

Answer 30

Lower ft during LR, part of first heel/rocker

Question 31

What does hinged AFO allow (think basic)

Answer 31

Sagittal plane motion

Question 32

3 main benefits of hinged AFO

Answer 32

-increases mobility in fxnal acts -allows tibial advancement during stance -prevents excessive PF

Question 33

Two types of hinged AFO

Answer 33

Pin type and elastic

Question 34

What is the main advantage of solid AFO

Answer 34

Resists PF

Question 35

What are 2 major disadvantages of solid AFO

Answer 35

-interferes with transitions through 3 rockers in stance -prevents tibial advancement during midstance

Question 36

What impairments does anterior floor reaction orthosis target

Answer 36

Motor control of knee and weak quads

Question 37

What does anterior floor reaction orthosis restrict Why

Answer 37

Tibial translation, ext moment Stabilizes knee during stance

Question 38

3 criteria for anterior floor reaction orthosis

Answer 38

-poor ankle support in stance -minimal DF during swing -knee flex/collapse during midstance

Question 39

What does the tone reducing/inhibiting dynamic AFO stabilize

Answer 39

Calc and rearfoot

Question 40

What two AFO’s are used for LMN/hypotonicity

Answer 40

Tone-inhibiting and articulating ankle (aka hinged)

Question 41

What two AFOs are used for mod to severe hypertonicity

Answer 41

Posterior leaf spring and carbon graphite