Orthotics Flashcards
what is orthotics
the science that deals with the use of specialised mechanical devices to support or supplement weakened or abnormal joints or limbs
what can an orthosis do
improve function
reduce pain
and/or prevent deformity
definition for valgus, varus and equinus
valgus - everted position in frontal plane
varus - inverted position in frontal plane
equinus - plantarflexed position in sagittal plane
features of foot orthosis and examples
moulded walking base used inside footwear
e.g. insoles and heel cups
what does a foot orthosis do
Re-distribution and reduction of plantar pressures
Relieve pain
Improve function
Prevent structural deformity
Correct mobile deformity Accommodate fixed deformity Limit or prevent joint motion
difference between mobile and fixed deformity
mobile
- foot can be manipulated into normal alignment
fixed
- foot cannot be manipulated into normal alignment
difference between mobile and fixed deformity foot orthosis
mobile
- foot orthosis to correct deformity
fixed
- foot orthosis to accommodate deformity
what is part of the physical assessment of a patient referred to the clinic
ROM, Muscle Powers, Sensation, Proprioception,
Circulation, Muscle Tone
how is valgus deformity dealt with
to correct
- Manipulate corrected position and hold foot by applying 3 point forces
- e.g. medial wedge on insole
to accommodate
- Accept foot position and accommodate to
achieve greater stability
- e.g. lateral wedge on insole
how is varus deformity dealt with
to correct
- Manipulate corrected position and hold foot by applying 3 point forces
- e.g. lateral wedge on insole
to accommodate
- Accept foot position and accommodate to
achieve greater stability
- e.g. medial wedge on insole
how is equinus deformity dealt with
Correct – Manipulate corrected position and hold foot by applying 3 point forces
(ensure knee is not made unstable)
Accommodate – Accept foot position and accommodate to achieve greater stability
- e.g. heel raise (ensures knee is not unstable)
if a heel raise is used to accommodate an equinus deformity what may also need to be done
Compensatory heel raise in contralateral shoe may be required
Knee hyperextension can occur if the equinus is not adequately accommodated
what are examples of features of a shoe that are good with orthotics
Soft leather upper
Few internal seams
Padded tongues and cuffs Lace/Velcro fastening
Wide and deep toe box Rocker soles
what are footwear adaptations
raises
wedges
flares
rocker soles
what is the function of shoe/heel raise
To accommodate fixed equinus foot or leg length discrepancy
what is the function of shoe wedges
To correct mobile or accommodate fixed varus/valgus foot
Can be added externally or internally in the heel and sole
what is the function of shoe flares
To increase stability from a varus/valgus foot
what is the function of rocker sole
Increase stiffness of sole
Increase toe spring
Ground reaction point shifted posteriorly
what is an AFO
ankle foot orthosis
Externally applied device which extends from just below the knee, around the ankle and across the sole of the foot
what can an AFO be used for
Correction of the musculo-skeletal system Maintenance of position
Assist motion about a joint
Resist motion about a joint
Protection
Improve walking speed and cadence
Reduce energy expenditure
how can an AFO mechanical characteristics be altered
Increasing/decreasing medial/lateral trimlines
Increasing/decreasing material thickness
Changing cross section shape
Adding reinforcement/stiffeners
Material choice
what will altering the heel height of shoes influence
the GRF around the knee
can also increase or decrease stability
what are knee orthosis
Externally applied device worn on the leg extending from mid-thigh to mid-calf
functional potential of knee orthosis
Relieve pain
Improve function
Prevent structural deformity
Correct mobile deformity
Limit or prevent joint motion
