Orthotics Flashcards

1
Q

what is orthotics

A

the science that deals with the use of specialised mechanical devices to support or supplement weakened or abnormal joints or limbs

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2
Q

what can an orthosis do

A

improve function
reduce pain
and/or prevent deformity

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3
Q

definition for valgus, varus and equinus

A

valgus - everted position in frontal plane

varus - inverted position in frontal plane

equinus - plantarflexed position in sagittal plane

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4
Q

features of foot orthosis and examples

A

moulded walking base used inside footwear

e.g. insoles and heel cups

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5
Q

what does a foot orthosis do

A

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

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6
Q

difference between mobile and fixed deformity

A

mobile
- foot can be manipulated into normal alignment

fixed
- foot cannot be manipulated into normal alignment

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7
Q

difference between mobile and fixed deformity foot orthosis

A

mobile
- foot orthosis to correct deformity

fixed
- foot orthosis to accommodate deformity

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8
Q

what is part of the physical assessment of a patient referred to the clinic

A

ROM, Muscle Powers, Sensation, Proprioception,

Circulation, Muscle Tone

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9
Q

how is valgus deformity dealt with

A

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

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10
Q

how is varus deformity dealt with

A

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

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11
Q

how is equinus deformity dealt with

A

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)

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12
Q

if a heel raise is used to accommodate an equinus deformity what may also need to be done

A

Compensatory heel raise in contralateral shoe may be required

Knee hyperextension can occur if the equinus is not adequately accommodated

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13
Q

what are examples of features of a shoe that are good with orthotics

A

Soft leather upper
Few internal seams
Padded tongues and cuffs Lace/Velcro fastening
Wide and deep toe box Rocker soles

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14
Q

what are footwear adaptations

A

raises
wedges
flares
rocker soles

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15
Q

what is the function of shoe/heel raise

A

To accommodate fixed equinus foot or leg length discrepancy

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16
Q

what is the function of shoe wedges

A

To correct mobile or accommodate fixed varus/valgus foot

Can be added externally or internally in the heel and sole

17
Q

what is the function of shoe flares

A

To increase stability from a varus/valgus foot

18
Q

what is the function of rocker sole

A

Increase stiffness of sole

Increase toe spring

Ground reaction point shifted posteriorly

19
Q

what is an AFO

A

ankle foot orthosis

Externally applied device which extends from just below the knee, around the ankle and across the sole of the foot

20
Q

what can an AFO be used for

A

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

21
Q

how can an AFO mechanical characteristics be altered

A

Increasing/decreasing medial/lateral trimlines

Increasing/decreasing material thickness

Changing cross section shape

Adding reinforcement/stiffeners

Material choice

22
Q

what will altering the heel height of shoes influence

A

the GRF around the knee

can also increase or decrease stability

23
Q

what are knee orthosis

A

Externally applied device worn on the leg extending from mid-thigh to mid-calf

24
Q

functional potential of knee orthosis

A

Relieve pain

Improve function

Prevent structural deformity

Correct mobile deformity

Limit or prevent joint motion

25
Q

common reasons for knee orthosis fittings

A

OA
Post surgery
Ligament injury
Mild instability

26
Q

what is KAFO

A

Knee Ankle Foot Orthosis

a.k.a Calliper

27
Q

how are cosmetic KAFO designed

A

Light in weight
Durable
Improved cosmesis

Typically made from thermoplastic

Side bars made from Aluminium Alloy (soft and light)

28
Q

how do drop locks work

manual drop locks

A

When knee is in extension, gravity causes a ring to drop and joint to lock

(manual drop locks - knee is in extension, a ring needs to be moved by hand to lock)

29
Q

what are semi automatic lock and bale locks

A

Semi- Auto
When knee is in extension, the
spring activates a ring to
lock

Bale
- Bar or cord activated ring lock joint

30
Q

what are polycentric lock and spline locks

A

polycentric lock
- more than one joint centre

spline locks
- Incremented joint to allow fixed setting
(can be used in contracture Mx)

31
Q

how does KAFO weight bear

A

requires to take the body weight through the side bars, reducing weight through the leg

32
Q

what is a HKAFO

A

Hip Knee Ankle Foot Orthosis
- Basically a KAFO with the addition of a hip joint and pelvic band

  • reduces the risk of hip dislocation
33
Q

what is the aim of a HKAFO and an example of one

A

aim to stabilise the hip and lower spine in cases where the patient is weak or paralysed

HGO = hip guidance orthosis

34
Q

what does HGO consist of

A

bilateral KAFOs linked via specially designed low friction hip joints

Used in conjunction with crutches the HGO allows reciprocal ambulation

Spinal support, instead of a simple pelvic, band can be used where greater trunk stability is required

35
Q

what are WHO and what does it do

A

Wrist Hand Orthosis

holds wrist/hand in static position
prevents movement at specific joints
used to prevent contracture development

36
Q

what are dynamic arthosis

A

Orthosis has springs and moving components

Holds arm in corrected position while allowing active movement at specific joints

Aids rehabilitation