Orthotics

Question 1

What is Orthotics?

Answer 1

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

Question 2

What is an Orthosis?

Answer 2

What is an Orthosis?

Question 3

What does an orthosis do?

Answer 3

improve function

reduce pain and/or deformity

Question 4

Who is an Orthotist?

Answer 4

Registered health care professional who specialises in the assessment of the whole body for biomechanical problems, and if appropriate may prescribe, measure, fit or review an orthosis

Question 5

AFO

Answer 5

Ankle Foot Orthosis

Externally applied device which extends from just below the knee, around the ankle and across the sole of the foot
Used for support and/or correction of foot/ankle deformities
Can also have affect on knee

Question 6

KAFO

Answer 6

Knee Ankle Foot Orthosis
- custom made externally applied device worn on the leg extending from thigh to foot

(commonly referred to as a “calliper”)

Question 7

HKAFO

Answer 7

Hip Knee Ankle Foot Orthosis

• addition of the hip section provides control to selected hip motions, as well as the leg
• it can also reduce or minimise the risk of the hip moving out of proper position or dislocating

Question 8

KO

Answer 8

Knee orthosis

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

Question 9

Valgus

Answer 9

Everted position in frontal plane

Question 10

Varus

Answer 10

Inverted position in frontal plane

Question 11

Equinus

Answer 11

Plantarflexedposition in sagittal plane

Question 12

Foot othrosis

Answer 12

A moulded walking base used inside footwear–Insoles and heel cups

Question 13

Foot Orthosis- Functional Potential

Answer 13

• Re-distribution and reduction of plantar pressures
• Relieve painImprove function
• Prevent structural deformity
• Correct mobile deformity
• Accommodate fixed deformity
• Limit or prevent joint motion

Question 14

Mobile Deformity

Answer 14

The foot can be manipulated into a “normal” alignment

Foot orthosis to CORRECT deformity

Question 15

Fixed deformity

Answer 15

The foot cannotbe manipulated into a ‘normal’ alignment

Foot orthosis to ACCOMMODATE deformity

Question 16

Assessment pathway

Answer 16

• Referral information and relevant patient history
• Physical Assessment
• static and dynamic gait assessment
• aims and objectives of patient and clinician

Question 17

Footwear

Answer 17

Accommodate foot in a well fitting and protective surrounding
Extra care to be taken with insensate foot
Soft leather upper
Few internal seams
Padded tongues and cuffs
Lace/Velcro fastening
Wide and deep toe box
Rocker soles

Question 18

Name four common footwear adaptions

Answer 18

Raises
Wedges
Flares
Rocker Soles

Question 19

What does a shoe/heel raise accommodate for?

Answer 19

equinus foot or leg length discrepancy

Question 20

What does a shoe wedge correct/accommodate for?

Answer 20

fixed varus/valgus foot

Valgus = medial wedge 
Varus = lateral wedge

Question 21

What does a shoe flare correct/accommodate for?

Answer 21

increase stability from varus/valgus foot

Question 22

What does a rocker sole correct/accommodate for?

Answer 22

increase stiffness of sole
increase toe spring
ground reaction point shifted posteriorly

Question 23

AFO functional potential

Answer 23

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

Question 24

list the four types of AFO

Answer 24

Solid AFO 
Posterior leaf spring 
AFO (PLS) 
Varus / Valgus control AFO
Jointed AFO

Question 25

AFO –How is it produced?

Answer 25

``` Assessment of patient’s functional loss Observation of gait Biomechanical assessment of gait deviations Identify functions required of orthosis Plaster wrap cast of patient’s lower leg ```

Question 26

How can AFO characteristics can be altered?

Answer 26

``` Increasing/decreasing medial/lateral trimlines Increasing/decreasing material thickness Changing cross section shape Adding reinforcement/stiffeners Material choice ```

Question 27

Functional Potential of a KO

Answer 27

``` Relieve pain Improve function Prevent structural deformity Correct mobile deformity Limit or prevent joint motion ```

Question 28

KO Potential Motion Control

Answer 28

FlexionHyperextensionAnterior/Posterior InstabilityMedial/Lateral InstabilityRotation

Question 29

Why would you fit a KO?

Answer 29

Osteoarthritis Post surgical Ligament injury Mild Instability

Question 30

Why must the deformity be mild in order for the knee orthosis to be mild?

Answer 30

short lever arms on the knee

Question 31

Functional potential of a FAFO

Answer 31

``` Correction of the musculo-skeletal system Maintenance of position Assist motion about a joint/joints Resist motion about a joint/joints Protection Improve walking speed and cadence Reduce energy expenditure ```

Question 32

considerations to determine what type of KAFO

Answer 32

``` patient age weight activity level occupation goals and expectations ```

Question 33

what is a conventional calliper made out of? | what are the cons?

Answer 33

metal and leather - heavy - hard wearing

Question 34

What are cosmetic KAFos made out of?

Answer 34

thermoplastics - light durable improve cosmoses

Question 35

Describe the two possible materials used for side bars of KAFOs

Answer 35

steel - hard material - heavy - hard wearing Dural - aluminium alloy - soft - light

Question 36

list the 7 types of knee joints used in a KAFO

Answer 36

``` Free Drop locks Manual Drop locks semi automatic locks bale locks polycentric locks spline joints ```

Question 37

what is a quad top?

Answer 37

ischial tuberosity rests on a ledge outside the socket

Question 38

Ischial containment

Answer 38

ischial tuberosity rests within socket

Question 39

What is the aim of a HKAFO? | name an example

Answer 39

stabilise the hip and lower spine in cases where the patient is weak or paralysed - Hip guidance orthosis (HGO)- basically a bilateral KAFO liked via specially designed low friction hip joints-allows for reciprocal ambulation

Question 40

``` Upper lim orthotics FO HO WHO EO EWHO SO ```

Answer 40

``` Finger Orthosis Hand Orthosis Wrist Hand Orthosis Elbow Orthosis Elbow Wrist Hand Orthosis Shoulder Orthosis ```

Question 41

Upper limb: Static orthosis

Answer 41

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

Question 42

Upper limb: Dynamic orthosis

Answer 42

- springs and moving parts - holds arm in corrected position while allowing active movement at specific joints - aids rehab