Orthotics Lab 1 - Shoes (2/3/17) (1/6) Flashcards Preview

Prosthetics and Orthotics (Spring 2017) > Orthotics Lab 1 - Shoes (2/3/17) (1/6) > Flashcards

Flashcards in Orthotics Lab 1 - Shoes (2/3/17) (1/6) Deck (72)
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1
Q

the shoe serves as the foundation for…

A

an orthosis

2
Q

what is the standard height of a heel

A

1 inch

3
Q

when might a higher heel be indicated (2)

A
  1. if there is decreased flexibility in the hindfoot

2. if there is pain in the heel

4
Q

what does increasing the height of the heel do

A

transfers weight toward the metatarsal heads

5
Q

what are the consequences if a heel is too high

A

the individual will need to compensate for the increased ankle PF by either flexing at the hip or knee or hyperextending at the knee then increasing lumbar lordosis

6
Q

difference between low and high quarter shoes

A

low quarter - extend to just below the malleoli

high quarter - extend above the malleoli

7
Q

what do low quarter shoes allow for

A

ankle mobility

8
Q

when may low quarter shoes be indicated

A

when ankle stability is not an issue or if they are being fit for a plastic orthosis which extends above the malleoli

9
Q

are low or high quarter shoes easier to don

A

low quarter shoes are easier to don

10
Q

when are high quarter shoes indicated

A

when there is ankle instability and support is required externally from the shoe

11
Q

with the Blucher shoe, the tongue is an extension of…

A

the vamp

12
Q

for Blucher shoes, is there a separation between the lace stay and vamp

A

yes

13
Q

can the throat of the Blucher shoe be opened relatively wide

A

yes

14
Q

for the Balmoral shoe, is there a separation between the anterior portion of the lace stay and the vamp

A

no

15
Q

in the Balmoral shoe, is the tongue a separate piece sewn to the vamp and anterior quarters

A

yes

16
Q

is the Blucher or Balmoral more preferable

A

Blucher

17
Q

why is the Blucher more preferable than the Balmoral

A

it is more easily donned

18
Q

downside of lace-to-toe

A

cosmetically less acceptable (ugly AF)

19
Q

when are specialty options for closure options (elastic laces, velcro, etc.)

A

they are indicated when fine motor dexterity and function are compromised

20
Q

describe function of a last

A

the last is the mold over which the components of the shoe are molded, therefore cannot be identified on the shoe itself

21
Q

what is an inflare

A

the vamp of the shoe is angled moderately inward

22
Q

what is an outlfar

A

the vamp of the shoe is angled outward

23
Q

what is a straight last shoe

A

the vamp is straight

24
Q

typical shoes have a _____ last, which is mildly curved inward

A

regular

25
Q

is a regular last useful to attempt to correct or accommodate a deformity

A

no

26
Q

when may an inflared shoe be warranted

A

to correct a flexible forefoot abduction (pronation) or to accomodate a rigid forefoot adduction (supination)

27
Q

when may an outflared shoe be warranted

A

to correct a flexible forefoot adduction (supination) or to accommodate a rigid forefoot abduction (pronation)

28
Q

when may a straight last be warranted

A

to correct a mild forefoot adduction or abduction deformity

29
Q

newborn shoes are typically constructed from a _____ last, making it difficult to distinguish left and right

A

straight last

30
Q

what characteristic would an in-depth last produce in a shoe

A

depth of the shoe is increased

31
Q

when would an in-depth last be indicated (4)

A
  1. when pads or a plastic inset will be worn inside the shoe
  2. to accommodate dressings
  3. when there is increased edema in the foot
  4. severe deformities in the foot
32
Q

when may a custom molded shoe be warranted

A

when there is a significant deformity in the foot which could not be accommodated in an extra depth shoe with inserts

33
Q

key ares to identify for shoe fitting (3)

A
  1. length
  2. width
  3. depth
34
Q

guideline for shoe length

A

shoe length should be 1/2 inch longer than the longest toe

35
Q

the widest part of the shoe should be aligned with…

A

the 1st metatarsal phalangeal joint

36
Q

how to measure depth in shoe fitting

A

examine the fit of the vamp and toebox for adequate clearance

37
Q

what position should fit be evaluated in

A

in a weightbearing position (because the foot spreads when it’s open) and non-weightbearing position if there is a flexible deformity

38
Q

what else may be considered that may influence size of the foot (2)

A
  1. time of day

2. prior activity level

39
Q

at the end of the day or after exercise, the foot can experience a ___ shoe size increase

A

1 - 1.5 shoe size increase

40
Q

a lift is primarily used to…

A

accommodate for a leg length discrepancy

41
Q

when else may a lift be used

A

to promote greater ease in swing on the contralateral side

42
Q

how much of a life can be accommodated within a shoe

A

approximately 1/2 inch

43
Q

what is the function of a cushioned heel

A

absorbs shock during loading as HS

44
Q

when is a cushioned heel indicated

A

when there is heel pain and may also be prescribed when the individual is using a solid AFO to assist with forward weight shift

45
Q

the overall function of a rocker sole, metatarsal bar, and rocker bar?

A

to promote smooth transition from heel strike to push off while relieving stress from the metatarsal heads

46
Q

what is a rocker sole

A

extends the length of the sole of the shoe

47
Q

what is a metatarsal bar

A

a strip of leather or rubber placed just posterior to the metatarsal heads

48
Q

what do the rocker styles do

A

serve to reduce stress at the metatarsal heads during pushoff phase of gait

49
Q

when are the rockers indicated

A

whenever there is pain in the metatarsal heads

50
Q

what does a flare do

A

increases the medial-lateral surface area on the bottom of the shoe

51
Q

where can a flare be placed

A

medial or lateral

52
Q

does a wedge maintain thickness universally on both sides?

A

no - one side is thicker than the other

53
Q

when a wedge is placed on the bottom of the shoe or between the inner and outer soles, what happens

A

the shoe is tipped in a desired direction

54
Q

two types of wedges

A

heel wedge or sole wedge

55
Q

heel wedges directly influence…

A

calcaneal position

56
Q

what do heel wedges do to 1. flexible deformities and 2. rigid deformities

A
  1. corrects flexible deformity

2. supporting a rigid deformity

57
Q

a sole wedge originates…

A

distal to heel

58
Q

a medial sole wedge will create a ____ effect on the forefoot

A

inversion

59
Q

a lateral sole wedge will create a ____ effect on the forefoot

A

eversion

60
Q

function of a flare

A

increase individual’s BOS when they are wearing shoes and may prevent inversion/eversion injuries

61
Q

function of a wedge

A

help correct flexible deformities or support rigid deformities

62
Q

what is a Thomas Heel

A

an extension of the breast of the heel anteriorly on medial side

63
Q

what does a Thomas Heel do

A

increases stability of the sole of the shoe when there is pronation

64
Q

what is a Reverse Thomas Heel

A

the breast of the heel is extended anteriorly on the lateral side

65
Q

can heel wedges be combined with Thomas/Reverse Thomas Heels?

A

yes

66
Q

the Thomas Heel (when utilized) is more likely to be used to increase the stability of the sole of the shoe when there is…

A

supination

67
Q

are Thomas Heels still popular?

A

not really

68
Q

what is a scaphoid pad

A

convex paid used within the shoe to support the longitudinal arch

69
Q

what is the proper positioning of a scaphoid pad within the shoe

A

the pad is placed under the longitudinal arch

70
Q

what is a metatarsal pad

A

soft domed shaped pad that supports the metatarsal arch and relieves pressure from the metatarsal heads by shifting pressure to the metatarsal shafts

71
Q

where should a metatarsal pad be placed

A

just posterior to the met heads and just anterior to the cuneiforms

72
Q

function of a heel spur

A

relieve pressure on the heel