Special Clientele > Orthotics > Flashcards

Orthotics Flashcards

(54 cards)

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1
Q

Orthotics

A
  • Use of specialized mechanical devices to support or supplement weakened or abnormal joints or limbs
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2
Q

3 Point System

A
  • pressure applied to a body part by 3(or more) pads with the outer pads applying pressure in one direction and the center pad applying a counter pressure in the opposite direction
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3
Q

Pressure

A
  • force divided by surface area

ie: pounds per square inch

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4
Q

How to decrease pressure?

A
  • Decrease force
  • Increase area
  • Increase lever arm: increase distance from axis of motion to pressure pad
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5
Q

Purpose of Orthotics

A
  1. Hold
  2. Assist
  3. Resist
  4. Support
  5. Stop
  6. Reduce Axial Loading
  7. Combinations of all above functions
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6
Q

Hold “purpose”

A
  • Prevent all motion
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7
Q

Assist “purpose”

A
  • Facilitate movement in a specific direction
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8
Q

Resist “purpose”

A
  • Inhibit movement in a specific direction
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9
Q

Support “purpose”

A
  • Allow for protective movement
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10
Q

Stop “purpose”

A
  • Allow movement within a pre-defined, limited ROM
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11
Q

Reduce Axial Loading “purpose”

A
  • Force acting along the lines of an object expressed in compression or tension
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12
Q

Pedorthics

A
  • Design and fitting of foot orthoses
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13
Q

Shoes “Pedorthics”

A
  • Extra depth shoe
  • Healing Shoe
  • Orthopedic Shoe
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14
Q

Extra Depth Shoe

A
  • Upper contour with additoinal vertical space

- Allows for insertion of orthotics

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15
Q

Healing Shoe

A
  • For any situation that requires a pressure offload of the forefoot
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16
Q

Orthopedic Shoe

A
  • Provides support - reinforcements

- 4 Types (Steel Shank, Reinforced Heel Counter, Solid Heel, Low Resilient Heel)

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17
Q

Steel Shank

A
  • Ortho Shoe

- Longitudinal plate that reinforces the sole

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18
Q

Reinforced Heel Counter

A
  • Ortho Shoe

- Stiffens the quarter, posterior shoe

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19
Q

Solid Heel

A
  • Ortho Shoe

- Higher heel reduces tension on the achilles tendon when firm

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20
Q

Low Resilient Heel

A
  • Permits slight planter flexion in those with limitations in the ankle
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21
Q

Internal shoe modifications

A
  • the closer the modification is to the foot, the more effective it is
  • Scaphoid Pad
  • Heel Cup
  • UCB / UCBL 3 Point counter pressure
  • Metatarsal pad
  • Heel pad or lift
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22
Q

Scaphoid Pad

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A
  • Internal

- Prevent depression to the sub-talor joint

23
Q

Heel Cup

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A
  • Internal

- Silicon Pad under the heel

24
Q

UCB / UCBL

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A
  • Internal
  • 3 point counter pressure system to control calcanneal eversion
  • semirigid longitudinal arch support with heel cup
25
Metatarsal Pad
- Internal - Restricts forefoot abduction - Transfers stress from metatarsal heads to metatarsal shafts
26
What is effective in reducing plantar pressure?
- Metatarsal Pad
27
Heel Pad or Lift
- Internal - Soft, with or without cutout for heel spur - Cushions with concave relief to reduce pressure
28
External Shoe modicfications
- Will erode - Client limited to wearing the shoe - Heel Wedge - Metatarsal Bar - Rocker Sole - Built Up Heel and/or sole
29
Heel Wedge
- External - alters alignment of calcaneous - Medial Wedge - Thomas Heel - Lateral Wedge
30
Medial Wedge
- Heel Wedge - Lateral Directed force - aids in realigning by filing void between sole and floor on medial side
31
Thomas Heel
- Heel Wedge | - Medial wedge with anterior extension for additional support
32
Lateral Wedge
- Heel Wege | - Shifts weight bearing to medial side of front of foot
33
Metatarsal Bar
- External - Placed posterior to the metatarsal heads to shift weight to the shafts at late stance, the bar transfers stress to shafts
34
Rocker Sole
- External - Shifts weight to metatarsal shafts and reduces MTP extension during pushoff - Facilitates roll-over and toe off when ankle dorsiflexion is limited
35
AFO
- Ankle Foot Orthosis - Double Upright - Posterior Leaf Spring - Solid Plastic AFO - Toe Off-AFO - Plastic Hinge AFO - Ypsilon AFO - Floor Reaction AFO - Knee-Ankle-Foot KAFO
36
Double Upright with TStrap
- AFO - Provides the greatest support and adjustability - Single or Double spring/stops (anterior/posterior)
37
Anterior Stop
- Limits Dorsiflexion
38
Anterior Spring
- Assists Plantar Flexion
39
Posterior Stop
- Limits Plantar Flexion
40
Posterior Spring
- Assists Dorsiflexion
41
Varas Deformity (T-Strap)
- Strap goes around the medial upright portion
42
Valgus Deformity (T-Strap)
- Strap goes around the later upright portion
43
Indications for Double Upright with T-Strap
- Foot drop - Poor Knee control in sagittal plane - Ankle Varus/Valgus - Foot drop with uncontrolled edema - Poor skin below knee
44
Posterior Leaf Spring
- AFO - For weakness that causes toe dragging - Plastic, lightweight, wear with regular shoes
45
Solid Plastic
- AFO | - Limits all foot and ankle motion
46
Toe OFF-AFO
- AFO - Fiberglass, carbon fiver and kevlar orthosis - Designed to provide dosiflexion assistance for mild to sever foot drop that is accompanied by mild to moderate ankle instability
47
Toe OFF-AFO contraindication
- with moderate to severe spasticity or edem
48
Plastic Hinged AFO (Steel Posterior Step)
- AFO - Prevents to drag and is plantar flexion resistant - imposes a flexion force at knee during early stance
49
What can a plastic hinge AFO prevent?
- Knee hyperextension
50
Ypsilon AFO
- Provides dorsiflexion assistance in the presence of mild to moderate drop foot - Promotes free ankle movements, medial, lateral, and rotational movement
51
Ypsilon Contraindication
- Moderated to severe spasticity or edema
52
Floor Reaction AFO
- AFO | - Provides a knee extension movement in stance without preventing flexion during swing
53
KAFO
- Knee-Ankle-Foot Orthoses - Double upright design - Knee Joints - Standard or offset - posterior to midline of the leg - Ratchet Joints - used to incrementaly increase ROM for contractures needed for knee flexion contractures
54
Gait Training with Bilateral KAFO's
- Begin in parallel bars (weight shifts, both hands to one hand) - Shift both hands from front to back, then progress to crutches - May need mirror for feedback
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