orthotics

Question 1

To improve function
increase or control range of motion
provide stability
To decrease pain
To protect for self harm

Answer 1

Orthotics

Question 2

Is the limitation imposed by the orthotic more important than the strengthening of the immobilized muscle?

Answer 2

Cost Benefit

Question 3

Cranial Remolding Orthoses

Answer 3

Infants between the ages of 3 and 18 months
Presenting with the following diagnoses:

Plagiocephaly (diagonal asymmetry of the skull)

Brachycephaly (a skull presentation with occipital flattening and wider and taller parietal areas)

Scaphocephaly (a skull presentation with an elongated anterior/posterior dimension and a flatter and taller parietal area)

Question 4

custom-made orthoses that encourage symmetric growth to improve head shape as it grows

Answer 4

CROs

Question 5

CROs

Answer 5

Cranial Remolding Orthoses

Question 6

Infants between the ages of 3 and 18 months can get CRO’s. What are CRO’s ?

Answer 6

Cranial Remolding Orthoses

Question 7

Plagiocephaly

Answer 7

diagonal asymmetry of the skull

Question 8

Brachycephaly

Answer 8

a skull presentation with occipital flattening and wider and taller parietal areas

Question 9

Scaphocephaly

Answer 9

a skull presentation with an elongated anterior/posterior dimension and a flatter and taller parietal area

Question 10

a baby has plagiocephaly, brachycephaly, or scaphocephaly, and they are between 3 and 18 months…..
they can have a ….

Answer 10

CRO, cranial remolding orthoses

Question 11

Discontinuation of the helmet, CRO, occurs when…

Answer 11

head shape has improved to parent and clinician satisfaction, the child is repositioning on their own, and torticollis is resolved.

Question 12

how long is a CRO worn?

Answer 12

Worn for 3 to 5 months, 23 hours per day

Question 13

Prior to CRO intervention,

Answer 13

head control is required, and 2 months of repositioning is recommended

Question 14

Used in the management of scoliosis to stabilize curve progression, or reduce pain by controlling the spine or segments of the spine. (Worn for 23 hours per day)

Used to provide trunk support (positioning) for educational activities. (Worn during the school day)

Used to prevent spinal segmental movement with certain spinal conditions. (vertebral fractures)

The segment of the spine impacted will dictate the size of the orthosis required.

Answer 14

Spinal Orthoses

Question 15

lower extremity, first thought should wear a good shoe

Answer 15

cuboid bones are not solidified yet
they have that fat pad still
to wrap them up in a brace is like wrapping up dice and fat
a good shoe
-heel counter (heel cup is firm to give support to calcaneus in neutral)
-arch support (longitudinal arch to stop excessive pronation with weight bearing)
-laces, give more mid foot stability

Question 16

basic foot support for children involve

Answer 16

-heel counter (heel cup is firm to give support to calcaneus in neutral)
-arch support (longitudinal arch to stop excessive pronation with weight bearing)
-laces, give more mid foot stability

remember the cuboid bone prob not solidified yet
fat pad still on foot, making it look like flat feet

Question 17

billy goat shoes

Answer 17

good for kids that have braces on ankles/orthotic
has a zipper on the side

Question 18

foot orthotic

Answer 18

arch support and padding along calcaneus and heel
help to decrease foot pain, associated with walking later on in the day
increase endurance

if kid demos slight valgus and pronate but maintain a small arch but they do complain their feet hurt or want to be carried or do not want to walk because of it…. but not just kids

Question 19

supra malleolar orthotic

Answer 19

a lot of
calcaneal valgus
midfoot pronation

slight eversion of foot
more stability around talocrural and subtalar joint
supports calcaneus and provides arch support
good for young children

Question 20

Athletic Support Orthosis

Answer 20

foot pain or inversion sprains
cant tolerate material used in orthotics or too hot this can be better

Provides stability of the ankle joint and support of the arches of the foot using velcro laces and nylon material
Used for active children who are involved in higher level gross motor or sports activities.

Question 21

night stretching splint

Answer 21

looks like an AFO
larger than an AFO though
has strap and pulls foot into DF
in order to elongate soft tissue, need to be on stretch for 6 hours
good for gastroc soleus tendon complex
can sleep in them
get kid used to it, then apply stretch
after 6 weeks put a little more DF

Worn until the child is done growing.

Question 22

Solid ankle joint AFO

Answer 22

good for toe walkers
powerful spasticity , where they sit in Plantar flexion
supports knee joint control (midstance, trying to block that quick snap into knee hyperextension)
good for crouched gait too

Ankle foot orthotic
Prevents ankle joint plantarflexion
Promotes knee joint control (flexion and extension) during ambulation
Provides toe clearance during swing through

Question 23

articulating AFO (less restrictive AFO)

Answer 23

allows for eccentric control of tibia moving forward or posteriorly over ankle joint

Prevents ankle joint plantarflexion
Allows ankle joint dorsiflexion and knee joint flexion

Question 24

Ground Reaction AFO

Answer 24

crouched gait pattern but have the ROM but not the strength during weight bearing phase of gait, assist with that motion, but needs to have the ROM in the knee joint in order for this to work.

Also called Floor Reaction AFO
Encourages knee joint extension and less flexion during ambulation.

Question 25

Neuro developmental treatment (NDT) Bobath

Answer 25

Intervention is aimed at the inhibition of abnormal postural reflex activity and movement and the facilitation of normal movement patterns seen during the first 3 years of life. Tapping Weight bearing Weight shifting

Question 26

Motor control through an intact CNS, autonomic nervous system Rood

Answer 26

Intervention includes the inhibition, facilitation, and activation of muscle action through the anatomically intact reflex arch Inversion Stroking of the paraspinal muscles Neutral warmth Introduced the stages of motor control

Question 27

Organization of tactile, proprioceptive, vestibular and visual information into meaningful perception and development of movement Ayers

Answer 27

Spinning Acceleration Visual perception skills

Question 28

Movement science Shepherd and Carr

Answer 28

Intervention is largely a training process with the patient as an active learner and problem solver Motor learning Stages of motor learning Task analysis Parameters of a task

Question 29

Dynamic system theory of motor development Thelen

Answer 29

The development of movement is complex Mechanical/musculoskeletal Neurological/neuromuscular Cognitive Perception/vision Environment/opportunities

Question 30

Disability outcome research in PT in the past has not fully investigated how an intervention affects participation. As we take a closer look at the effectiveness of our services for children with disabilities we need to ask ourselves how our interventions have affected the child’s ability to participate in the settings in which the child spends his or her day. PTs have an obligation to promote healthy functioning embodied by the ICF and strive for optimal participation” in society by young adults, who just happen to have a disability.

Answer 30

Disability outcome research in PT in the past has not fully investigated how an intervention affects participation. As we take a closer look at the effectiveness of our services for children with disabilities we need to ask ourselves how our interventions have affected the child’s ability to participate in the settings in which the child spends his or her day. PTs have an obligation to promote healthy functioning embodied by the ICF and strive for optimal participation” in society by young adults, who just happen to have a disability.