What orthotics do spina bifida patients have
HKFO
what are indications for orthotics
improve stability in stance phase
eliminating unwanted motion
corrective forces
assist during swing phase
improve base of support
improve efficiency of gait
According to APTA how do you fit a brace
- what is the specific diagnosis
- idengtify the age range
- describe the child’s level of function before and after
- clear description of the type of AFO
- look at specific systematic review, what level of significance do you need, do not generalize beyond the specifics
what is a UCBL used for
children presenting with pronation during midstance; stabilizes a flexible foot
- mild low tone
what diagnoses is usually seen with a UCBL
juvenile idiopathic arthritis
what are the indications for a supramalleolar orthotic (SMO)
-for flexible pronation of ligamentous laxity
-mild/mod hypotonia
what does the SMO permit
fill active DF and PF
where do the trim lines proximate for the SMO
to the met heads and above the malleoli
what are the biomechanics of the SMO
controls midfoot and rearfoot
fixation of pronation and supination
maintains subtalar joint in neutral alignment
which dx use SMO
low tone - down syndrome
JIA - control pronation
developmental delay - calcaneal pronation
mild CP with neuromk control problems
spina bifidi - s1 to no loss
when is an SMO contraindicated
with fixed contractures such as equinus deformities
what are solid AFOs prescribed for
maintaining ankle at a neutral position
what are the 4 indications for a solid AFO
-resting night splint
-postoperative support
-non-ambulatory child who uses standing device
-short-term stabilization
what 2 dx indications are seen with solid AFO
-functional or spastic equinus
-spina bifida: L4 to S1 with weak gastroc and or knee instability
when is a solid AFO contraindicated
equinus contractures
what are the 5 functional indications for a solid AFO
-external support, stability and limit on ankle ROM are needed
-kids with excessive ankle motions and when more stability of the ankle is needed
-want to increase stride length or decrease cadence
-specific skill execution is limited when barefoot
-walking results in excessive energy expenditure
Solid AFO is not idea for a child who is
active and ambulatory
what are the 3 main characteristics of a leaf spring AFO
-limited resisted PF
-genreates spring with loading during DF
-consider for increased knee extension and drop foot
describe the characteristic of a hinged AFO
has a free hinged joint and permits ankle DF and prohibits a measure of PF from 5-20 degrees
what are the 4 indications for a hinged AFO
-DF at initial contact is limited or absent
-shoes provide limited PF power
-sit to stand takes too long
-more DF is needed for stairs
what are the 2 diagnostic indication for hinged AFO
hemiplegia
peripheral neuropathy
what are the 2 contraindications for hinged AFO
fixed and severe equinus deformity
crouch deformity
describe what a dynamic AFO: DAFO looks like
-plastic cast
-Plantar surface contours
-full wrap around shell for flexible control of foot
-fully integrated padding
what does a anterior floor reaction orthosis or ground reaction orthosis do
applies an anterior floor reaction force to reduce knee flexion and prohibits pronation and DF (set to 5 degrees)
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Gait75
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Cerebral palsy4
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Practical #184
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Motor Learning and Interventions for CP80
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Orthotics31
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Congenital Muscular Torticollis69
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Pediatric Physical Therapy Models: early intervention and school setting55
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Developmental Coordination disorder30
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Hypotonia and developmental Delay28
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JIA78
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Brachial plexus injury46
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TBI78
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Myelodysplasia95
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Pre-term infants70
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Neuromuscular diseases91
