Orthotics 3

Question 1

What is a metatarsal bar?

Answer 1

• block of material attached to the sole of the shoe (outside)
• placed proximal to metatarsal heads

Question 2

What does a metatarsal bar do?

Answer 2

prevents rocking through gait (great toe extension)

Question 3

Who needs metatarsal bar?

Answer 3

• bunionectomy
• metatarsalgia
• sesamoiditis
• great toe replacements

Question 4

What is a rocker bar/bottom?

Answer 4

• basically a sketcher shape-up

- redistributes body forces over entire plantar surface of foot in WB

Question 5

Who might need a rocker bar?

Answer 5

• limited DF
• ankle pain
• diabetics

Question 6

How can a rocker bar help someone with limited DF?

Answer 6

• facilitates smooth roll during stance phase

- reduces shear stress and trauma to midfoot and forefoot

Question 7

What is a Thomas heel used for?

Answer 7

• improve foot balance

- relieve excessive pressure on shank

Question 8

medially flared Thomas heel

Answer 8

• used with rearfoot valgus to decrease incidence of eversion injuries
• prevents excessive pronation

Question 9

laterally flared Thomas heel

Answer 9

• used with rearfoot varus to decrease inversion injuries

- prevents excessive supination

Question 10

What must be done for hammer toes, claw toes, mallet toes?

Answer 10

• change toe box (vamp)

- avoid buying a shoe that rubs

Question 11

What happens if a shoe rubs on the toes?

Answer 11

• changed gait pattern

- issues further up the chain

Question 12

What is gout?

Answer 12

• form of arthritis

- characterized by severe pain, redness, and tenderness of joints

Question 13

tx goals for gout pt

Answer 13

• prevent or limit motion of painful or inflamed joints
• accommodate foot deformities
• cushion impact of loading on involved joints

Question 14

What can a PT do for a gout pt who needs to walk?

Answer 14

• met-bar

- rocker boot

Question 15

examples of plantar fasciitis orthotics

Answer 15

• arch support
• night splinting
• heel cups

Question 16

Why must you gradually change wearing schedule of an orthosis for a plantar fasciitis pt?

Answer 16

can cause more pain and injury if you just put them in and have them wear it all the time

Question 17

crush box

Answer 17

can take a mold of the pt’s foot and send off to get orthotics made

Question 18

shoe garments

Answer 18

• crush box
• casting
• rigid

Question 19

problem with rigid orthotics

Answer 19

• doesn’t allow cushion

- takes a long time to adapt to it