P&O Final Exam
Whats difficult to do ind with an HGO? What else is difficult? What correlates to increased success w/ HGO? Used most commonly for what age group?
1. Don/doff 2. Transfer sit<>stand 3. Good trunk strength 4. School aged children
What is difficult w/ a RGO? What else?
1. Don/doff 2. Wearing and tearing on clothing -multi repairs -hot to wear
How does the Stance and swing phase influencing jts KAFO work?
1. Dynamic loads trigger locking 2. Unlocking of the knee jt depends on where they are in gait cycle (PSw-swing)
How does TLSO for scoliosis work?
1. End point control 2. Curve protection 3. Continuous transverse support
What is the AFO critical for in the neuro population? What will it allow? How?
1. Energy conservation 2. Independent community ambulation 3. Guides and controls ankle and knee jts during stance and swing
How do you decide if pt needs an FFO?3
1. Examine foot-ankle alignment 2. Examine STN position 3. Dynamic gait analysis
What are compensations for rearfoot varus in STN? What if they don't compensate? What happens at the knee?
1. Excessive pronation 2. Will walk on o/s of the foot 3. Extension
What are compensations for rearfoot valgus in STN? What if they don't compensate? What happens at the knee?
1. Excessive supination 2. Walk on medial boarder of foot 3. Knee flexion
What activates the stance & swing phase influencing jt KAFO? What happens if you don't?
1. Heel strike 2. It wont lock unless WB through heel at IC
What do Jewett and CASH LSO limit? They encourage what? For who?
1. Limit trunk flexion 2. Trunk hypertext 3. Vertebral compression fx to unload vertebral body (osteoporosis, MVA)
Drop lock on an KAFO are not indicated for who?
1. Limited hand function 2. Significant LE spasticity/knee flex contracture 3. Difficulty balancing w/ one AD
What is the Last of the shoe? What does it determine? Options? Most shoe have what type of last? What does that do to toe box? What motion does that cause?
1. Line along the bottom of the shoe 2. Shape of the shoe 3. Straight, medial, or out flared 4. Medial 5. Toe box is directed inward from the heel 6. Inversion
What needs to be done first in a AE harness to operate TD? Then what?
1. Lock the elbow 2. Use shoulder flex and scap ABD to operate TD
What is a forequarter amputation? What does surgeon try to spare and why? Issue w/ prosthetic?
1. No clavicle or scapula (no shoulder jt) 2. Soft tissue so prosthetic can rest on it 3. Heavy prosthesis w/ little function
What does research say about FKO vs no brace? Why wear them?
1. No difference in ant tibial translation 2. Pt feels secure
The spiral and hemi-spiral AFOs have no what? Why are the effective? The intimate fit not indicated for who?
1. No fasteners 2. Light weight 3. Edema/obese limbs
What is an elbow disarticulation? What maintains shoulder ROM? How much removed loses shoulder function?
1. No radius or ulna 2. Long humerus 3. <30% left = no shoulder function
Contraindication for thermoplastic KAFO?
1. Obese 2. Uncontrolled/ fluctuating edema
How do you determine what motion the orthotic is controlling?
1. Opposite of the central force
How do AFOs control instability in stance? Applying forces where?
1. Optimally aligning ankle 2. Medial-lateral or Ant-post directions
Treatments for spasticity?
1. Oral meds 2. Injections 3. Surgeries 4. Baclofen pumps
What are movements of open chain supination?
1. PF (sagittal) 2. Inversion (frontal) 3. ADD (transverse)
What are the 2 most common diseases associated with a high risk foot?
1. PVD 2. Peripheral neuropathy
What should be considered when choosing prosthesis of the UE?3
1. Painless 2. Sensation 3. Can we create a pinch
What population for bail lock? What must they be able to do?
1. Paraplegic 2. Maintain bilateral UE support on crutches while standing
What is the Counter of the shoe? Purpose? What does it prevent? Should be firm/reinforced esp for who?
1. Part that Achilles comes in contact with 2. Reinforces heel 3. Excessive calcaneal/rearfoot motion 4. Plantar fasciitis
Infants dx w/ DDH from birth wear what? Position? What does it limit? What should they be able to do? Wear progression?
1. Pavlik brace 2. Hip flex 100-120 ABD 30-40 3. Ext and ADD 4. Kick actively 5. 24hr/day to only night/nap time
Shoe must match what? Low arches/pes planus need what? High arches/pes cavus?
1. Person's foot structure 2. More stability/supination 3. More flexibility (pronation)
AFO are ideal for?
1. Pes equinus (PF and Iverted foot in swing) or Ankle varus 2. CP and CVAs
HKAFOs are traditionally for what pts?4
1. Polio 2. SCI 3. Myelomeningocele 4. Spastic quad CP
What are 2 types of thumb amputations?
1. Pollicization 2. Toe-to-thumb transfer
The degree of correction of scoliosis depends on what 4 factors?
1. Position of pad 2. Magnitude of corrective force 3. Direction of force 4. Duration of force
What are types of Dynamic AFOs?4
1. Post leaf spring (thermoplastic) 2. Conventional DF assist 3. Articulating thermoplastic 4. Hybrid (metal-plastic)
What does FKO do? What does a valgus orthoses do?
1. Prevent ant translation of tibia 2. Decrease medial knee pain by decreasing excessive valgus force at knee
Why is PKO worn? How? Who wear these?
1. Prevent injury 2. Protection to soft tissue restraints of the knee 3. Linemen
Goal of spinal orthosis for scoliosis? It will not result in what? Good outcome when what?
1. Prevent progression 2. Permanent correction of spinal alignment 3. Spinal curve is close to pre-bracing angles
What is a Conventional AFO-DF assist? What is good about conventional AFOs?
1. Produces force to aid in desired jt motion 2. Can adapt to different shoes
What is a PKO? Purpose?
1. Prophylactic Knee orthosis 2. Used for prevention 3. Does not stop or correct unless extreme
What will a KAFO do? 3
1. Protect jt that is crosses 2. Proved structural integrity 3. Increase function
Purpose of hip orthosis for MS impairments? Orthotic by itself will not control what?
1. Protect or position the jt w/n a desirable range of flex/ext & ADD/ABD 2. Hip rotation
What are functional uses of an Aesthetic Prosthesis?
1. Provide a stable working surface 2. Restore additional length 3. Preserve useful sensation 4. Improve function 5. Contribute to better rehab potential
Where does a 3/4 length foot orthoses end? Sulcus length? Full length?
1. Proximal to met heads 2. Ends at sulcus between ball of foot/toes 3. Distal ends of toes
3 point loading system? What are prox & distal forces? Counter force? What if motion control is desired in multiple planes?
1. Proximal, Distal, and Central/Counter Force 2. Force applied in the same direction 3. 3rd force in opposite direction somewhere b/t them 4. May need more points
Stance and swing phase influencing jts KAFO for pt depends on what?3
1. Pt ability 2. Environment 3. Nature of task
2* problems w/ scoliosis?
1. Pulmonary 2. Cardiac 3. Spine instability 4. Shoulder impingement 5. Pneumonia
What is the primary goal of PTB AFO? How much knee flexion? BW is loaded where? Result?
1. Reduce axial loading to the knee, foot, and ankle 2. 10 degrees 3. Ant shell of AFO and patellar tendon 4. Decreases load on tibia, fibula, and foot
What is a RKO? Purpose?
1. Rehab knee orthosis 2. Protect jt (dial lock/immobilizer)
What is a wrist disarticulation? What motion is preserved?
1. Remove everything distal to radius and ulna 2. Supination and pronation
When do pts complain due to neuropathy?
1. Rest 2. Activity
What is the goal of an FFO using Root's theories? 2
1. Restore normal foot alignment 2. Promote STN position
How does HGO work? What does this allow?
1. Rigidity of the orthosis from WB to allow progression of the contralateral limb to progress in swing 2. Alternating gait
Craig Scott KAFOs are good for who?3
1. SCI 2. Muscular Dystrophy 3. Spina bifida
What are types of trunk orthoses?
1. SI belt 2. Corsets
What plane is DF & PF? Axis?
1. Sagittal 2. Medial/lateral axis b/t med and lat malleoli
All dynamic AFOs allow for what motion at the ankle? What makes Posterior Leaf Spring (PLS) distinct?
1. Sagittal plane 2. Trimlines are behind malleoli
Orthoic for What is Brunnstrom stage 3? What if moderate to severe edema?
1. Same as Brunnstrom stage 2 2. Conventional metal upright AFO
Infant > 6 months dx w/ DDH wear what? How is hip set? What can parent still do?
1. Scottish-Rite brace 2. Flex 90 and ABD 30 3. Hold and bathe infant
What are spiral and hemi-spiral AFOs made with?
1. Semirigid plastic
What is key when choosing a prosthetic? Why?
1. Sensation 2. If you cant see it you cant feel it (working in dark or reaching into something)
What 3 systems may be involved in diabetic neuropathy? Screen what?
1. Sensory - Motor - Autonomic 2. Must screen the circulatory system to rule out or rule in
How can an AFO control knee? When should AFO be used over KAFO?
1. Setting ankle at DF or PF 2. If quad is >3+
What BE amputation is pronation and supination lost? Elbow power?
1. Short (60% gone) 2. Very short (<35% RL)
What KAFO will work for a knee they will not have an extension moment or free jt motion?
1. Single axis locked 2. Offset locked
What KAFO will work for controlling genu Recurvatum?
1. Single axis locked 2. Offset unlocked 3. Offset locked
What KAFO will work for controlling genu valgum or varum?
1. Single axis unlocked 2. Single axis locked 3. Offset unlocked 4. Off set locked
How is Hemi-spiral AFO different?
1. Slightly greater control of pes varus/supination
What is the hook better at grasping than the hand? When else is it better?
1. Small objects 2. Restricted areas
What are types of Static AFOs?4
1. Solid Ankle 2. Ant Floor reaction 3. Patella Tendon Bearing 4. Supramalleolar (SMO)
Current evidence states what about foot orthoses? What does this mean?
1. Somatosensory rather than mechanical 2. Use whatever orthotic you want
What is the toe box of the shoe? Has to be high enough to accommodate for what?
1. Space inside shoe where toes are 2. Toe deformities (hammer toes)
What is Brunnstrom stage 2? What is present? Movements? What does pt gain?
1. Spasticity appears 2. Basic synergy patterns 3. Minimal voluntary and isolated movements present 4. Voluntary control over synergies
Other than SCI pt who else use HKAFOs? Goal? Why is max stability needed? Type of jt and stability is related to what?
1. Spina Bifida (Myelomeningocele) 2. Upright posture 3. Flaccid paralysis 4. Level of lesion & hip/trunk strength
What are types of BE amputation sockets?
1. Split socket 2. Muenster-Type Prosthesis 3. Standard socket
SI belt is design for what? Used commonly for who? It is a cure?
1. Stability 2. Pregnant, post partum, general disability 3. No only temp fix
Cross training shoe developed and combined what?
1. Stability from firm counter for side to side motion 2. Medium weight 3. Good shock absorption
What are the 5 fundamental gait prerequisites?
1. Stability in stance 2. Swing phase prepositioning 3. Clearance in swing 4. Adequate step length (of opposite LE) 5. Energy conservation
What are Metatarsal bars/rocker bottoms external shoe mods? What do they reduce? Improve what? Good for who? Facilitates what in absence of metatarsal flexibility?
1. Stacked leather or rubber on sole of shoe under metatarsal heads 2. Pressure on met heads during push off (PSw) 3. Toe rocker for fused toes/ankle jts 4. Transmet amputee and hallux rigidus 5. Forward propulsion
Which KAFO is designed specifically for quad weakness? What does it allow? What does this result in?
1. Stance and swing phase influencing jts KAFO 2. Knee to lock at IC (1st rocker) and unlock at heel off (3rd rocker) 3. More natural gait pattern
What type of AFO is Anterior floor reaction? Can you tell the type by look at gait?
1. Static 2. No
What are the 2 types of AFOs?
1. Static AFO 2. Dynamic AFO
Spinal orthoses for scoliosis are designed to what? Reduce what? Raise what? Reduce likelihood of what?
1. Stiffen spine 2. Curve or stop progression 3. Critical load (take more of the load) 4. Additional deformation
How do Conventional AFOs control ankle? What type of stops? What is the AFO made of?
1. Stops and assists 2. Bichannel adjustable lock (BiCAAL) or Single channel jt 3. Metal and leather
What does suitable footwear minimize? Provides what? What does it act like? Important for what population?
1. Stress on all portions of the foot 2. Provides support 3. Shock absorber for GRF 4. DM
Advantages of a conventional KAFO?3
1. Strong 2. Durable 3. Easily adjustable
What is done for pre-prosthetic training?3
1. Stump wrapping (edema) 2. ROM (shoulder & elbow) 3. Massage (edema & desensitization)
3 Things FFO does not do?
1. Support Medial Longitudinal Arch 2. Provide cushioning and shock absorption 3. Adhere to the outside of a shoe (it is intrinsic)
What are the 2 purposes of harness and controls of an AE prosthesis?
1. Suspend prosthesis form shoulder 2. Transmit power to flex the prosthetic forearm, lock and unlock the elbow, and operate the Terminal device
Purpose of Harness and controls in BE prosthesis? What is used as sources of power or force? How do you operate the terminal device?
1. Suspend prosthesis from shoulder so socket is held firmly on the stump 2. Body motions 3. Transmit force via a cable
When does toe rocker occur? What happens?
1. Terminal stance to push off 2. BW rolls over MTP jts
When does Conventional AFO DF assist compress? Recoil?
1. Terminal stance/Preswing 2. Swing
The tighter the springs in Conventional AFO...? What blocks motion? What conventional AFO is most common?
1. The more assistance it provides 2. Pegs 3. Conventional AFO-DF assist
What determines the flexibility of the PLS?
1. Thickness of thermoplastic
What amputations don't necessarily need a prosthetic?
1. Thumb 2. Digits
What are amputations that don't need a prosthesis?
1. Thumb 2. Digits
What are 2 types of radial deficiency congenital amputations?
1. Thumb Hypoplasia 2. Absent Radius
How is there an ext moment w/ Anterior floor rxn AFO? Limits what? What happens to GRF? What happens as length and stiffness of toe plate increases? Limiting what?
1. Tibia restrained from advancing over fixed foot 2. Limiting 2nd rocker 2. GRF pass ant to knee earlier in stance phase 3. Keeps knee in ext limiting 3rd rocker (TS-PSW)
What can be evident of high plantar pressure?2
1. Tissue that have healed/former ulceration sites 2. Presence of toe or partial foot amputations
What is function of prosthesis for child if it does not permit active prehension?
1. To get used to using both UE 2. Shape RL 3. Symmetrical lengths during mobility 4. To prevent them from getting use to how it feels w/o RL 5. Limit social awkwardness for parent and child
What will allow mobility in a post surgical fx orthotic? It will not what?
1. Total contact thermoplastic circumferential control 2. Unload jt completely
What are some adjustments for an RGO?
1. Traditional 2. Unlocked hip jts to allow for free hip flexion and extension 3. Locked hip jts simulating more of an HKAFO mechanism
What plane is ABD and ADD at the ankle? Axis?
1. Transverse plane 2. Longitudinal parallel to tibia
What are spinal orthotics considered? Pt must be edu on what?
1. Treatment for instability and deformity...not an assistive device 2. How to wear it
What is interesting about HKAFO and kids w/ Spina bifida? When do they start to stand? What is difficult for them?
1. Type of orthoses may change w/ growth/age 2. 12-18 months for standing 3. Controlling exaggerated ant pelvic tilt/hyperlordosis
What are vocational and economic factors w/ UE prosthetics/amputations?
1. Type of work 2. Might have to change profession 3. May not be able to work same job to support family
What are types of Stance and swing phase influencing jts KAFO?
1. UTX Swing and free walk 2. Swing phase lock 3. Load responsive jt 4. G Knee 5. E Knee
What are 2 types of ulnar deficiency congenital amputations?
1. Ulnar hypoplasia (no ulna) 2. Radio-humeral synostosis
Contraindications for Myoelectric prosthesis?
1. Unable to bear weight of prosthesis 2. Radical limb and muscle tiss removal 2* cancer 3. Poor pt motivation 4. Poor learning ability 5. Inabilty to follow usage guidelines
Single axis locked knee KAFO are for who? What will it effect?
1. Unable to control knee in stance phase 2. Clearance in swing
Who are Anterior Floor rxn AFOs not good for? 2 What if they have a knee contracture?
1. Uncontrolled genu Recurvatum 2. Structural knee instability (ACL ligament) 3. Knee flexion contracture >10*
What does a drop lock in a KAFO prevent? What insures lock will not drop accidentally? What needs to be obtained in order to lock or unlock? Indicated for who?
1. Unwanted Flexion and hyperextension 2. Ball bearing 3. Full extension 4. For someone w/ little stability or standing
Why are Hybrid Plastic-Metal AFOs easy to work with? Good for who?
1. Versatility and adjustability 2. Those who have rapid changes in their functional status
Purpose of Charleston bending brace? When is it worn?
1. Very aggressive correction of scoliosis 2. Worn at night only
Why are orthotics easier to obtain than a prosthetic?
1. Very quick ordering system (1-2 days) 2. Less expensive 3. Full closet of orthotics 4. Easy to change orthotic type
Purpose of a split socket? What is used to aid in suspension?
1. Very short limb <35% of RL 2. Cup to hold RL in socket
What are types of prosthetic hands?
1. Voluntary opening 2. Voluntary closing 3. Passive (cosmetic)
What are two kinds of hooks? Which is easiest and first to learn?
1. Voluntary opening (easiest to learn) 2. Voluntary closing
Why does bucking occur at knee?2
1. Weak quads 2. Poor timing in gait
Women rarely assess what in a shoe? What does that cause?
1. Width 2. Calluses, corns, bunions, hammertoe, ingrown toe nails
What needs to be considered in an UE prosthetic need?
1. Wrist 2. CMC 3. Thumb 4. Metacarpals 5. Prox phalanges
Degree of scoliotic curve best measured how? What degree for conservative rehab? Brace?
1. X-ray 2. < 25* 3. 25-45*
What is the sole of the shoe? What if it is too rigid? How and when?
1. bottom of shoe 2. Will interfere w/ the toe rocker 3. Terminal stance requiring MTP hyperextension
How much spinal growth achieved by age 10?
80%
What provides the central force in an AFO?
Closure/in-step and shoe
What are causes of UE amputations? Which is most common?
1. Acquired (most common...trauma) 2. Vascular 3. Infection 4. Tumors 5. Congenital
Lumbosacral corset most effect for what? Minimal effectiveness for what? Use when?
1. Acute LBP 2. Discogenic pain 3. In sitting but not in standing
Prefabricated orthoses does not offer what? It is not a what?
1. Adequate control of foot motion or resistance to GRF 2. Not a FFO
What are indications for Myoelectric prosthesis?
1. Adequate stature 2. At least 1 EMG site 3. Motivation 4. Sufficient learning ability 5. Adequate funding 6. Functional need for Myoelectric prosthetic fitting
Usually the RKO can regulate what? How much ROM for ACL 0-7 day p/o? How long it is locked? AAROM? Full ROM when?
1. Adjustable ROM 2. 0-90 NWB 3. 2-4 weeks or have good quad control 4. 0-130 6 weeks 5. 10-12 weeks
What does a Hybrid Plastic-Metal AFO have? What does it have instead of metal uprights? Whats the channel made of? Similar to?
1. Adjustable ankle locking jt 2. Thermoplastic uprights 3. Metal 4. Conventional AFO
What are 3 congenital amputations?
1. Agenesis 2. Partial Amputation 3. Complete Amputation
What is the current evidence about FFOs? How? Plan of care focus?
1. Aid in decreasing repetitive tissue stress 2. Limiting magnitude & rate of foot motion (over pronation) -Preventing movement into the microfailure zone 3. Proximal hip strengthening to decrease load on jts and increase shock attenuation thru/o the LE
What is the drawback of a solid/static (non-articulating) AFO? What may need to be modified?
1. All rockers are compromised 2. Shoe
What are conventional KAFOs? How is it worn?
1. Aluminum or stainless steel uprights w/ stirrups for shoe attachment 2. Over clothes
What is a BE amputation? What is difficult and why?
1. Amputation of arm below the elbow BE = Below elbow 2. Fitting prosthetic b/c of epicondyles
How does static AFO control knee hyperextension? Control Buckling/flexion?
1. Ankle in slight DF 2. Ankle in slight PF
Where is the fulcrum in an AFO? Counter forces?
1. Ant to ankle 2. Plantar surface of the foot and posterior proximal calf
How do static AFOs maximally control DF/PF? 3
1. Ant/Post force coupling 2. Length of foot plate 3. Thickness of foot plate
What AFO creates a PF-knee ext force couple?
1. Anterior floor reaction AFO
PTB AFO is an excellent option for who? Ex?3
1. Anyone who requires reduced WB through foot 2. Charcot Marie (DM- CMT) -Ulcers on plantar surface -Slowly healing fx of foot
Purpose of Milwaukee? Boston? Miami?
1. Apex is above T7 2. Inferior to T7 lighter than Milwaukee 3. Inferior to T7
What is the usual component at the ankle of a Craig Scott? Knee?
1. DF assist (bi/uni-channel) 2. Off set locking knee jt
What populations are proper footwear and size critical?4
1. DM (CMT disease) 2. Elderly 3. Obese 4. PVD
Purpose of Corset (fabric)? Good for what? What will long term use lead to?
1. Decrease axial loading of vertebral bodies (not effective) 2. Hernia and rib injuries 3. Muscle atrophy of trunk muscles increasing chance of re-injury
What is Brunnstrom stage 4? What occurs? Orthotics?
1. Decrease in spasticity 2. More complex movement are learned as synergies lose their dominance 3. Same as What is Brunnstrom stage 3
What are the drawbacks of PLS? Not effective for who?
1. Decreased mediolateral control 2. Decreased knee control 3. Not effective for severe spasticity
Soft foot orthoses accommodate more of what? Least at controlling what? Con? Pro? What is it not?
1. Deformity and shock absorption 2. Motion 3. Decreased durability 4. Light weight 5. Not an FFO
Goals for scoliotic orthotic intervention?
1. Derotation 2. Spinal balance 3. Delay/eliminate need for surgery
What is the most critical aspect to correctly prescribing the style of orthosis? Those at high risk for curve progression are better managed w/ what? What is crucial?
1. Determining the apex of the curve 2. CTLSO 3. Wearing time
What is the most common cause of neuropathic foot? What is commonly affected? Clinical manifestation?
1. Diabetic neuropathy 2. Distal symmetrical polyneuropathy 3. Multiple components, affecting multiple body systems
What changes design of shoe? What should be included b/4 selecting footwear?
1. Difference in demand on foot 2. Alignment and assessment
What is Brunnstrom stage 6? What b/co possible? Orthotic? Ideally what intervention is minimal? Why?
1. Disappearance of spasticity 2. Individual jt movements and coordination 3. Same as Brunnstrom stage 5 4. Orthotic 5. To maintain stability, promote mobility, & progress gait
What is good about the intimate fit of the thermoplastic KAFO? What does it control? Total contact design allow for greater what?
1. Disperses the forces better 2. Movement in sagittal plane 3. Transverse and frontal plane control
How is MSt-TSt affected w/ neuromuscular impaired gait?
1. Does not transition form mobile to rigid adapter for heel rise 2. Continued forward progression of trunk and hip
What is a Syndactyly congenital amputation?
Webbing
Scoliosis surgery required when?4
1. >45* 2. >5* change in 6 month period 3. pain 4. dysfunction
What motions are limited in a HKAFO?
1. ABD 2. ADD 3. Rotation
What are the triplanar motions of the ankle/foot?
1. ABD & ADD 2. DF & PF 3. Eversion/ Inversion
Control of ankle in KAFO is the same as for? What is important to understand?
1. AFOs 2. How ankle and GRF influence knee function and forward progression in gait
What do FFOs resist? Traditional rear-foot and forefoot positionings in FFO provide up to how much motion?
1. Abnormal GRF 2. 2 degrees of motion control
How many Brunnstrom stages ?
6
Orthotic use depends on what?4
- Strength - ROM - Motor control - Proprioception
How often is idiopathic scoliosis identified in adolescence? What are not seen as symptomatic?
1. 90% 2. <20*
When is a Lift external shoe mod used? Causes? What should be attempted first? When can internal be used?
1. >3/8 inch structural LLD 2. Congenital, hip fx, scoliosis 3. Try in shoe first 4. 1/8 - 1/4 inch LLD
Disadvantages of a conventional KAFO?5
1. *Heavy* 2. Must be attached to shoe 3. Less cosmetic 4. Fewer contact pts reduce control 5. Difficult to control varus and valgus stresses
Single axis KAFO allows how much flexion & ext? What does it prevent? What does it provide? What is needed?
1. 180* 2. Hyperextension 3. Med/lat stability 4. Some quad strength
What does Articulating/hinged thermoplastic AFO allow easy progression of? What does it control/limit? What does it improve? They only have what movement?
1. 1st and 2nd rockers 2. Knee hyperextension 3. Mobility and energy efficiency 4. Sagittal plane
What type of lever system is an orthotic? What must it be able to do?
1. 1st class 2. Magnitude of opposing forces must sum to zero
How long should orthoses be worn day 1? Day 2? Day 3? Full day of wear should occur by when? Progress to what?
1. 2 hours 2. 4 hours 3. 6 hours 4. W/n 2 weeks 5. All activities (sports, running, work)
What is a standard heel? Purpose of heel? What should be done if pt has limited ankle ROM?
1. 3/4 inch 2. Absorb shock and disperse GRF at IC 3. Use softer compressible heel
FKO has what type of point system? What types of units?
1. 4 point stabilizing force 2. Polycentric, flexion control, Ext assist
How much pronation in an ankle? Rear foot varus?
1. 4-6* 2. 0-8*
What must pt have to wear an Articulating /hinged thermoplastic AFO? What makes it effective? What can be used for this?
1. 5* active DF 2. PF stop mechanism usually 90* 3. Pin or Velcro
Weight gain as little as how much will increase foot size by one full size w/n 5 years? Causes?
1. 9 IBS in 5 years 2. Pregnancy, obesity, distal edema
An orthotic is designed to do what? Too much force or force over a long enough time will lead to what? Similar wearing schedule as?
1. Apply a force on a body segment in the presence or absence of WB 2. Tissue deformation and skin breakdown 3. Prosthetic
What may change w/ each procedure to manage spasticity? What remains the primary goal?
1. Appropriate AFO 2. Optimizing function
When does spiral and hemi-spiral AFOs coil to its original shape?
1. As ankle comes to neutral in MSt 2. In swing
Static AFOs are effective at assisting in what? What else? Provides external stability for what jts?
1. Assists in swing clearance 2. Preposition foot for IC 3. External stability for knee and ankle thru/o stance phase
What brace is indicated for Leg Calve Perthes? Hip position? Why?
1. Atlanta/Scottish Rite brace 2. 30-45 ABD 3. To prevent loss of ROM
What 3 modes does the Stance and swing phase influencing jts KAFO have?
1. Auto stance control (weight activated) 2. Unlocked 3. Locked
What locking system KAFO is good for those w/ poor hand fine motor skills? How does pt unlock it?
1. Bail lock KAFO 2. Backing up to seat and putting pressure on lever
Examples of when KAFO is needed?
1. Ballistic hyperextension 2. Uncontrolled knee flexion during weight acceptance 3. Excessive varus or valgus
The forces translated to the body by orthoses are designed to what? What further alleviate forces adding comfort?
1. Be distributed over as much SA as possible 2. Relief areas (padding or flexible loading absorbing material)
HKAFO prescription depends mostly on what?3
1. Biomechanical deficits 2. Neuromuscular impairments 3. Individual acceptance & compliance
No orthotic will perfectly mimic what? Anatomical jts have what type of axis? Orthotics? Why is this a problem w/ orthotics?
1. Biomechanical motion of the anatomical jt 2. Triplanar/ polycentric axis 3. Single axis 4. There will be a torque or moment translated to the jt as some point in ROM
How do you measure normal foot & ankle alignment according to root?
1. Bisect lower leg parallel w/ bisected calcaneus 2. Plane of metatarsal heads perpendicular to bisected calcaneus 3. Distal 1/3 of lower leg perpendicular to the floor
Must have good what to use Craig-Scott KAFO? What type of locomotion?
1. Body awareness and proprioception 2. Swing thru pattern
What causes developmental dysplasia of the hip (DDH)?
1. Breech births 2. Hypermobility 3. Malpositioning in utero (extreme flex, ADD, or ER)
Primary curve in scoliosis is called what? 2* curve name? Scoliosis named how?
1. C curve 2. S curve 3. Convexity of the curve and region of spine
What does RGO use for gait? For what? As one hip flexes in swing what happens to the other hip? What does this eliminate? Used mainly for what dx?
1. Cable system 2. To provide hip jt motion to advance LE 3. It extends thru stance phase 4. Simultaneous hip flexion (jackknifing) 5. Kids w/ SB
What is interesting about Brunnstrom stages of recovery?
1. Can plateau at any stage 2. Can start at any stage
What b/co a priority on the orthotic to limit torque moments on jt? What else will it increase? Can orthotics reduce forces on a fused jt?
1. Careful placement of straps, bands, or pads 2. Comfort 3. Yes
What should be monitored if wearing HKAFOs?2
1. Circulation 2. Sensation
Where are the med & lat jts placed in single axis KAFO? Who is this meant for? What if quad is weak? Issue w/ that?
1. Close to the anatomical knee jt 2. Those w/ enough muscle function for knee stability early in stance 3. May move into hypertext later in stance 4. Structural (MCL/LCL/ACL) instability and pain
What is a Muenster-Type prosthesis? What is needed? What is not needed?
1. Comes over epicondyle for suspension 2. Cable to operate TD 3. No additional suspension needed
AFO must be what for compliance? Most common design? AFO should provide support/stability when? Clearance? Should not compromise what?
1. Comfortable & Cosmetic 2. Thermoplastic 3. Stance 4. Swing 5. Rocker system
What MS impairments use orthotics?
1. Congenital and developmental disorders 2. Overuse injuries 3. Systemic disease 4. Neoplasms
Goals of FFO? 3
1. Control Excessive STJ and Mid tarsal Jt motion 2. Decelerating pronation 3. Allow STJ to function close to its neutral position in MSt
What is the primary objective of a HKAFO? Most designs allow for what?
1. Control hip 2. Single mechanical axis allowing flex/ext when unlocked
Which AFOs are not ideal for those with hypertonicity or neuromotor equinovarus?
1. Conventional AFO DF assist 2. PLS
What is a KAFO that also has the ability to stabilize the hip? Designed for who? It provides what? Why is this a good choice for SCI?
1. Craig-Scott KAFO 2. Paraplegia w/o hip control 3. Minimal bracing w/ max stability 4. Light weight
What will be used over HKAFO? What must be present?
1. Craig-Scott KAFO 2. Some hip ext and abs (maybe)
Who are Anterior floor rxn AFOs good for?3
1. Crouched gait 2. HS spasticity 3. Weak quads
More likely need intervention for idiopathic scoliosis?3
1. Curve begins b/4 1st period 2. Double curve pattern 3. Curve that progressed >5* w/n 6 months
Purpose of Thermoplastic KAFO? What does distal shell encompass? Proximal shell?
1. Custom made for intimate fit 2. Foot, ankle, and lower leg 3. Thigh, greater trochanter, and femoral condyles
What are movements of open chain pronation?
1. DF (sagittal) 2. Eversion (Frontal) 3. ABD (Transverse)
What are types of harness and controls? 3 Which is most common?
1. Figure-Eight harness (most common) 2. Chest strap w/ shoulder saddle harness 3. Figure-nine harness
What is difficult for a shoulder disarticulation? What is preserved?
1. Fitting prosthesis 2. Scapula and clavicle
What is Brunnstrom stage 1? Characteristic? Orthotic options for ankle? Knee? Goal?
1. Flaccidity (immediately after onset) 2. No voluntary movement on affected side 3. MAFO, non-articulating, DF assist 4. Locked single axis or offset KAFO 5. Max stability
What is Legg Calve Perthes (LCP)? Goal of orthotic?
1. Flattening of femoral head and avascular necrosis 2. Contain femoral head w/n acetabulum during active stages of disease to ensure remodeling
RKO can accommodate for what? Easy to what?
1. Fluctuating edema & atrophy 2. Don/doff
Spiral and hemi-spiral AFOs can have moderate control over what? What does that depend on? 2
1. Foot and ankle 2. Trimline height & thickness of thermoplastic
How are ankle stops named in conventional AFO? Which stop is most common?
1. For the motion they restrict (DF or PF stop) 2. 0* PF stop for swing
How is IC affected w/ neuromuscular impaired gait? LR? MSt?
1. Forefoot and lateral boarder IC 2. Poor loading of limb 3. Prohibits progression of tibia w/ trunk flexion and forceful knee extension
What are types of Single axis KAFO?
1. Free Knee 2. Drop lock (locked in knee ext)
What is required to use a Myoelectric prosthesis? Placement?
1. Free of skin grafts and scars 2. Over a motor point
What plane is eversion/inversion? Axis? This motion primarily occurs where?
1. Frontal plane 2. Long axis of the foot 3. Subtalar jt (STJ)
What is required to use a drop lock in an single axis KAFO? Purpose of drop locks?
1. Full knee extension 2. Prolong standing
Goal in PT for HGO orthotic? What locks the leg/orthotic?
1. Fully weight shift on one side to enable contra limb to advance 2. WB causing rigidity
What is a FKO? Purpose? What will it do?
1. Functional knee orthosis 2. Return to sport brace 3. Stop and correct motion
What is Brunnstrom stage 5? What should be done? What b/co more clear? What b/co more defined?
1. Further decrease in spasticity 2. Re-eval of foot/ankle, gait, posture, and functional deficits 3. Functional prognosis 4. Gait deficits/compensations
What happens to GRF as body progresses forward in a Offset Knee jt? What may be added for long term standing? Appropriate for who?
1. GRF quickly move ahead of orthotic jt creating mechanical ext force 2. Drop locks 3. Pt w/ limited knee control due to Lower motor neuron lesion (polio, SB, Lower TS cord injury)
What determines progression of idiopathic scoliosis?4
1. Gender (female) 2. Age 3. Menarcal (first period) 4. Presence of mature growth centers (open growth plates)
Factors leading to idiopathic scoliosis?5
1. Genetic 2. Growth velocity 3. Ligamentous imbalances 4. Muscles imbalances 5. Vestibular/CNS dysfunction (No one reason-Multifactorial)
Who are Conventional AFO DF assist appropriate for? Pathologies?2
1. Gross DF strength deficits 2. Peroneal nerve palsy, CMT disease
What orthotics provide structural support to lower trunk and lower limbs during stance?
1. HGO 2. Reciprocal Gait Orthosis (RGO)
What is a Hip Guidance Orthosis (HGO)? Designed for who?
1. HKAFO that includes lumbosacral support 2. Paraplegia who are unable to advance LE
Never use prosthesis to what? Clean socket with? Never do what to the hook?
1. Hammer or pry 2. Soap and water daily 3. Never oil the hook
What must be taught when using Craig-Scott KAFO? What will that also do?
1. Hang in "Y" ligaments 2. Cause hyperlordosis at L/S
What is a Philadelphia collar purpose? Purpose of ant shell? Post shell?
1. Hard plastic for more support 2. Support chin 3. Support occiput
What does Anterior floor reaction AFO do? How? For who? 3
1. Harness GRF and converts into sagittal plane stability for knee in stance 2. Set in slight PF to create ext moment at knee 3. Weak quads, buckling, crouch gait
What is used in surgery for scoliosis? Purpose?
1. Harrington rods 2. Derotate spine
What are conventional AFOs?
1. Has bar (metal stirrups or Uprights) on the o/s of shoe 2. Can be static or dynamic
What is the purpose of Offset Knee jt KAFO? Key feature? What happens to GRF in early stance? What happens in late stance?
1. Help w/ knee bucking 2. Posterior alignment of knee axis 3. GRF closer to knee axis limiting knee flexion moment reducing work of quad 4. Returns to normal GRF
Advantages of Myoelectric prosthesis?
1. High cosmesis 2. Freedom from harnessing 3. Superior pinch when compared to VO hook of conventional prosthesis
What are running shoes designed for?
1. High force w/ higher heels for sock absorption 2. Lighter than walking shoes 3. Breathable 4. Flexible forefoot/last
What are common MS deficits in neuropathy?
1. High plantar pressures 2^ mus imbalances 2. Foot deformities 2^ mus imbalances 3. Limited jt mobility
What are b-ball shoes designed for?
1. High tops for med/lat support 2. Added lateral material to prevent inversion sprains 3. More shock absorption
Poor alignment and function at the knee are often a result of poor what?
1. Hip and/or ankle -alignment -strength -ect
What should be done for shock attenuation and somatosensory input at the foot? What may that provide?
1. Hip strengthening -Full length orthotic 2. Pain relief and control
What are types of BE amputation terminal devices? Purpose of each?
1. Hooks (lateral pinch) 2. Hands (3 jaw chuck)
Use of a KAFO will depend on what? When would a KAFO be warranted?
1. How well KAFO meets their needs and goals 2. < 2/5 strength (max stability needed at knee
What does the figure-nine harness do to allow control of terminal device? Used when?
1. Humeral flexion w/ scapular abduction 2. If you don't need suspension
Orthotic Fracture stability enhanced by what? How is lever arm created?
1. Hydrostatic pressure created as rigid wall of orthosis compresses soft tissue and muscle 2. Ext of orthosis above and below fx
When does heel rocker occur? Purpose? 2
1. IC to foot flat 2. Deceleration of foot to floor -Weight acceptance
What will AFO do to shoe size? Heel height & AFO? More stable solid AFO requires what? PLS will lose effectiveness in what shoes?
1. Increase 1/2 to 1 2. Dramatically alter biomech. func of orthotic 3. Softer heel 4. Loafers & slippers
What is the pros to a FKO? Cons?
1. Increase afferent feedback 2. Increase energy expenditure & impair blood flow
What is the purpose of the Supramalleolar orthotic (SMO)? How? Like a what?
1. Increase control of subtalar valgus/varus 2. Lengthening the proximal lever arm upward 3. High top sneaker
How might the shoe be modified for 1st rocker in a solid AFO? What will aid in 2nd and 3rd rocker? Purpose?
1. Increased cushion at heel to compensate for fist heel rocker 2. Rocker bottom 3. Facilitate smooth forward translation through stance
What is Brunnstrom stage 3? Characteristics?
1. Increased spasticity 2. Some movement patterns out of synergy are mastered (synergy still predominate)
What are some PT examination techniques for neuropathy?
1. Increased vibratory perception thresholds 2. Loss of protective sensation (Semmes Weinstein Monofilament testing)
Drawbacks of Conventional AFO DF assist? 3
1. Increased weight 2. Decreased Surface contact area (proprioception) 3. Min to no med/lat stability
What are amputation levels of the digits?
1. Index and long finger 2. Ring and small fingers 3. Multiple digit amputations
What is the purpose of the hanging on Y ligaments w/ the design of the Craig Scott KAFO? Purpose?
1. Induce GRF that fall Ant to knee and post to hip 2. No muscular control required to ambulate with AD
Contraindication of a conventional KAFO?
1. Issue w/ energy expenditure make weight of KAFO a factor 2. When frontal plane control is important
According to recent evident how effective are FFOs? What did not affect the results? What may not be relevant for assessment?
1. It only provided 2* of motion 2. Firmness of material, contact w/ MLA, STJ positional at RF/FF 3. Calcaneus
How is clearance in swing done w/ an AFO? Who would this be a problem in?
1. Keeping foot in neutral 2. Decreased DF strength, poor timing, abnormal ext synergy (PF)
What is the Variable Position Knee joint (dial lock) KAFO designed for? What happens to GRF at knee in crouched gait?
1. Knee flexion contractures who can't obtain full knee ext 2. Stays behind the knee
Variable Position Knee joint (dial lock) KAFO looks like what? One serration/click is how may degrees?
1. Knee immobilizer 2. 6*
To prescribe a knee orthotic what must be understood?
1. Knee mechanics 2. Goal of pt w/ return to sport/work 3. Mechanical properties that the brace affords
What orthosis is commonly prescribed for LBP? Made to do what?
1. LSO 2. Accommodate to deformity or straight for postural re-ed
Philly collar does not prevent what? Why? Which cervical orthoses have a higher lateral trim than philly collar?
1. Lateral flex & rotation 2. Low trimlines 3. Miami and Newport-Aspin
What is added for Brunnstrom stage 3 orthotic?
1. Length and firmness to footplate 2. Tone inhibiting bumps 3. Increased height of trimlines 4. Add thickness of varying degrees to plastic
Why a Semi rigid foot orthoses?
1. Less control and correction than rigid 2. More motion control than soft orthoses 3. May be more comfortable for the wearer
What makes HGO better than HKAFO? SCI level?
1. Less energy b/c pt does not have to lift limb off ground to advance 2. C8 or lower
Advantages of thermoplastic KAFO? (Why pt. like them)
1. Lighter weight 2. Interchangeable w/ shoe (pt like) 3. More cosmetic
What is the purpose of internal cams on Stance and swing phase influencing jts KAFO? What phase of gait? What happens to cam in TS-PSw?
1. Locks knee from upward pressure on push rod 2. IC-MSt 3. CAM is unloaded and lock disengages allowing knee flexion for limb clearance
Purpose of the Variable Position Knee joint (dial lock) KAFO? What else does it provide?
1. Locks knee in most extended position providing external mechanical stability 2. Progressive low load prolonged stretch decreases severity of contracture
What are BE amputation levels?
1. Long 2. Medium 3. Short (60% gone) 4. Very short (35% RL)
Longer or thicker a foot plate in static AFO what? Good for who?
1. Longer the knee is in extension 2. Weak quads
What is done in solid AFO to control abnormal toe grasp experienced in a CP and Spastic CVA?
1. Longer toe/footplate 2. Tone inhibiting bar to decreases grasp reflex
What are soft tissue characteristics of high risk foot?
1. Loss of fat pad 2. Edema 3. Changes in color, temp, texture of skin 4. Open wounds
What level of SCI can use HKAFOs? What type of HKAFO? Aided by what?
1. Lower TS and LS 2. Single axis 3. Exaggerated lordosis hanging on Y ligaments
Ankle orthotic for Brunnstrom stage 2? Knee?
1. MAFO, may hinge ankle, DF assist 2. Single axis (lock/unlocked), or offset KAFO
Force has 3 characteristics? What can all these be manipulated by?
1. Magnitude 2. Direction 3. Point of application (manipulated by orthotic)
Purpose of orthotic after post surgical fracture?
1. Maintain a body part in an optimal alignment 2. Limit jt motion 3. Unload WB forces
Static AFOs primary function? Where?3
1. Maintain ankle and foot in fixed position 2. TCJ, STJ, and forefoot
How does AFO allow adequate step length? What does that allow? What else?
1. Maintains stability of the talocrural jt in terminal stance and preswing 2. Contralateral limb to maintain proper step length 3. Effective propulsion of the limb in swing
What does LSO limit? Exerts what? Why? What type of pressure system?
1. Majority of gross motion of the spine(flex/ext) 2. Circumferential pressure 3. To increase intracavitary pressure 4. 3 point
Foot orthotics choice should focus on what? 4
1. Material 2. Balance and Control motion 3. Pt comfort 4. Cost
Indications for thermoplastic KAFO?
1. Max control is needed (increase SA reduces force) 2. Light weight for deconditioned pt 3. Control of transvers/frontal plane is needed
What is the purpose of rigid orthoses? Pros? Cons?
1. Maximal correction and control of deformity 2. Durable, light weight, little space taken up in shoe 3. Poor shock absorber
What does PKO protect? Do they prevent injuries? Why?
1. Med meniscus, MCL, ACL & PCL 2. No conclusive evidence 3. Too many variable to control
What should be done for a rear foot varus? Goal for rearfoot deformities? Goal for forefoot varus?
1. Medial wedge 2. 50% correction of deformity 3. 100% correction of deformity
How does static AFO control inversion/eversion? 2
1. Medial-lateral force coupling 2. Ankle/ foot trimlines
Conventional design of HKAFO?
1. Metal uprights and leather belts 2. Thermoplastic custom fit designs
When does spiral and hemi-spiral AFOs coil like a spring? Why?
1. Mid stance to terminal stance 2. To aid in push off as the ankle DFs
When does ankle rocker occur? How?
1. Midstance as tibia advances over fixed foot 2. Ticeps surae eccentrically controls speed of tibia
Most common TLSO for scoliosis?3
1. Milwaukee 2. Boston 3. Miami
Main goal of PLS? For what types of pt?
1. Mobility
What relationship still remains in the KAFO? Improved function usually does not mean what?
1. Mobility vs Stability 2. Normal (it is what is best for the pt)
Most AFO are what? How is it made?
1. Molded AFO (MAFO) 2. Heat formed over a positive model using person's own leg
Why a hand over a hook? What is hand better at?
1. More cosmetic 2. Grasping large/round objects
The thermoplastic AFO encompasses what? Trimlines?
1. Most of the lower leg and foot 2. Ant to malleoli
If KAFO immobilizes the knee what allows motion to improve function? How? What is not in pt's best interest? If it is what will orthotist do? Pt population?
1. Motion at ankle 2. Allows progression of tibia over fixed foot 3. Have both ankle and knee locked 4. Add external shoe mod to facilitate ankle rocker 5. Usually W/C bound w/ brief moments of standing
Orthotic for Brunnstrom stage 5 depend on what? What may be used? What can be considered now?
1. Motor control 2. PLS, spiral/hemispiral, DF assist/PF stop, Stance & swing phase KAFO 3. Dynamic orthotics
How do you reduce the magnitude of the central force? What does that also do? Problem with this?
1. Move prox is dist forces further away 2. Provides greater leverage and a more comfortable fit 3. The longer the prosthetic the less cosmetic and difficulty to don/doff
Indication of a conventional KAFO?
1. Need max strength and durability 2. Obese 3. Fluctuating edema
What type of FKO for lateral patellar tracking (PTFJ dysfunction)? Not good for when? Good PT treatment for this?
1. Neoprene sleeve w/ J strap 2. Dynamic situation 3. Strengthen glutes and limit valgus stress
What is the most common reason for breakdown in a foot? Activity? Why does it breakdown?
1. Neuropathic foot 2. Walking 3. They don't feel it
What is "upper" part of shoe? What are the 2 types? What is Blucher? Oxford? Which is best for orthoses?
1. the curvature of the tip of the shoe 2. Blucher or Oxford 3. Has a more rounded end 4. Is more pointed 5. Blucher
What is an orthotic?
1st class lever b/t two ends of a segment where the forces occur
Conventional vs Molded thermoplastic KAFO pic. Purpose of these KAFOs?
2. Control knee flexion
Forequarter prosthesis. No much movement where?
2. Elbow & shoulder
What does chest strap w/ shoulder saddle allow/control? May be problematic for who?
2. Females
Which rockers are limited in Anterior floor rxn AFO?
2nd(LR-MSt) & 3rd (TSt-PSw)
How impaired is the hand if the thumb is amputated?
40% impaired
Rotation of vertebrae in scoliosis goes to what side? Rib hump?
Convex side
How does PLS affect 2nd rocker?
Allows enough DF needed for tibia advancement overt the foot in midstance
What is an AE amputation?
Amputation above the elbow
What determines degree of knee control in Anterior floor reaction AFO?3
Amt of 1. PF 2. Rigidity of AFO 3. Length of toe plate
What are you treating in a pt with a KAFO?
Ankle or knee never both
What is the purpose of orthotics in neuromuscular impairments
As an adjunct to other interventions to minizie effects of spasticity
What is the goal of an AFO?
Assist in safe energy efficient gait
What age is child fitted w/ prosthesis?
At 6-8 months
Disadvantage of thermoplastic KAFO?
Can be hot to wear leading to skin breakdown
Stance and swing phase influencing jts KAFO is similar to what types of knee prosthetic?
Combo of weight activated and microprocessor
Sole purpose of Aesthetic prosthesis?
Comestic...no moveable jt
What problem is unique to training the UE amputee?
Concept of handedness if lose dominant hand
What is the primary goal of the functional foot orthoses (FFO)?
Control abnormal foot functioning during stance
How does PLS affect 1st rocker?
Controlled lowering of foot toward the ground
What is a good AFO for fluctuating edema?
Conventional AFO DF assist
What should not be the first option for fontal plan stability of knee?
Conventional KAFO
How does PLS affect 3rd rocker?
Hold ankle at 90* assisting w/ clearance and positioning for next heel strike
What stop in Conventional AFO would be useful for controlling knee bucking/flexion in MSt?
DF stop to limit DF which limits knee flexion
Conventional KAFO not good for who?
Deconditions or CV compromised pt
What should be considered in digit amputations?
If the stubs/residual are in the way
What will make a HKAFO appropriate for a pt more than a Craig Scoot KAFO?
Difficulty controlling exaggerated ant pelvic tilt/hyperlordosis
Why is there a poor compliance with HKAFOs?
Difficulty don/doff and very cumbersome
What makes a high risk foot challenging foot to manage?
Impairments in multiple systems
What is important in controlling the prosthesis in a BE amputation?
Elbow power
What is required in a AE prosthesis?
Elbow unit
How does anterior floor rxn AFO work biomechanically?
Enables pt with little quad function to be stable in stance
What decrease as a result of the Stance and swing phase influencing jts KAFO?
Energy expenditure & low back stressors
KAFOs are indicated when what?
Excessive motion occurs at knee in stance phase that can't be controlled by AFO
What is a more dynamic brace than RKO?
FKO
What is a Myoelectric or Externally powered prosthesis? For who?
For AE or BE
What is the purpose of external shoe modifications?
For fixed foot deformities that are too large or complex for in shoe corrections
AFO won't control what?
Frontal plane knee deviations
If you want max control of a jt you have to what?
Go one level above jt
Why is there fatigue using an UE prosthesis?
Heavy and require concentration
When does spiral and hemi-spiral AFOs uncoil?
IC-LR/Stance when limb accepts weight
If orthoses set in PF it will do what?
Induce hyperextension
Who are solid AFO indicated for? 4
Issues with: 1. Inversion/ eversion 2. Foot drop (DF weakness) 3. Extensor tone/synergies/ PF spasticity 4. Knee hyperextension or hyperflexion
The mechanical jt in a HKAFO is attached where?
Level b/t the greater trochanter and iliac crests
What is agenesis?
Limb does not from or underdeveloped in utero or
How does AFO maintain swing phase repositioning?
Maintains ankle in neutral DF and eversion/inversion to prep for weight acceptance
What connects distal and proximal shell in thermoplastic KAFO?
Metal knee jts and side bars
What is a phocomelia congenital amputations?
Middle of jt is missing fusing prox and distal (flipper appendage)
What is a Polydactyly congenital amputation?
Most common congenital amputation
Subtalar neutral should first be observed how?
NWB then WB
What KAFO will work for a knee requiring extension moment and free jt motion?
Offset unlocked knee
When is pt fitted for myoelectric prosthesis?
Once girth stabilizes and it is determined that it is right for them
What are functional foot orthosis (FFO)?
Orthopedic device designed to promote structural integrity by resisting GRF that cause abnormal skeletal motion in stance
What is done in the Anterior floor rxn AFO to absorb the ext moment?
Padded anterior shell at proximal anterior tibia
In relaxed standing most pt are in what position at the ankle and do what to reach STN?
Pronated and need to supinate to reach STN
Best outcomes for idiopathic scoliosis?
Pt Wear full brace and TE
Rigid foot orthoses are for who?
Pt who need more control or have foot or gait abnormalities
What is Radio-humeral synostosis?
Radius and humerus fuse together...no ulna
Purpose of shoe wedges?
Put foot in neutral
What must person have to use Bail lock KAFO?
Quad and glute strength or control descent or use UE to assist
Are radial or ulnar deficiencies more common?
Radial more common
What is a single channel Conventional AFO also called?
Single Klenzak
What is Thumb hypoplasia?
Small or underdeveloped thumb
Always start w/ what UE prosthetic?
Standard
If lateral curvature of the spine is reduced in scoliosis what happens?
Spinal rotation is reduced
What must you determine in the use of the orthotic?
Stability or mobility
Which knee should be the first option in gait training?
Stance and swing phase influencing jts KAFO
What is important about the locking and unlocking of the Stance and swing phase influencing jts KAFO?
That it happens at the appropriate time
Spiral and hemi-spiral AFO Pic
The hemi spiral AFO will not go around the whole leg
Thickness of the thermoplastic and ankle ROM of an AFO will affect what jt?
The knee
What is the main goal of an orthotic?
Transfer GRF generated by pt to a balanced parallel force system to control motion
What if primary curve is corrected in scoliosis?
Usually 2* curve resolves
What KAFO will work for reducing a knee flexion contracture?
Variable position locked
How is DDH confirmed?
x-rays