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Orthotics & Prosthetics Exam 1
LE orthotics, AFOs, KAFOs, HKAFOs, back bracing, foot orthotics, hand splinting
94
Health Care
Graduate
10/23/2012

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Term
Heel rocker = initial contact >> ...
Definition
loading response/foot flat
Term
Conventional orthoses constructed of
Definition
metal
Term
1º reason RGOs & HKAFOs not frequently used:
Definition
cumbersome
Term
Which pt population more often utilizes RGO/HKAFO?
Definition
pediatric
Term
1st rocker =
Definition
heel rocker
Term
2nd rocker =
Definition
ankle rocker
Term
3rd rocker =
Definition
forefoot rocker
Term
Ankle rocker occurs during which phase of gait
Definition
M St
Term
Calcaneal ROM needed for normal fxn
Definition
30º (20º inv, 10º ev)
Term
Reactive chain: calcaneal ev >> (ankle motion)
Definition
foot pronation (DF, abd, ev)
Term
Reactive chain: calcaneal ev >> (knee motion)
Definition
flex, valgum, IR
Term
Reactive chain: calcaneal ev >> (hip motion)
Definition
flex, add, IR
Term
Reactive chain: calcaneal inv >> (ankle motion)
Definition
supination (PF, add, inv)
Term
Reactive chain: calcaneal inv >> (knee motion)
Definition
ext, varum, ER (screw-home)
Term
Reactive chain: calcaneal inv >> (hip motion)
Definition
ext, abd, ER
Term
Foot orthotic categories (4)
Definition
rigid,
semi-rigid,
flexible,
diabetic
Term
SMO
Definition
supramalleolar orthosis
Term
UCBL
Definition
UC-Berkeley lab orthosis
Term
Tone-reducing footplate: components (5)
Definition
support lat, long, met arches;
groove for FHL;
relieve met heads & center of heel;
hyperext toes 2-5;
depress 1st ray
Term
Purpose of any LE orthotic device:
Definition
"support extremity while promoting efficient, safe, predictable gait that is as close to non-pathologic as is possible"
Term
Stance phases of gait (6)
Definition
IC,
LR,
MSt,
TSt,
PSw,
ISw
Term
Purpose of loading response
Definition
preserve forward progression/shock absorption (heel rocker)
Term
Purpose of MSt
Definition
preserve forward progression (ankle rocker)
Term
Purpose of TSt
Definition
foot becoming rigid lever for propulsion (forefoot rocker)
Term
Purpose of PSw
Definition
initiate knee flex for swing
Term
When to use pre-fab AFO (3)
Definition
diagnostic tool,
end of rehab,
need is not that great
Term
Problems of pre-fab AFO (4)
Definition
degrade quickly,
fit less than optimal,
greater cost over time,
minimal control over hindfoot for M/L stab
Term
When to consider metal AFO over plastic (6)
Definition
compliance concerns,
ht/wt > 6'/230lb,
correctable varus/valgus,
adjustability,
diabetic,
edema
Term
Pt who benefits from dorsi assist
Definition
no active DF, but strong quads (to prevent knee buckling)
Term
Types of knee bracing (5)
Definition
rehabilitative,
fxnl,
patellofemoral,
OA,
prophylactic
Term
OA knee often has additional deformity in another plane...what is it?
Definition
valgus/varus
Term
Legg Calve Perthes - etiology
Definition
malformation of acetabulum,
avascular necrosis of femoral head
Term
Pediatric braces for LCPD (3)
Definition
Pavlik harness,
Scottish Rite orthosis,
Legg Calve Perthes splint
Term
Which direction/position is best for hip fx healing?
Definition
abd
Term
Features of orthopedic shoes (2)
Definition
extra depth,
solid sole
Term
Features of diabetic shoes (3)
Definition
natural materials (breathable),
"seamless" inside,
diabetic insert
Term
Fitting strategy for AFO, KAFO, HKAFO, RGO (5)
Definition
ID problem,
determine goals,
select rx plan,
eval for success,
reload
Term
Basic concepts for orthotics (3)
Definition
3-point pressure,
counteract GRF,
any other input that impedes efficient gait
Term
Primary goal of AFOs (3)
Definition
Maintain neutral ankle,
prevent malalignments/contractures,
provide stable BOS
Term
Primary goal of KAFOs (in addition to AFO goals) (2)
Definition
exert control over knee,
prevent knee ligt laxity
Term
Types of AFOs (3)
Definition
conventional,
plastic,
hybrid
Term
Conventional AFOs - pros (3)
Definition
strong,
adjustable,
few skin issues
Term
Conventional AFOs - cons (3)
Definition
weighty,
lack of 3D control,
attached to shoe
Term
Plastic AFOs - pros (4)
Definition
total contact/3D control,
lightweight,
interchangeable shoes,
limitless features
Term
Plastic AFOs - cons (4)
Definition
skin irritation,
edema probs,
torques,
plastic fatigue
Term
Hybrid AFOs - pros (3)
Definition
strength::weight ratio,
no torque,
3D control
Term
Hybrid AFOs - cons (2)
Definition
not adjustable,
major failures
Term
Types of knee joints (KAFOs) (3)
Definition
free motion
locking
stance phase control
Term
Orthosis for Myelomeningocele:
@ L1-L3
@ L4-S1
@ S__
Definition
L1-L3: RGO
L4-S1: AFO
S__: SMO
Term
"Mechanical" LBP
Definition
local, radiates toward knees; ST related
Term
Soft back bracing used for:
Definition
pain
Term
Elastic wrap-around back brace used for:
Definition
lumbar strain
Term
Goal of bracing in disc herniation
Definition
hyperextend area and/or incr intra-cavitary pressure
Term
Brace of choice for simple disc bulge/herniation
Definition
corset, soft bracing
Term
Brace of choice for total disc rupture c nerve injury
Definition
LSO, TLSO (restrictive)
Term
Goal of back bracing in compression fx (3)
Definition
hyperext lumbar spine,
distract vertebrae (via incr intra-cavitary pressure)
restrict motion
Term
Common compression fx orthosis
Definition
Jewett hyperext orthosis
Term
Goal of back bracing in post fx
Definition
neutral spine, restrict motion
Term
Goal of back bracing in spondy__
Definition
flex lumbar spine
Term
Braces of choice for spondy___ (3)
Definition
chairback,
corset,
LSO/TLSO
Term
Brace for flexible kyphosis
Definition
(Knight-)Taylor brace
Term
Examples of soft cervical braces (2)
Definition
Miami J,
Philadelphia collar
Term
Examples of cervical immobilizers (2)
Definition
SOMI, halo
Term
Def'n of scoliosis
Definition
3 vert c combined curve of ≥10º
Term
Cobb Angle
Definition
measure of scoliotic curve; measures angle between highest and lowest affected vertebrae in curve
Term
Risser sign
Definition
method of determining skeletal maturity by observance of pelvic XR
Term
Causes of scoliosis (3)
Definition
birth defect,
neuromuscular,
idiopathic
Term
Types of scoliosis (2)
Definition
structural (fixed, vertebral prob)
non-structural (spine deformed by leg length, mm spasm, inflamm)
Term
Risser sign:
1 =
2 =
3 =
4 =
5 =
Definition
1 = 25% ossification
2 = 50% ossification
3 = 75% ossification
4 = 100% ossification
5 = 100% ossification & apophysis has fused to iliac crest
Term
Lumbar scoliotic curve is predominantly L or R, and flexible or inflexible?
Definition
L, flexible
Term
Thoracolumbar scoliotic curve is long or short?
Definition
long
Term
Thoracic scoliotic curve is usually L or R?
Definition
R
Term
Basic concepts behind scoliosis orthoses (4)
Definition
3 pt pressure,
low stress/long duration,
incr intracavitary pressure,
posture training
Term
Examples of scoliosis braces (3)
Definition
Milwaukee,
Boston (below T7),
Charleston bending brace (nighttime)
Term
Theories of foot orthotic development (2)
Definition
SJN - subtalar joint neutral (based on NCSP)
SALRE - subtalar axis location and rotation equilibrium (based on RCSP)
Term
Why pts need foot orthotics (6)
Definition
biomechanical correction,
soft tissue stress,
pressure relief,
leg length,
neuromuscular realignment,
pelvic frontal plane alignment
Term
Feiss line
Definition
apex of med malleolus,
navicular,
volar aspect of MTP 1

(assess in standing, then 30º knee flex)
Term
Neutral/resting hand position
Definition
mid pron/sup,
12-20º wrist ext,
phalanges partially flexed,
thumb partial opposition
Term
Functional hand position
Definition
20-35º wrist ext,
thumb abd & opposition,
45-60º PIP flex
Term
Patient understanding of hand splinting (5)
Definition
purpose,
independence,
safety,
what to expect/look for,
ability to request alterations
Term
Types of hand splints (3)
Definition
static
static progressive
dynamic
Term
Purpose for static hand splints (7)
Definition
position/maintain alignment
correct deformity
protect/support/immobilize for healing
relieve pain
base for attachments for eating/writing
inhibit tone
exercise
Term
Common types of static hand splints (3)
Definition
resting splint (cock-up splint)
dorsal wrist splint
airplane splint
Term
Purpose for dynamic hand splints (3)
Definition
assist motion
incr ROM
position/maintain alignment
Term
Hand splinting for ulnar n lesion
Definition
anti-claw splint
Term
Hand splinting for median n lesion
Definition
spica splint
(nighttime: thumb abd splint)
Term
Hand splinting for radial n lesion
Definition
wrist cock-up splint
Term
Considerations for normal gait (2)
Definition
segments always move in forward direction,
angular velocity of segments is not uniform throughout gait
Term
Shank angle at MSt
Definition
inclined 10-12º
Term
Components of "the big V" at 50% gait cycle (3)
Definition
max hip ext,
knee ext,
inclined shank & thigh
Term
Considerations for successful AFO tuning (4)
Definition
AA AFO
HSD
SVA
footwear characteristics (e.g. stiffness of heel)
Term
Prime determinant of gait c AFO
Definition
SVA
Term
Contraindications for articulated AFO (4)
Definition
midfoot instability,
No DF PROM c knee ext,
excessive DF in MSt & TSt,
excessive tone
Term
Articulated AFO helpful for ... (2)
Definition
stairs
sit-to-stand
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