foot and ankle
what happens in OKC supination
calcaneal inversion, adduction and PF
what is the pommel?
the thingy that goes between the thighs- good for when someone has adduction contracture
your patient is experiencing hind and mid foot instability, what orthotic would you recommend?
UCBL
when do the plantar flexors have their highest activation level and what type of contraction
terminal stance, eccentric
what is the Post-op knee brace progression(ACL, MCL, meniscus)
immobilizer, T-scope, hinged
what is forefoot varus
inversion deformity of forefoot on calcaneus
what is the most important thing to think about for WC fitting
trunk and pelvic alignment and stability
Your patient with CVA presents with severely impaired coordination that is the same bilaterally. They have poor targeting, inappropriate amplitude and impaired balance. Which type of CVA do you guess they had?
cerebellar
what and when are each of the rockers?
1- heel, initial contact → loading response
2- ankle, midstance → terminal stance
3- forefoot, terminal stance → pre swing
4- toe off, pre swing → initial swing
what is a sugar tong splint
rigid, covers wrist and elbow; limits supination and pronation. Elbow 90 deg, wrist neutral. Treats carpal, distal radial or ulnar fx
what is the compensation for forefoot valgus
calcaneus inversion, supination
what is the dojo cushion good for?
avoiding skin break down
you have a pt who excessively flexes both their knee and hip while in the swing phase of gait. what kind of gait is this? what could it be caused by?
steppage gait
weakness or paralysis of the dorsiflexors, foot drop
what is the difference between a medial and lateral whip
lateral whip= IR at hip during toe off followed by heel moving away from body
Medial whip = ER at hip followed by heel moving close to body
how are ankle and knee motions related (PF, DF, knee flexion, knee extension)
Increased knee flexion, increased DF
Increased knee extension, increased PF
what is the windlass mechanism
During terminal stance, the plantar fascia shortens, raising the longitudinal arch and increasing the stability of the foot
55-65 deg of 1st MTP extension is needed for proper windlass functioning
what are hangers
attach footrest to chair
After your patient had a stroke they are experiencing a decrease in DF ROM throughout gait due to a lack of strength of the tibialis anterior. what deviations could this cause?
foot slap, abbreviated heel contact, foot drop, drag, contralateral vaulting, foot flat contact
what deviation might you see if a a patient has limited functional shortening of the impaired side
vaulting on contralateral side
what are the different back braces/orthotics
Corset- made of fabric, may include metal stays. Increases intra abdominal pressure to provide lumbar support but allows movement. Used for LBP
Milwaukee orthosis & Boston brace- types of orthotics for scoliosis, milwaukee includes cervical component
Taylor orthosis- shoulder piece to limit trunk flexion/extension
Jewett orthosis- places spine into hyperextension
Cash orthosis- restricts spinal flexion
what indicates poor first ray stability
callus under 2nd met head
what environmental issues should be accounted for?
door width, ramps, terrain, tables, furniture, counter/sink height, toilet, shower, windows
your pt is experiencing a decrease in DF even after strengthening and stretching. this is causing their knee to hyperextend. what orthotic do you recommend?
hinged AFO
what is the difference between an endoskeleton and exoskeletal prothetic
Exoskeletal- hard outer shell provides structural support, cosmetics by coloring and contouring of hard outer shell
Endoskeletal– pylon provides structural support; choose material based on weight and use, cosmetics with foam cover and nylon
what are the gait speeds for different community ambulation?
Step off curb- 1.5 sec
Cross traffic lanes- 4m/lane
4 lane= .88m/s
2 lane = .44 m/s
Step onto sidewalk- 1.5 sec