Peds - 10

6

100

Phase: all phases
Description: external rotation of femur
Possible causes: spasticity or contractures of ER, weakness of IR
Analysis/examine: tone, ER ROM, strength of IR 

Hip external rotation 

200

Gait deviation: crossing feet over midline 

Scissoring 

300

Orthosis: KAFO with a pelvic band that surrounds the lower torso 

Hip-knee-ankle-foot orthosis (HKAFO) 

400

Metatarsal bar and rocker bar can be best used for which diagnosis? 

Diabetic neuropathy 

500

Plastic insert; prefabricated or custom made; streamlined and lightweight; early stance - posterior upright acts as a spring bending backward slightly; swing phase - upright recoils "springing" forward to lift the foot; adjustment limited; can remove to weaken spring but cannot add to increase rigidity ; lowest level of AFO 

Posterior lead spring AFO 

7

100

Gait deviation: both legs affected, can be crouched or LE in extension, tight muscle movement pattern, typically in PF and knee extension

Spastic diplegia 

200

Orthosis: Encompass a shoe and terminate below the knee

Ankle foot orthosis (AFOs) 

300

Orthosis: foot level; foot control only; stops inversion and eversion; heel cup

University of California Berkley (UCB) 

400

Composed of a foundation, an ankle control, a foot control, and a supersculpture; control of the foot; can control the knee; limiting or assisting PF and/or DF; clear toes during swing 
Foundation: shoe
Insert: plastic, carbon fiber, metal

AFO 

500

Prevent toe drag; PF resistance with metal ankle with posterior stop; imposes flexion force at knee during early stance; prevent knee hyperextension; limiting PF

AFO with posterior stop 

8

100

Orthosis: Applied to the foot and placed inside or outside a shoe 

Foot orthoses (FOs)

200

Phase: all phases
Description: internal rotation of femur
Possible cause: spasticity or contractures of IR; weakness of ER; excessive forward rotation of contralateral pelvis
Analysis/examine: tone, IR ROM, strength of ER 

Hip internal rotation 

300

Orthosis: Covers part of the torso and the lower limbs 

Trunk-hip-knee-ankle-foot orthosis (THKAFO)

400

Orthosis: Stops right above malleoli, medial and lateral stability of the ankle, does not control the knee, we use this for lower tone children, not typically covered by insurance, can be the step down of an AFO  

Super malleolar orthotic (SMO) 

500

Limits active muscle activation; very stable

Solid ankle foot orthosis 

9

100

1. Ataxia
2. Hemiplegic
3. Spastic diplegia
4. crouch
5. toe walking
6. scissoring 

General deviations 

200

Gait deviation: ankle in DF, knee flexion, hip flexion; LE can begin to bow 

Crouch

300

Female shoes are what width size? 

B width 

400

U-shaped steel fixture; center portion riveted to bottom of shoe; heavy and bulky; long term users 

Stirrup 

500

Adjustable motion assistance; steel DF spring assist; incorporated into each stirrup near ankle; spring compresses in stance and rebounds during swing; tightness of spring adjusted by turning screw on top of spring; bulkier than posterior leaf spring; yield slightly into PF at heel contact; slight protection against inadvertent knee flexion 

Articulated spring assist AFO 

10

100

Gait deviation: half the body; typically on toe of the affected side and arm is in contracted flexion synergy 

Hemiplegia 

200

Gait deviation: INCONSISTENT, cerebellum issues, drunken gait, wide base of support, core weakness, may compensate with arms

Ataxia 

300

Orthosis: Extends from the shoe to the thigh 

Knee-ankle-foot orthosis (KAFOs) 

400

Males shoes are which width size? 

D width 

500

Hinge limits DF; achieve propulsion during late stance; prevent knee collapse; trimlines are anterior to the malleoli ; not common

Anterior stop AFO