Biomechanics -- Final Material shoes-orthotic and prosthetics

kdw750's version from 2015-07-17 20:46

Orthotics and Prostetics

Question Answer
two classes of AFOsstatic Dynamic
3 main pruposes of AFOscontrol arc motion of tibia over foot, control STJ motion, control the calf
single vs double AFO indication kids adults
indications for DFory AFOweak anterior group
what do dorsiflexory assist AFO help withswing phase toe clearance,cont rolled loading and for dorsiflexor weakness
indications for plantarflexory stop AFOposterior deep or superficial spasticity, spastic equinus, knee hyperextension path,
moment of plantorflexory stop AFO createknee flexion moment
indications for dorsiflexory stop AFOweak quads or weak PFors, weak ankle PFors
how is function determined in posterior splint AFOtrimlines and ankle position

orthotics and Prostetics cont.

Question Answer
pros for total contact AFOthermoplastic molded, fits into shoe better, lightweight, control in all 3 planes, anterior trim line is at center of malleoli
cons for total contact AFOdoenst accomodate for edema, warmer
floor rxn AFOsim to solid ankle AFO but footplate extends futher, ankle is held in PF, provides sagittal plane knee stability
posterior leaf srping AFOsim to solid ankle AFO but the post ankle are is trimmed back for more flexibility
off-loading AFOreduce axial load (off loads ulcers)
supramalleolarfor clearance in swing phase, from UCBL
which AFO is primarily for cerebral palsy and spastic problemstension reducing
what is the indication for spring leaf AFOsdropfoot or slapfoot
what is the use of SMOsaddresses sagital plane problems. may be used as a transitional orthosis
when would shoe fillers be useddistal to listfrancs amputation ONLY
describe the SACHheel strick compression to mimic plantarflexion
describe the energy storing footreduces energy consumption by storing it

Internal Shoe modifications

Question Answer
purpose of shoe modsimprove shoe fit
name the 6 internal shoe modsheel grip, tongue pad, heel pad, val/var wedge, met raise, FF extension,
why should a heel grip be avoided forces foot into the toebox
function of tongue padbest way to prevent heel slipping and relieves irritation on the dorsum
3 ways to use the met raisedirectly to foot, orthotic modification, shoe modification
how does the met raise workextend from the 1st-4th interspace just proximal to met head 2-4. spreads the met heads.
the neuroma pad is what type of internal shoe modificationmetatarsal raise
3 indications of met raisesneuroma, HPK or pain on sub 2-4 met heads, shallow foot
what is the purpose of a FF extension take up space in the toebox
How do pedorthists inappropriate use wedgesslow down the wearing of the heel. helps shoe fit better (not good for ft)
purp of heel padprevent malleolar irritation from the topline, may be used when heel counter is too rigid and/or concave and/or hitting the wrong spot of foot.
Heel pad vs heel liftheel lift treats pathology. heel pad improves shoe fit

External Shoe mods

Question Answer
7 external shoe modsflares, stabilizers, rockers, bars, excavations, sole expansions, closures
fxn for external shoe modssingle modality, in conjunction with other modalites like foot orthoses, severe pathology or deformity
general fxn for flaresincrease base of support
purp of lat heel flaresforces early pron, prevents lateral roll, lateral ankle instability, residual clubfoot deformity. BUT it may cause pronatory symptoms
purp of med heel flaredecelerates pron and prevents medial roll over, common for pts who pronate through their shoes, PTTD
purp for stabilizersincrease the base of support, reinforce the upper so that the foot doesn't roll out of sole. extends from sole about 1/2 the upper. aka flanges
med stabilizer 2 indicationspronatory problems (PTTD and severe flexible flatfoot)
lat heel stabilizer 2 purposeslateral instability: severe RF varus from a residual clubfoot pt who have excessive lateral shoe wear
5 rocker typesheel, FF, toe, double, heel to toe
pt who needs heel rockermore controlled loading at heel contact, for pts with decreased ankle joint motion, required for very rigid shoes ( prevent Frankenstein gait), helps with shin splints
FF rocker indicationsdecreases or eliminates need for MTP motion, hallux limitus....
which mod decreases ankle joint DF in terminal stanceforefoot rocker
purp for toe rockerprovides toe off, important for rigid soled shoes
2 purp of double rockerhelps offloads midfoot: midfoot arthritis, plantar prominence in midfoot
2 indications for double rockerhelps offload the midfoot:midfoot arthritis,plantar prominence in midfoot
heel to toe rocker for gaithelps control loading,
indications for heel to toe rockerafter pantalar arthrodies, ankle fusion, anklyosis of the ankle
purp of met barsoff load met heads, similar to FF rocker
excavation purposesoffload a bony prominence
3 purp for sole expansionwidens the sole, bunions, or midfoot colapse in charcot neuropathy
closure typesVelcro, elastic, side/back
indication for elastic closureedema, unable to reach ft due to obesity or back problems, unable to manipulate hands
elastic lacesallows for changing edema or cant reach ft
side or back closurecant reach ft
custom molded shoes indicated forsig deformity: charco foot, stage 3 PTTD, congenital deformity, RA with deformity, post partial amputation
cast ht and type for custom molded shoesbi-valve, univale or STS cast, must go above ankle



Question Answer
four components of shoe fitwidth, girth, heel to ball, heel to toe
What does the width of the shoefit measure1st-5th met heads
What does the girth of the shoefit measuredorsal to plantar thickness
what does the proper heel to ball length shoe allow for1.allows the arch of the shoe to be in the correct position on the foot
2.proper bending of the foot at the 1st MTP
what is the most important size in shoesheel to ball length
what is the arch lengththe heel to ball length
what happens if the heel to ball length is too shortDF 1st ray
what are the 7 different shoe typesmoccasin, mule, clog, oxfords, pumps, sandals, boots MM COPS B
what shoe types is used for posterior heel irritationmule and clog
what type of shoe develops rim callusmule, sandal, clog
what shoes are bad for hammer digit? why?clogs, because toe grips to keep shoe on
what is a good shoe for nail problemssandals
what are the indications for the oxford bulcher opening1. orthoses 2 higher insteps 3. thicker feet
what are the 4 indications for boots?increased ankle stability, warmth/protection, hide AFO, accommodate orthoses
what are the indications for moccasinprovides protection but doesn't need support like a child learning to walk or a wheelchair bound person.
what are the contraindications for moccasinsomeone who needs support
what are the indications for muleany kind of posterior heel irritation like handlund's deformity, Achilles enthesopathy.
what is a common problem with the mule shoe typeheel callus/rim callus
what are the indications for a pump shoedorsal exostosis or norieties
which type of pt should not wear a sandal everneuropathic pt
name the two types of oxford openingblucher and balmoral
which oxford opening is V shapedbalmoral
which shoe type is any slip-on open-toed shoe? pump
which shoe type is the standard shoeoxford
what are the inidcations for a general oxford shoe typegood support, adequate toe space, best for orthoses
what is a contraindication for the oxford shoe typemay cause difficult with haglund's deformity and dorsal exostoses in the midfoot

shoe anatomy

Question Answer
upper (6 parts)part of shoe not plantar to the foot (toebox/toecap, vamp, lininings, quarters, counter, tounge)
sole (4 parts)part of the shoe plantar to the foot (outer, mid and insoles, shank)
Heel vs heel baseheel: aka toplift- part of the shoe that wears down and can be replaced.
heelbase: actual heel of the shoe
quarterback half of the shoes upper (medially and laterally)
Counter"between quarter and sole) reinforcement at the back of the heel. provides RF control and maintains the shape of the shoe. Can be important in a running shoe
Vampfront part of the shoe
Throatlineseam that connects the vamp and quarter
shankportion of the sole that connects the heel to ball of the shoe. may be reinforced, prevents the shoe from collapsing
toplinetop rim of shoe's quarters. Can irritate the malleoli mostly laterally and in children dress shoes
toeboxportion of shoe that covers the toes. an extra depth toe box needed for accommodative orthoses or significant sagittal plane deformities
outsoleportion of shoe that contacts the ground
midsolebetween in and out sole. important in athletic shoes because the midsole is where most shock absorption happens
insoleportion of shoe that comes in contact with the foot. its leather, fabric or synthetic. can contribute to hyperhydrosis(seating) and/or bromhydorises(odor)
last-3 definitionsmodel on which the shoe is constructed. method of attaching the upper to the sole. shape of the sole of the shoe