Biomechanics - Orthotics

reyobusi's version from 2015-06-30 15:46


Question Answer
what is the shellpressed to the positive, hard material that will hold the foot
what does a deeper heel cup providemore control in the orthosis
where do flanges end distally on the footat the metatarsal heads
where does a lateral clip end distallybefore the 5th met styloid process
what degree of deformity would a neutral shell be good formild
what is the main idea of a schaffer platan arch support
do you post a neutral shellno


Question Answer
describe the ABCD pediatric devicesA has long medial flange with front tapered from lateral to medial, b has long medial flange with a square front (toe), type c has long lateral and medial with square toe, type d has a long lateral flange tapered to lateral toe
what is the gereal idea of functional orthoticsprevent compensation by making the STJ function near the neutral position
what is the purpose of an arch fillprovides the arch with height
what is the purpose of the kirby skiverasping off the positive at the medial cal tub to increase supinatory moment at STJ
UCBL purposemax support with minimal STJ motion
UCBL indicationssevere flexible flatfoot, or STJ locked conditions (coalitions, arthritis, etc)
UCBL castingRectus, Neutral, PWB
UCBL consits really big, shoe gear is tough
pronated device purposekeep STJ pronated
Pronated device indicationstarsal coalition, STJ arthritis, STJ Arthodesis
pronated device contraindicaitonswhen you need to resupinate
pronated device conslimited indications, can hurt proximal limbs
Schaffer plate purposearch support
schaffer plate indicationswhen you dont want a normal ROM
schaffer contraindicationswhen you want to maintain normal ROM
schaffer proswhen you stand in one spot all day
schaffer constakes up more room in a shoe than a functional
schaffer castingrectus
nuetral shell purposereduce not eliminate, compensation
neutral shell indicationsgradual posting desired (achilles stretch).. needing little support or control
neutral shell contraindicationsneed maximum support
cast techiqueneutral
accomodative functionpad foot, reduce shearing forces, protect deformity
accomodative indicationswhen the gpoal is to take pressure off another area
accomodative cast techniquePWB
accomodative proswell liked and tolerated
accomdative consshoe gear needed
when to use type a pedsmild pronation, medial flange lateral clip and 1-3 met platform
when to use B pedsmoderate pronation... medial flange lateral clip and full met platform
when to use type c pedssplay foot or full pronation, medial and lateral flange full forefoot
when to use type d pedstreat intoeing, forces abductory twist, full lateral flange, sub 4-5 platform
whitman functioncaused pain at navicular to force supination
robertspronation, medial flnage lateral clip... prevents calcaneal eversion
whitman robertslike type B with medail flange lateral clip, no heel seat so takes up less room,,, used for pronation
reverse robertsintoeing... like type d
general idea of function orthosesto allow the foot to function near STJ neutral


Question Answer
what is the general rule with postsposting usually matches the forefoot deformity, and the NCSP (rearfoot deformity)
what does a flat post dstop rocking
what does a kirby skive dopush towards re-supination by creating a higher medial base of the heel seat
what is an inverted pourthe positive is built up medially
what to do with obesity in functionalsarch fill, thicker shell
modifications to functionals in genu valgumuse flat post at rearfuuo
functional modification for equinusless postin, slightly pronated to allow for pronation to compensate for equinus, heel lift
severe flexible flatfoot functional modificationkirby skive, blake inverted pour
forefoot extensionprevent slipping, take pressure off met heads
forefoot extension with met head cutoutoff-load a specific area
neuroma padspreads out the met heads, relieves neuroma
first ray cutout1st ray PF, causing resupination of STJ
indications for 1st ray cutouthallux limitus, hypermobile 1st ray, long 1st met
1st ray cutout with 2-5 bar postrigid PF 1st ray, elimitates valgus effect PF 1st ray has
kinetic wedgepushes plantarflexion and eversion, effects 1st ray
cluffy wedgewedge under hallux, promotes 1st ray PF by DF hallux
dancers padaccomodates under the 1st MTP... sesamoiditis, HPK
mortons extensionapplies DF moment to 1st ray... hallux rigidus because DF 1st ray PF hallux
plantar fascial grooveaccomodates PFasc band
heel liftlimb length, achilles, equinus (less tension on PFasc)
medial flangestops pronation... prevents roll off medial side and supports medial column
deep heel seatprevents pronation by controlling the calcaneus
extended medial heel postprevents pronation... increases GRF medial to STJ
inverted pourfor pronation, build up medial side
kirby skiveincreases medial GRF to STJ,,, pushes supination
lateral flangecontrols transverse plane pronation
medial heel post flarecontrols pronation increases GRF medial to axis of STJ
flat rearfoot postlateral ankle instability by preventing rocking
lateral heel post flarelateral ankle instability
lateral cliplateral ankle instability by preventing eversion of calc
equinus casting modsgoal is to allow a little bit of pronation... cast STJ pronated, less rigid shell, post to less than full, lower the arch, add heel lift