Lower Extr Emity Orthose S: A Prim Er: Abby A Mpil, PT, DPT

t re mi t y
e r E x r
Low : A P r i me
t h o se s
O r
P T, D PT
AMPIL ,
ABBY
Outline
!   Define orthosis
!   Common reasons to use an orthosis
!   Different types of orthosis
!   Design
!   Rationale and indications
!   Review additional considerations
What is an orthosis?1
!   Externally applied device that is designed and fitted to the
body to achieve one or more of the following goals:
!   Control biomechanical alignment
!   Correct or accommodate deformity
!   Protect and support an injury
!   Assist rehabilitation
!   Reduce pain
!   Increase mobility
!   Increase independence
Why do YOU care?
!   Your kids may have orthoses!
!   Familiarity of language
!   General understanding of rationale
!   Be able to help take them off/on
Get ready for acronyms!!
!   UCBL !   KAFO
!   University of California !   Knee ankle foot orthosis

Biomechanics Laboratory
!   FRAFO
!   SMO
!   Floor reaction ankle foot
! Supramalleolar orthosis orthosis
!   AFO
!   Ankle foot orthosis

Types of orthoses
!   Foot orthosis !   Hinged AFO
!   UCBL !   Solid AFO
!   SMO !   Floor Reaction
!   Posterior Leaf !   KAFO

Spring AFO
Reasons to use an
orthosis2
!   Improves stability during walking by blocking problematic joint
motions
!   Improve foot clearance (not catching feet on the floor) by assisting

joint motions
!   Improves efficiency of gait pattern to minimize energy expenditure
!   Preventing deformity and secondary orthopedic issues by providing

optimal skeletal alignment
!   Preventing contracture (muscle shortening) by holding a joint in

position where the muscle is lengthened
Foot Orthosis (FO)3
!   Indication:
!   Arch support in patients

who are pronated (flat
feet)
UCBL3
!   Indications:
!   Arch and heel support

!   Higher level of support
than foot orthoses
SMO3
!   Can help control
pronation (flat feet) AND
supination (arches too
high)
!   Relatively rigid control,

but ankle and knee
motion still allowed
Posterior Leaf Spring AFO2,3
!   Controls foot drop (toe
pointing down)
!   Allows the ankle to come

forward when the foot is
on the ground during
walking
!   Helps push foot off the

floor before it swings
through
Hinged AFO2,3
!   Very versatile design;
can add stops or springs
to block or assist many
different motions at ankle
or knee
!   Commonly used to
prevents walking up on
toes, while still allowing
the ankle to come
forward
Solid AFO2,3
!   Locks ankle in a fixed position
!   Prevents walking on toes
!   Prevents “crouch gait” (hips

and knees bent, ankle forward)
!   Prevents drop foot
!   Prevents hyperextension at
knees
!   Can be used at rest to prevent

calf muscle shortening
Floor Reaction AFO2,3
!   Designed to prevent
crouch gait (knee
buckling)
KAFO2,3
!   Commonly used in paralysis
or profound weakness
!   Locks at knee joint keep it

straight when upright, but
unlock to allow sitting
!   Typically used alongside an

assistive device (crutches or
walker)
!   Can be used at rest to prevent

calf and hamstring muscle
shortening
Additional considerations3
!   Possible issues
! Overbracing
!   Underbracing
!   How long do they wear the brace for?
!   Lifespan of brace
!   Fit issues
!   Day vs. night use
Movie time!
https://www.youtube.com/watch?v=sPctE4DFpdU
NK S !
THA
tions?
Q u e s
References
!   1. About ortheses and prostheses. (n.d.). Retrieved April 1,
2016, from https://www.aopa.org.au/careers/what-are-
orthoses-and-prostheses
! Novacheck, T. F., Kroll, G. J., Gent, G., Rozulmalski, A.,

Beattie, C., & Schwartz, M. H. (2009). Orthoses. In Gage, J.R.,
Schwartz M.H, Koop S.E., Novacheck, T.F. The Identification
and Treatment of Gait Problems in Cerebral Palsy (pp.
327-348) (2nd ed.). London: Mac Keith Press.
!   3. Foundations of Pediatric Orthotics. (n.d.). Retrieved April

1, 2016, from
https://pediatricapta.org/includes/fact-sheets/pdfs/
Orthotics.pdf

Lower Extr Emity Orthose S: A Prim Er: Abby A Mpil, PT, DPT

Uploaded by

Document Informationclick to expand document information

Copyright:

Available Formats

Lower Extr Emity Orthose S: A Prim Er: Abby A Mpil, PT, DPT

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Lower Extr Emity Orthose S: A Prim Er: Abby A Mpil, PT, DPT

Uploaded by

Copyright:

Available Formats

t re mi t y

! University of California ! Knee ankle foot orthosis

! Ankle foot orthosis

! UCBL ! Solid AFO

! SMO ! Floor Reaction

! Posterior Leaf ! KAFO

! Improve foot clearance (not catching feet on the floor) by assisting

! Improves efficiency of gait pattern to minimize energy expenditure

! Preventing deformity and secondary orthopedic issues by providing

! Preventing contracture (muscle shortening) by holding a joint in

! Arch support in patients

! Arch and heel support

! Relatively rigid control,

! Allows the ankle to come

! Helps push foot off the

! Prevents walking on toes

! Prevents “crouch gait” (hips

! Prevents drop foot

! Can be used at rest to prevent

! Locks at knee joint keep it

! Typically used alongside an

! Can be used at rest to prevent

! Novacheck, T. F., Kroll, G. J., Gent, G., Rozulmalski, A.,

! 3. Foundations of Pediatric Orthotics. (n.d.). Retrieved April

You might also like

!   University of California !   Knee ankle foot orthosis

!   Ankle foot orthosis

!   UCBL !   Solid AFO

!   SMO !   Floor Reaction

!   Posterior Leaf !   KAFO

!   Improve foot clearance (not catching feet on the floor) by assisting

!   Improves efficiency of gait pattern to minimize energy expenditure

!   Preventing deformity and secondary orthopedic issues by providing

!   Preventing contracture (muscle shortening) by holding a joint in

!   Arch support in patients

!   Arch and heel support

!   Relatively rigid control,

!   Allows the ankle to come

!   Helps push foot off the

!   Prevents walking on toes

!   Prevents “crouch gait” (hips

!   Prevents drop foot

!   Can be used at rest to prevent

!   Locks at knee joint keep it

!   Typically used alongside an

!   Can be used at rest to prevent

!   3. Foundations of Pediatric Orthotics. (n.d.). Retrieved April