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Pathomechanics/Design and Fitting Considerations
Terms in this set (22)
what are the physiological systems involved in pathomechanic deformities?
what are the neurological pathomechanics?
-has abnormal forces in one or more planes which results in excessive stresses on soft tissue and joints
-may cause ligamentous laxity
what are the musculotendinous pathomechanics?
-continuing ligamentous laxity
what are the skeletal pathomechanics?
-unpredictable (requires radiographic study)
what are the ligamentous pathomechanics?
-affected by other factors (aging, pregancy, mobilization/immobilization, chemical)
what are the primary uses of LE orthoses?
what must the design of orthoses be based on?
-mechanical design to compensate for functional loss due to weakness, paralysis or deformity
what would a medial arch support and sabolich trim be used for?
for compensation of weak post tib.
what are desired tolerances determined by?
-location and intensity of force needed to accomplish compensatory function
-location and quantify of clearance needed to protect areas which do not tolerate pressure and may or may not be consistent with standard designs
-each individual orthosis
For design standards (non-adjustable), joint alignment must be so that:
1. medial and lateral joint heads are parallel to one another
2. Ankle, Knee and Hip joints must be perpendicular to the mid-sagittal line.
3. Joint axes must be parallel to the floor and to associated joint axes.
what are characteristics of flexure joints? (swedish fish)
-no real center of axis
-exact alignment cannot be achieved
-approximate alignment provides most consistent results
what are the standards in the sagittal plane for the ankle?
-height = distal tip of medial malleolus
-Medial = AP center of medial malleolus
-Lateral = AP center of lateral malleolus (tibial torsion)
what are the standards in the sagittal plane for the knee?
-Height = MTP plus 1/2 dist to adductor tubercle
-AP = 1/2 anterior to posterior minus patella (exception off set)
What happens when you bring joint axis posterior to weight line
creates an extension moment - creates more stability (example --weak quads)
what are the standards in the sagittal plane for the hip?
-Height = 1 inch proximal to GT
-AP = 1/2 inch anterior to GT
what are UCBL timelines?
-Medial = high as comfortably possible
-Lateral = can be lower than medial
-Length = sulcus or logner
-Long arch = accentuate posterior to navicular
-Heel Wedge = medial inside orthosis (must stabilize)
what are ankle AFO trim lines?
-Solid = anterior to malleoli
- Semi Rigid = at malleoli
-Posterior leaf spring (flexible) - posterior to malleoli
what are the AFO trim lines of:
proximal = 2-3.8 cm distal to neck of fib
shank = trim lines will vary dependant on goals and style *** A medial trimline on the shank can help the ankle's arch from collapsing medially)
what are the KAFO trimlines on the thigh?
Distal = snug proximal to medial condyle (to stabilize femur), no condyle contact, posterior equal distance from popliteal as proximal AFO trim
Proximal = ischial containment, GT level
considerations related to cosmesis of orthoses
-symmetry where possible
-clean smooth trim lines
-consistent smooth finish of surface
-neat clean straps
-orthosis looks finished
what are safety considerations regarding orthoses?
-finished edges and surfaces (plastic and metal)
-appropriate trim lines
-componentry and design choice
-understand orthosis function
-support use of device
-aid pt incorporate into daily use
-evaluate change in condition (functional goals, safety concerns)
THIS SET IS OFTEN IN FOLDERS WITH...
Principals of Orthotics
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