24 Questions
What is an important consideration for achieving optimal knee extension during the stance phase of gait?
Maintaining an SVA of 10° to 12° of inclination
What is the purpose of extending the medial and lateral trim lines distally to cover the metatarsal phalangeal joints?
To prevent tibial progression and subsequent knee collapse
What is the ideal patient profile for an AFO that uses floor reaction force through the toe aspect of the foot plate?
Patients with weakness and lack of voluntary plantarflexion
What is the myth about AFO management in CP that has been debunked?
AFOs should be set at 90°
What is the benefit of achieving the correct SVA angle during stance phase?
It facilitates the optimum alignment of the GRF in relation to the ankle, knee, and hip joints
What is the relationship between the AFO and the SVA?
The AFO and SVA are independent of each other
What is the primary goal of AFO management in CP?
To achieve optimal knee extension during stance phase
What is the significance of the Shank to Vertical Angle (SVA) in AFO management?
It measures the angle of the tibial shank relative to the vertical
What is AFO-FC tuning defined as?
The process of fine-tuning an AFO for optimal performance during a particular activity
What is the primary goal of AFO management in CP?
To resist unwanted dorsiflexion and maintain GRF alignment
What is the ideal alignment of the SVA during Mid-Stance and Terminal Stance?
Between 10-12°
What is the purpose of marking the trim line at the ankle?
To allow flexion of the polypropylene
What is the primary function of the Ankle-Foot Orthosis (AFO)?
To maintain the foot in a plantigrade position
What is the standard trim line design option?
A horizontal line 2 cm below the fibula head
What is the benefit of using a PLS orthosis?
It allows for dorsiflexion of the ankle while preventing passive plantar flexion
What is a common indication for prescribing an AFO in children?
Mild hypotonia and excessive pronation
What is a crucial factor in achieving optimal performance of an AFO?
The design of the AFO
What is a benefit of using a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
It provides circumferential control of the rear and forefoot
What is the primary goal of orthotic treatment for gait correction?
To achieve optimal alignment of the GRF
What type of material is typically used to fabricate a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
Thin, flexible thermoplastic
What is an important consideration when prescribing an AFO?
Matching patient desires with functional requirements
What is a potential goal of orthotic treatment using an AFO?
To provide a more energy-efficient gait
What is an important consideration when applying forces to an AFO?
Separating swing and stance phase problems
What is a characteristic of a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
It has a higher medial side than lateral side
Study Notes
Ankle Foot Orthosis (AFO) Management in Cerebral Palsy (CP)
- AFO tuning is the process of fine adjustments to optimize the AFO's performance during a particular activity, such as walking.
- The type and stiffness of the material used for the AFO, as well as its design, affect the orthosis' impact on a child's gait.
Shank to Vertical Angle (SVA)
- SVA is defined as the angle of the tibial shank relative to the vertical in the sagittal plane.
- The optimal SVA at mid-stance is between 10° to 12° of inclination, with a range of 7° to 15° of inclination.
- Reaching the correct inclination of the SVA permits the thigh segment to become inclined and the pelvis and trunk to progress in a vertical position.
AFO Design and Function
- The main function of the AFO is to maintain the foot in a plantigrade position, providing a stable base of support.
- The AFO supports the foot in midstance and prevents drop foot during swing phase.
- AFOs provide a more energy-efficient gait.
Orthotic Prescription Principles
- Good assessment is key to successful prescription.
- The prescription should match patient desires with functional requirements.
- Orthotic needs may change over time.
- A detailed prescription should include the design of the device, materials used, joints, straps/suspension, function, casting/anatomical angle, tibial inclination angle, wedging or tuning, and footwear & adaptations.
Force Application
- Three-point force systems should be applied to have an effective orthosis.
- Perform static and dynamic analysis to identify segment deviations.
- Separate swing and stance phase problems and organize force systems.
Supra Malleolar Ankle Foot Orthosis (SMAFO)
- SMAFO extends to just above the malleoli and to the toes.
- The medial side is higher than the lateral, holding the calcaneus more firmly and supporting the longitudinal arch.
- SMAFO provides circumferential control of the rear and forefoot to maintain a neutral alignment.
- Commonly prescribed for young children with mild hypotonia and excessive pronation, or flexible pes planus (i.e., hind and midfoot instability).
Learn about the process of fine-tuning Ankle Foot Orthosis and Footwear Combination (AFO-FC) to optimize its performance during walking. Understand how to achieve the desired Subtalar Vertical Axis (SVA) and optimize the position of the Ground Reaction Force (GRF) during stance phase.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
