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Questions and Answers
What is an important consideration for achieving optimal knee extension during the stance phase of gait?
What is an important consideration for achieving optimal knee extension during the stance phase of gait?
What is the purpose of extending the medial and lateral trim lines distally to cover the metatarsal phalangeal joints?
What is the purpose of extending the medial and lateral trim lines distally to cover the metatarsal phalangeal joints?
What is the ideal patient profile for an AFO that uses floor reaction force through the toe aspect of the foot plate?
What is the ideal patient profile for an AFO that uses floor reaction force through the toe aspect of the foot plate?
What is the myth about AFO management in CP that has been debunked?
What is the myth about AFO management in CP that has been debunked?
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What is the benefit of achieving the correct SVA angle during stance phase?
What is the benefit of achieving the correct SVA angle during stance phase?
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What is the relationship between the AFO and the SVA?
What is the relationship between the AFO and the SVA?
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What is the primary goal of AFO management in CP?
What is the primary goal of AFO management in CP?
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What is the significance of the Shank to Vertical Angle (SVA) in AFO management?
What is the significance of the Shank to Vertical Angle (SVA) in AFO management?
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What is AFO-FC tuning defined as?
What is AFO-FC tuning defined as?
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What is the primary goal of AFO management in CP?
What is the primary goal of AFO management in CP?
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What is the ideal alignment of the SVA during Mid-Stance and Terminal Stance?
What is the ideal alignment of the SVA during Mid-Stance and Terminal Stance?
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What is the purpose of marking the trim line at the ankle?
What is the purpose of marking the trim line at the ankle?
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What is the primary function of the Ankle-Foot Orthosis (AFO)?
What is the primary function of the Ankle-Foot Orthosis (AFO)?
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What is the standard trim line design option?
What is the standard trim line design option?
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What is the benefit of using a PLS orthosis?
What is the benefit of using a PLS orthosis?
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What is a common indication for prescribing an AFO in children?
What is a common indication for prescribing an AFO in children?
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What is a crucial factor in achieving optimal performance of an AFO?
What is a crucial factor in achieving optimal performance of an AFO?
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What is a benefit of using a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
What is a benefit of using a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
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What is the primary goal of orthotic treatment for gait correction?
What is the primary goal of orthotic treatment for gait correction?
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What type of material is typically used to fabricate a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
What type of material is typically used to fabricate a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
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What is an important consideration when prescribing an AFO?
What is an important consideration when prescribing an AFO?
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What is a potential goal of orthotic treatment using an AFO?
What is a potential goal of orthotic treatment using an AFO?
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What is an important consideration when applying forces to an AFO?
What is an important consideration when applying forces to an AFO?
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What is a characteristic of a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
What is a characteristic of a Supra Malleolar Ankle Foot Orthosis (SMAFO)?
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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).
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Description
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.