UCBL Foot Orthoses Flashcards

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Questions and Answers

What are the indications for UCBL?

Very severe midfoot break

Severe spasticity

Hindfoot angulation greater than 10 degrees (correct)

Flexible (correct)

What are the contraindications for UCBL?

Mild spasticity

Severe spasticity (correct)

Hindfoot angulation greater than 10 degrees

Vertical talus (>45 degrees) (correct)

What are the key design features of UCBL?

High medial and lateral trimline, external post med/lat, doesn't impinge malleoli.

What are the common diagnoses for UCBL?

Forefoot transverse deformities (ABd/ADd) Signup and view all the answers

What are the trimlines for UCBL?

Encompass 1st and 5th shafts, 2-3mm proximal to 1st/5th met heads, inferior to malleoli. Signup and view all the answers

What does the Carlson modification include?

Sustentaculum tali support - shelf, internal medial heel wedge, external medial heel post. Signup and view all the answers

What are the design features of SMO?

Increased lever arms compared to UCBL, better coronal plane correction, improved swing phase through improved BOS. Signup and view all the answers

What are the trimlines for SMO?

Superior to superior border of malleoli, dorsal wrap, bisect met heads, full foot plate. Signup and view all the answers

How can you control hyperextension in an AFO?

More proximal posterior trimline, add or increase posterior stop, set AFO in a few degrees of DF initially. Signup and view all the answers

What is the three-point force system for dorsiflexor weakness?

DF in swing, superior force at met heads, posterior and distal at instep strap. Signup and view all the answers

What are the indications for a full-length foot plate?

Claw toe, hammer toe, mid-foot fracture, tone or spasticity present. Signup and view all the answers

What is the three-point pressure system for valgus?

Medial force at 5th met, lateral directed force sup and inf to medial malleoli. Signup and view all the answers

What is the three-point pressure system for varus?

Lateral directed force at 1st met, medial directed force sup and inf to lateral malleoli. Signup and view all the answers

What does it indicate if a patient presents with 1st met head discomfort?

Excessive pronation/valgus. Signup and view all the answers

What nerve is affected if a patient has weak hip flexors after a gunshot to the hip?

Femoral nerve. Signup and view all the answers

What are the indications for Solid Ankle AFO?

Poor balance, instability, inability to transfer weight, moderate to severe foot abnormality. Signup and view all the answers

What are the indications for Articulated AFO?

DF weakness only, presence of DF ROM, control knee flexion instability. Signup and view all the answers

What allows for the measurement of the stirrup length?

2x height to distal tip medial malleolus + width of heel + 6mm. Signup and view all the answers

What muscle group is affected when a patient has a short sound side step?

Plantarflexors because they cannot control rate of second rocker. Signup and view all the answers

Study Notes

UCBL Overview

Indicated for hindfoot angulation greater than 10 degrees, mild spasticity, and flexible foot structures.
Contraindicated in cases of severe spasticity, vertical talus (over 45 degrees), and very severe midfoot break (dropped navicular).

UCBL Design Features

High medial and lateral trimlines are designed to avoid impinging on the malleoli.
Includes external posts for medial and lateral support to enhance stability.

UCBL Clinical Applications

Effective for treating flexible pes planus and hindfoot deformities (varus/valgus).
Addresses forefoot transverse deformities (abduction/adduction) in patients.

UCBL Trimline Specifications

Trimlines encompass the 1st and 5th metatarsal shafts, positioned 2-3mm proximal to their heads.
Full coverage of the calcaneus is necessary, featuring a dorsal wrap and hindfoot post for support.

Carlson Modifications

Innovative features include sustentaculum tali support, an internal medial heel wedge, and an external medial heel post.

SMO Characteristics

Increases lever arms compared to UCBL, providing better coronal plane correction.
Enhances swing phase stability through a broader base of support.

SMO Trimline Specifications

Trimlines are positioned superior to the malleoli with a dorsal wrap that bisects the metatarsal heads.
Full footplate support is included, descending posteriorly to permit plantarflexion.

Managing Hyperextension in AFO

Use a more proximal posterior trimline to avoid impeding fibular neck flexion.
Consider adding a posterior stop and setting AFO initially in a few degrees of dorsiflexion.

Dorsiflexor and Plantarflexor Weakness

For dorsiflexor weakness, a three-point force system applies superior force at met heads and distal pressure at the instep strap.
For plantarflexor weakness, inferior force at met heads and anterior proximal force at the heel are crucial.

Full Length Foot Plate Indications

Indicated for conditions like claw toe and mid-foot fractures, especially when spasticity or tone is present.
Promotes knee extension during gait.

Three-Point Pressure Systems

Valgus management employs medial forces at specific metatarsals and directed forces around the malleoli.
Varus management requires similar directional forces, specifically focusing on the first metatarsal.

Callus Management

Discomfort at the 1st met head may indicate excessive pronation; a medial sabloch tab may assist.
Discomfort at the 5th met head suggests excessive supination; a lateral sabloch tab is recommended.

Posterior Leaf Spring Specifications

Trimlines should be positioned 1 inch distal to the fibular neck and behind the malleoli, allowing useful rigidity adjustments.

Establishing Forces in AFOs

The posterior leaf spring can prevent plantarflexion during swing and manage dorsiflexion during stance through a structured three-point force system.

Solid AFO Design and Application

Solid AFOs cover 60% of the gastrocnemius and require full footplate integration to prevent pressure on the navicular area.
Suggested for poor balance, significant muscle tone issues, and various gait abnormalities.

GRAFO Applications

Primarily used in conditions like crouch gait and knee instability; serves as an alternative to KAFO.
Full footplate support is essential for effective dorsiflexion stops and knee extension.

Other AFO Types

Articulated AFOs focus on dorsiflexion weakness with specific indications for knee flexion control.
PLS is indicated in patients with dorsiflexion weakness and no significant stability issues, providing minimal influence at the knee or hip.

Specialty Orthotic Features

Metal double uprights are suggested in cases of fluctuating edema or personal preference.
Drop locks are indicated for patients with significant quadriceps weakness to enhance stability.

Key Measurements and Clearances

Knee clearances should be 3mm laterally and 6mm medially, while ankle joint clearances are 6mm medially and 5mm laterally.
Stirrup length is derived from specific anatomical measurements, ensuring a tailored fit for each patient.

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Description

Explore essential terms related to UCBL (University of California Biomechanics Laboratory) foot orthoses. This quiz covers indications, contraindications, design elements, and diagnoses associated with UCBL. Enhance your understanding of orthotic applications in clinical practice.