Types of Orthosis PDF

Typesof orthosis ➢ Temporarily orthosis: Used for certain time after injuryor operation. ➢ Permanent orthosis: Used for ever when there is muscle weakness, paralysis or deformity cannot be corrected. Or ➢ Static orthosis: does not allowmovement. ➢Dynamic orthosis : allows movement. 11 7- Groun...

Typesof orthosis ➢ Temporarily orthosis: Used for certain time after injuryor operation. ➢ Permanent orthosis: Used for ever when there is muscle weakness, paralysis or deformity cannot be corrected. Or ➢ Static orthosis: does not allowmovement. ➢Dynamic orthosis : allows movement. 11 7- Ground-reactionAFO: ➢This orthosis is used in the presence of correctible knee flexion contractures or flexible ankle dorsiflexion contracture and contraindicated when these contractures are fixed 74 KAFO- KneeControls 5-Adjustablekneelockjoint(dial lock): ➢ The serrated adjustable knee joint allows knee locking at different degrees of flexion. ➢ This type of knee joint is used in patients with knee flexion contractures that are improving gradually with stretching. 122 HKAFO Hip joint:typicallya metal hinge joint ➢ Controls for abduction, adduction and rotation ➢ Controls for hip flexion when locked, typically with a drop ring lock; a locked hip restricts gait pattern to either a swing to or swing through gait Pelvic attachments ➢ A leather covered, metal pelvic band; attaches the HKAFO to the pelvis between the greater trochanter and iliac crest; adds to difficulty in donning and doffing; adds weight and increases overall energy expenditure during ambulation. 127 ReciprocatingGaitOrthosis(RGO) ContainsatrunkbandaddedtoaHKAFO Utilizes plastic molded solid ankle orthoses with locked knees, plastic thigh shell, a hip joint with pelvic and trunk bands; the hips are connected by steel cables which allow for a reciprocal gait pattern (either 4point or 2point); when the patient leans on the supporting hip, it forces it into extension while the opposite leg is pushed into flexion allowing limb advancement 132 InfrapatellarstrapKO 137 Patellarstabilizing braces(Palumbo KO( ➢ Improve patellar tracking;maintain alignment ➢ Lateral buttress or strap positions patella medially ➢ A Central Patellar cutout may help positioning and minimizes compression 138 Three-waykneestabilizer: 142 Supracondylarkneeorthosis ➢ Resists hyperextension at the knee without hindering flexion, thus is used to eliminate the need for a mechanical knee lock. ➢ It also resists genu recurvatum and provides mediolateral knee stability. 147 4- Kneeorthosisforaxialrotationcontrol:  These orthosis can provide angular control of sagittal (flexion-extension) & frontal(mediolateral)planesinaddition tocontrollingaxialrotation.  This orthosis is used mostly in management of sports injuries oftheknee.  Theseorthosesincludethe: Articulated hinged kneeorthosis 148 Articulated– hinged KO: control knee motion and provide added stability. ➢ Post surgery KO protects repaired ligaments from overload ➢Functional KO is worn long-termduring selected activities Examples include: Lenox Hill, Pro-Am, Can-Am, Don Joy 149 SpecializedKO Neoprenesleeves ➢ Nylon coated rubber material ➢ Provide compression, protection and proprioceptive feedback ➢ Provide little stabilization unless metal or plastic hinges are added ➢ Retains body heat which may increase local circulation ➢ A central cut out minimizes patellar compression ➢ Can be used in other areas of the body such as the elbowand thigh etc 151 Hip AbductionOrthosis ➢ Commonly used post-operatively to position the femoral head optimallywithin the acetabulum. ➢ Hip Abduction orthoses can be an HO only or can have a KAFO extension. 154 Indicationsforrecommendingorthoticdevices: ➢ To relief pain. ➢ To limit motion (immobilization after surgery, after traumatic injury, Compression # management & Kinesthetic reminder to avoid certain movements). ➢ To correct deformity e.g. Scoliosis management ➢ To relieve symptoms of a disease by supporting or assisting the MSk & neural systems. ➢ To reduce axial loading,mechanical unloading ➢ To improve function in a certain segment of the body. ➢ Assist and improve movement and function ➢ Reduce muscle tone. ➢ Protect against injury. ➢ Provide proprioceptive feedback. ➢ Provide rest. Designcharacteristicsof anorthoticdevice: Most important features include the following: ➢ Weight of the orthosis ➢ Adjustability ➢ Functional use ➢ Cosmoses ➢ Cost ➢ Durability ➢ Material ➢ Abilityto fit various sizes of patients ➢ Ease of putting on (donning) and taking off (doffing) ➢ Access to tracheostomy site, peg tube, or other drains ➢ Access to surgical sites for wound care ➢ Aeration to avoid skin maceration from moisture Durationof orthoticuse: ➢It is determined by the individual situation. ➢In situations where instability is not an issue, recommend use of an orthosis until the patient can tolerate discomfort without the brace. ➢When used for stabilization after surgery or acute fractures, allow6-12 weeks to permit ligaments and bones to heal. Effectsof theorthosismayleadto: ➢Decrease pain ➢Increase strength ➢Improve function ➢Increase proprioception ➢Improve posture ➢Correct of spinal curve deformity ➢Protect against spinal instability ➢Minimize complications ➢Assist healing of ligaments and bones Associateddrawbacksof theuseof anorthoticdevice: ➢ Discomfort ➢ Local pain ➢ Skin breakdown ➢ Nervecompression ➢ Muscle atrophy with prolonged use ➢ Decreased pulmonarycapacity ➢ Increased energy expenditure with ambulation ➢ Difficulty donning and doffing orthosis ➢ Difficulty with transfers ➢ Psychological and physical dependency ➢ Increased segmental motion at ends of the orthosis ➢ Poor patient compliance Benefitsof orthosis: ➢Improve function. ➢Save energy. ➢Increase endurance. Disadvantages& limitationsoforthoses: ➢Limit mobility and ROM of the joint. ➢Restrict rotation around a joint. ➢Movemen is usually limited to certain direction. ➢Weakness of other muscles in opposite direction. ➢The device is exposing to wear and tear. ➢It needs maintenance, care, cleaning, repairing, and frequent changing of shoes. Principlesandconsiderationfororthoses: Orthosisshould: ➢provide support and stability to the hip, knee and ankle joints. ➢be designed to permit safe and effective ambulation by patients. ➢Provide the need and requirements of the patient to support or to mobilize. ➢Correlate to the findings of tests & measurements. ➢Correlate with pateint personality and the impact of device upon him. ➢Prevent the development of deformity and require modifications in design. ➢Orthosis is only one component of the treatment and is not the whole treatment. ➢Conserve the time and energy of the patient. ➢The materials used should be light, sturdy and resistance to wear. Maintenance of orthosis: Patient should be taught for: ➢Cleaning the leather. ➢Oiling the joints. ➢Wash the orthosis if possible.