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CLINICAL METHODS IN LOWER EXTREMITY ORTHOTICS

CLINICAL METHODS IN LOWER EXTREMITY ORTHOTICS. GENERAL TOPICS. ANATOMY. FOOT/ANKLE COMPLEX KNEE HIP. ANATOMY. FOR EACH JOINT…… BONE COMPOSITION LIGAMENTOUS STABILITY ROM PRIMARY MUSCLES. NEUROLOGY. CNS v.s. PNS MOTOR ( efferent ) v.s. SENSORY (afferent) NERVE CONDUCTION

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CLINICAL METHODS IN LOWER EXTREMITY ORTHOTICS

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  1. CLINICAL METHODS IN LOWER EXTREMITY ORTHOTICS GENERAL TOPICS

  2. ANATOMY • FOOT/ANKLE COMPLEX • KNEE • HIP

  3. ANATOMY • FOR EACH JOINT…… • BONE COMPOSITION • LIGAMENTOUS STABILITY • ROM • PRIMARY MUSCLES

  4. NEUROLOGY • CNS v.s. PNS • MOTOR (efferent) v.s. SENSORY (afferent) • NERVE CONDUCTION • MUSCLE ACTIVATION

  5. NEUROLOGY • A GENERAL OVERVIEW OF ESSENTIAL NEUROLOGY TO BETTER UNDERSTAND THE CAUSE AND CHARATERISTICS OF PATHOLOGIES

  6. PATHOLOGY • POLIO • CLUBFOOT • SPINA BIFIDA • FRACTURES • CEREBRAL PALSY (CP) • MUSCULAR DYSTROPHY (MD) • MULTIPLE SCLEROSIS (MS) • SPINAL CORD INJURY (SCI)

  7. PATHOLOGY • FOR EACH PATHOLOGY….. • ETIOLOGY • SIGNS & SYMPTOMS • FUNCTIONAL DEFICITS • POSSIBLE ORTHOTIC MANAGEMENT

  8. BIOMECHANICS & GAIT ANALYSIS • LINE OF ACTION • TBF/GRF LINE • CENTRE OF GRAVITY • MOMENTS • LEVER ARMS • PRESSURE • CORRECTIVE FORCES (3PPS) • NORMAL v.s. ABNORMAL GAIT

  9. BIOMECHANICS & GAIT ANALYSIS • BASIC, GENERAL NOTIONS WILL BE PRESENTED IN ORDER TO BETTER UNDERSTAND THE PATIENT'S BIOMECHANICAL NEEDS AND HOW AN ORTHOSIS CAN PROVIDE THE REQUIRED SUPPORT OR CORRECTION

  10. PATIENT ASSESSMENT • SUBJECTIVE ASSESSMENT • OBJECTIVE ASSESSMENT • SYSTEMATIC APPROACH

  11. PATIENT ASSESSMENT • THE GOAL OF THIS MODULE IS TO PRESENT A LOGICAL AND SYSTEMATIC APPROACH TO PATIENT EVALUATIONS • ONCE UNDERSTOOD, IT WILL BE APPLICABLE TO ANY PATIENT THAT WALKS THROUGH THE DOOR

  12. ORTHOTIC DESIGN & RATIONALE • AFO • flexible • rigid • articulated • anterior shell • PTB

  13. ORTHOTIC DESIGN & RATIONALE • KAFO • free joint • drop lock v.s. swiss lock • posterior offset joint • ankle/foot section

  14. ORTHOTIC DESIGN & RATIONALE • THE ONLY LIMITATION TO THE VARIETY OF DEVICES THAT ARE POSSIBLE FOR YOUR PATIENT IS YOUR IMAGINATION • THE MOST APPROPRIATE CHOICE MUST BE BASED ON A THOROUGH ASSESSMENT AND THE SPECIFIC NEEDS OF THE PATIENT

  15. CASTING • MEASUREMENTS & MARKINGS • JOINT POSITION (ANGLE) • HEEL HEIGHT • WEIGHT BEARING v.s. NON-WEIGHT BEARING TECHNIQUE • 2 PART CASTING TECHNIQUE • CORRECTIVE FORCES

  16. CASTING • SUCCESS OF THE ORTHOTIC TREATMENT STARTS WITH PROPER CASTING • THIS MODULE WILL FOCUS ON THE CLINICAL IMPLICATIONS OF THE WAY YOU CAST YOUR PATIENT

  17. RECTIFICATION • SMOOTHING CAST & CHECKING MEASUREMENTS • PRESSURE SENSITIVE v.s. PRESSURE TOLERANT AREAS • PLASTER REDUCTIONS & BUILD-UPS • CORRECTIVE FORCES • PLASTER FINISHING

  18. RECTIFICATION • PROPER RECTIFICATION WILL OF COURSE INFLUENCE THE FIT, BUT ALSO THE DEGREE AND EFFICIENCY OF CORRECTION OFFERED BY THE ORTHOSIS

  19. FABRICATION • DESIGN RATIONAL • MATERIALS & COMPONENTS BASED ON ASSESSMENT

  20. FABRICATION • WHEN CHOOSING MATERIALS AND COMPONENTS, THE DESIRED EFFECT OF THE ORTHOSIS MUST BE CONSIDERED

  21. FIRST FITTING PROCEDURE • "10 STEP CHECKLIST"

  22. FINISHING & DELIVERY (CHEKOUT PROCEDURE) • "10 STEP CHECKLIST"

  23. ORAL PRESENTATIONS • SUMMARY OF PATIENT • DESCRIPTION OF DEVICE • EVALUATION OF DEVICE • POSSIBLE CHANGES

  24. ORAL PRESENTATIONS • IN ORDER TO BE A GOOD CLINICIAN, SELF EVALUATION IS CRUCIAL. BEING ABLE TO ANALYSE WHAT WAS DONE WELL OR WHAT WAS DONE WRONG WILL ALLOW YOU TO BECOME BETTER IN THE FUTURE • A CLINICAN MUST HAVE THE ABILITY TO BE VERY CRITICAL AND AVOID THE URGE TO SAY "GOOD ENOUGH"

  25. CASE STUDIES • EFFECTS OF WRONG PRESCRIPTION • EFFECTS OF WRONG ALIGNMENT

  26. CLINICAL RECORD KEEPING • PATIENT FILES • ASSESSMENT SHEET • MEASUREMENT CARD • TREATMENT RECORD (PATIENT NOTES)

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