Equipment and Devices

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NPTE NPTE Fichas sobre Equipment and Devices, creado por Mia Li el 25/06/2019.
Mia Li
Fichas por Mia Li, actualizado hace más de 1 año
Mia Li
Creado por Mia Li hace alrededor de 5 años
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Length of crutch: 1. substract 16 inches from height 2. measure from 2" below the axilla to a point 6" in front and 2" lateral to the foot 3. supine: from axilla to 6-8" lateral to the heel
______ of elbow flexion is desirable for crutch using. 20 - 30 deg.
A Lofstrand (forearm) crutch should cover ________ of the proximal forearm or ________ below the elbow. 1/3 of the proximal forearm. or 1-1.5" below the elbow
What type of crutches can be used for stair-climbing? Axillary crutches and forearm crutches
Which nerves and blood vessels are the most prone to compression injury if a person uses axillary crutches 1. radial nerve 2. axillary artery
A patient has bilateral LE involvement due to spina bifida and uses axillary crutches to ambulate. Which step pattern do you recommend? Swing-through (indicated for BLE involvement)
Cane measurement: 6" from the side of toes to the ulnar styloid/wrist crease to allow for 20 - 30 deg elbow flexion.
Where should the drive wheels of the WC be for an amputee to accommodate for the change in center of weight? Drive wheels placed posterior to the backrest.
If a patient is hemiplegic and has weak RLE and RUE, how should the w/c be designed to accommodate? Seat close to ground to allow LE propulsion.
Patient fitting for w/c/ has back extensor spasm. Which feature will you recommend? Tilt-in-space (also for pressure relief)
Patient with C5 injury and quadriplegia is unable to maintain upright trunk. How should you modify the backrest? Reclining back.
Your patient is obese and requires a w/c fitting. Recommend the tire, backrest and other features to maximize safety and comfort. Tire: hard (more durable) Backrest: adjustable (accommodate increased posterior bulk) Reclining feature: accommodate for cardiovascular compromise. Powered chair.
Maximal BWS when gait training. 55% (otherwise, foot won't stay flat)
Starting and weaning method for BWS system gait training. Start at 40% support and decrease in 10% increments.
What is the three-point principle for orthotics? 1. a single force at the area of deformity 2. two additional counterforces 50% each acting in the opposite direction
Foot orthosis recommendation: leg length discrepancy. Heel lift
Foot orthosis recommendation: Limited DF. Heel lift.
Foot orthosis recommendation: Pes planus. Scaphoid pad or longitudinal arch supports.
Foot orthosis recommendation: Metatarsalgia. 1. metatarsal pad 2. rocker bar
Foot orthosis recommendation: pronation and flexible pes valgus varus post (medial heel wedge)
Foot orthosis recommendation: genu varum or flexible pes varus. Valgus post (lateral heel wedge)
Foot orthosis recommendation: Forefoot varus medial sole wedge
Foot orthosis recommendation: Forefoot valgus Lateral sole wedge
Foot orthosis recommendation: weak or inflexible foot that lacks forward propulsion. Rocker bar
What feature helps to limit knee recurvatum in stance and toe drag during swing phase? Common problem: excessive plantarflexion. Feature: PF stop (posterior stop)
What pathological gait pattern can be prevented by a DF stop (anterior stop)? 1. knee buckling. 2. excessive knee flexion during early stance.
Which feature in the KAFO helps extend the knee and stabilize the knee during early stance? Offset joint.
Contraindication for an offset joint. Knee flexion contracture.
A specialized orthoses for children with T9-12 SCI. THKAFO
Who should avoid heel lifts and rocker bars? Patient with insensitive foot.
Possible reason for the following orthotic gait deviation: Lateral trunk bending. (leaning towards the orthotic side). 1. KAFO medial upright too high 2. insufficient shoe lift 3. hip pain 4. weak/tight abductors on the orthotic side 5. short leg 6. poor balance
Possible reasons for the following orthotic gait deviation: Circumduction or vaulting. 1. locked knee 2. excessive PF 3. weak hip flexors 4. weak dorsiflexors
Possible reasons for the following orthotic gait deviation: Anterior trunk bending. 1. inadequate knee lock 2. weak quads 3. hip/knee flexion contracture
Possible reasons for the following orthotic gait deviation: Posterior trunk lean 1. inadequate hip lock 2. weak glute max 3. knee ankylosis
Possible reasons for the following orthotic gait deviation: Hyperextension of knee. 1. inadequate PF stop 2. inadequate knee lock 3. calf band too deep 4. weak quads 5. loose knee ligaments or extensor spasticity 6. pes equinus
Possible reasons for the following orthotic gait deviation: Excessive knee flexion/buckling. 1. inadequate DF stop 2. inadequate knee lock 3. knee/hip flexion contracture 4. weak quads 5. knee pain
Possible reasons for the following orthotic gait deviation: Foot slap 1. inadequate DF assist or dorsiflexors 2. inadequate PF stop
Possible reasons for the following orthotic gait deviation: Toe-first contact 1. inadequate DF assist 2. inadequate PF stop 3. inadequate heel lift 4. heel pain 5. extensor spasticity 6. pes equinus 7. short leg
Possible reasons for the following orthotic gait deviation: Flat foot contact 1. inadequate longitudinal arch support 2. pes planus
Possible reasons for the following orthotic gait deviation: Excessive pronation 1. transverse plane malalignment 2. weak invertors 3. pes valgus 4. spasticity 5. genu valgum
Possible reasons for the following orthotic gait deviation: Excessive supination 1. transverse plane malalignment 2. weak evertors 3. pes varus 4. genu varum
Possible reasons for the following orthotic gait deviation: Wide BoS 1. KAFO or medial upright too high 2. HKAFO hip joint aligned in excessive abduction 3. poor balance 4. sound limb too short
Ideal reserved length for amputation: 1. tibia 2. femur 1. 20 - 50% 2. 35- 60%
The socks should not exceed ____ ply thickness for proper fitting and weight bearing of the socket. 15 ply
Pressure sensitive areas when fitting a patellar-tendon-bearing knee socket. 1. anterior tibia 2. anterior tibial crest 3. fibular head 4. peroneal nerve
Pressure-tolerant areas when fitting a patellar-tendon-bearing knee socket. 1. patellar tendon 2. medial tibial plateau 3. tibial and fibular shafts 4. distal end of tibia
What might be the prosthetic or anatomic causes of the following gait deviation? Excessive knee flexion upon initial contact. 1. high shoe heel 2. insufficient PF 3. stiff heel cushion 4. socket too far anterior or excessively flexed 5. cuff tabs too posterior
What might be the prosthetic or anatomic causes of the following gait deviation? Insufficient knee flexion upon initial contact. 1. low shoe heel 2. excessive PF 3. soft heel cushion 4. socket too far posterior or insufficiently flexed 5. extensor hyperreflexia 6. weak quads 7. anterodistal pain 8. arthritis
What might be the prosthetic or anatomic causes of the following gait deviation? excessive lateral thrust excessive foot inset
What might be the prosthetic or anatomic causes of the following gait deviation? excessive medial thrust excessive foot outset
What might be the prosthetic or anatomic causes of the following gait deviation? Early knee flexion (drop off) 1. high shoe heel 2. insufficient PF 3. keel too short 4. DF stop too soft 5. socket too anterior or excessively flexed 6. cuff tabs too posterior 7. flexion contracture
What might be the prosthetic or anatomic causes of the following gait deviation? Delayed knee flexion when walking uphill 1. low shoe heel 2. excessive PF 3. keel too long 4. DF stop too stiff 5. socket too posterior 6. socket not flexed enough 7. extensor hyperreflexia
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Abduction during stance 1. long prosthesis 2. abducted hip joint 3. inadequate lateral wall adduction 4. sharp or high medial wall 5. abduction contracture 6. weak abductors 7. laterodistal pain
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Circumduction 1. long prosthesis 2. locked knee unit 3. loose friction 4. inadequate suspension 5. small socket 6. loose socket 7. foot in PF 8. abduction contracture 9. poor knee control
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Lateral bend during stance. 1. short prosthesis 2. inadequate lateral wall adduction 3. sharp/high medial wall 4. abduction contracture 5. weak abductors 6. hip pain or instability
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? forward flexion in stance 1. unstable knee unit 2. short walker or crutch
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? lordosis in stance 1. inadequate socket flexion 2. hip flexion contracture 3. weak extensors
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Medial whip during heel off 1. faulty socket contour 2. knee bolt externally or internally rotated 3. foot malrotation 4. prosthesis donned in malrotation
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Foot rotation during heel contact. 1. stiff heel cushion 2. malrotation of foot
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? High heel rise during early swing 1. inadequate friction 2. slack extension aid
What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Terminal impact during late swing. 1. inadequate friction 2. taut extension aid 3. forceful hip flexion
Wheel chair measurement: 1. seat width 2. seat depth 3. seat height 4. arm rest height 5. back height 1. seat width: hip width + 2" 2. seat depth: femur length - 2-3" 3. seat height: insure minimal clearance of 2" if have foot plate 4. arm rest height: seat platform to just below elbow at 90 deg flexion with neutral shoulder 5. back height: seat platform to desired height
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