Orthotics and prosthetics - PowerPoint PPT Presentation

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Orthotics and prosthetics

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Myoelectric - use intact proximal muscles to give electromyographic signals to ... Supination/pronation. Add thin washers to adjust sup/pro ... – PowerPoint PPT presentation

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Title: Orthotics and prosthetics


1
Orthotics and prosthetics
2
LE Prosthetics
  • Residual limb shaping issues
  • Weight bearing problems
  • Use of stockings or socks
  • Will they use it?
  • Balance problems
  • How hard is it to don/doff
  • endoskeleton/exoskeleton

3
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5
Cosmetic replacement minimal functional use but
excellent appearancematched to skin color
6
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7
Myoelectric - use intact proximal muscles to give
electromyographic signals to move terminal device
8
body powered use cables and harness to move
terminal device by more proximal muscle movements
9
Hybrid systems - combination of body powered and
myoelectric
10
Terminal devices
  • Voluntary opening hook or hand
  • each rubber band gives 1 lb. force
  • Voluntary closing hook or hand
  • Cosmetic glove
  • Passive hook
  • Otto Bock

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15
Remember...
  • Skin should be unremarkable without irritation 10
    minutes after removal
  • Initial wearing time on new prosthesis 20-30
    minutes
  • if no redness which does not subside in 10
    minutes, increase wearing time by 30 minutes per
    day.
  • gradually increase wear time to develop tissue
    strength
  • wash limb daily
  • wear sock over residual limb

16
Terminal device operation
  • Wrist flexion/extension

17
Supination/pronation
  • Add thin washers to adjust sup/pro
  • Small allen screw adjusts tension on sup/pro

18
Shoulder harness
  • Northwestern ring goes slightly toward uninvolved
    side of back
  • Prosthesis is on this side

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21
AFO - Ankle foot orthosis
22
AFO - Ankle foot orthosis
  • used to limit or assist in dorsiflexion or
    plantarflexion
  • prevent mediolateral motion
  • can be used to prevent or correct deformities or
    contractures
  • when ankle component in plantarflexion, extension
    moment created in knee
  • when ankle in dorsiflexion, flexion moment in
    knee
  • reduce energy expenditure during gait

23
AFOs used on those with...
  • CP
  • foot drop
  • peripheral neuropathy
  • spastic hemiplegia
  • polio
  • MS
  • TBI

24
Pressure Relieving AFO
25
Knee Stabilizing Orthoses
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KAFO - knee ankle foot orthosis
  • Same as AFO component to thigh to limit knee
    motion
  • Used for pts with paralysis or weakness in ankle
    and knee
  • Used to prevent genu recurvatum, genu varum (bow
    leg), or valgus (knock knee)
  • Difficult to don/doff

28
Thoracolumbosacral orthosis
  • Used to stabilize trunk and prevent scoliosis.
  • Reduce compression on intervertebral
  • reduces LBP
  • S/P Scoliosis surgery usually worn 3 months
  • Thoracolumbosacral flexion-extension control
    orthosis - prevents excess flex/ext
  • Thoracolumbosacral flexion-extension-lateral
    control - restricts flex/ext/lateral bending
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