552 Exam 2 Study Guide
*Orthotics* - ANS-- Know the general categories to describe orthotics and the purpose
of each type
- Recommend orthotics for painful joints, tissue protection and immobilize for healing
- Understand principle of splinting fewest joints possible
- Describe appropriate angle of pull (90 degree) and rationale
- Understand principles related to materials, fit, and safety
What is the purpose for splinting? - ANS-1. Support a painful joint
2. Immobilize
3. Protect healing or damaged tissue
4. Provide stability
5. Restrict unwanted motion
6. Substitute for weak/absent muscles
7. Prevent contractures
8. Correct contractures
9. Increase passive motion
10. Modify tone
Primary Purpose: Immobilization (static) orthosis - ANS-Primary Purpose: provide
support, stabilization, protection or immobilization
-Communicate purpose to patient
-can be for fractures
-serial static orthosis/casting
Ex: hand based thumb spica, short opponents, short thumb (HFO)
Primary Purpose: Serial static orthosis/casting - ANS-"Low load", prolonged duration
stretch, remolding or refabricaiton of orthosis/cast as ROM increases
-communicate purpose to patient 10 to 15 minutes four times a day 10 to 15 degree at a
time
-If wear longer than 10 to 15 it can become more painful
Primary Purpose: Mobilization static orthosis - ANS-*-Anything used to stretch/facilitate
motion
-Purpose is to promote ROM using screws, velcro, hinges*
-includes nonelastic components such as screws, Velcro, turnbuckles, or hinges used to
promote ROM
-adjustments can be made easy by the user typically
,Primary Purpose: Mobilization elastic orthosis - ANS-*-Use moving parts to permit,
control, or restore movement with components such as rubber bands, elastic or springs
*
Ex: dynamic dorsal block, Kleinert (WHFO)
-Radial nerve palsy orthotics (WHFO)
Primary Purpose: Peripheral nerve injuries orthotics - ANS-1. Keep denervated muscles
from remaining in an overstretched position
Ex: prevent wrist drop
2. Prevent joint contractures (Nerve damage, so muscles cant fire like they are
supposed to)
3. Prevent development of substitution patterns
4. Maximize function
Primary Purpose: Status post burn orthotic fabrication - ANS--based on direction and
line of pull of scar
-where is the scar?
-dorsal hand burns have specific protocols due to close proximity to extensor tendons
-can use scar inserts to elongate tissue
-may begin using 5 days (7-10 is recommended) post grafting
Recommend orthotics for painful joints, tissue protection and immobilize for healing -
ANS-- Immobilizer orthotic is best for pain especially CMC thumb arthritis (thumb spica)
- Resting hand orthotic: burns for skin protection and maintenance and pain
- See notes for list of orthotics and specific associated conditions
Understand principle of splinting fewest joints possible - ANS-- You do not want to
immobilize joints unless absolutely necessary. It can cause more harm that good in
terms of decreasing joint mobility, increasing stiffness and potential contractures
Persevering:
muscle strength
muscle integrity
bone intensity
Describe appropriate angle of pull (90 degree) and rationale - ANS-- The direction and
magnitude of the forces applied to a joint or finger are important when applying force to
increase passive ROM. The direction of pull must be at a 90-degree angle to the axis of
the joint and perpendicular to the axis of rotation.
,-As ROM increases adjustments can be made to the outrigger to maintain the
90-degree angle. You don't want the line of pull to be in a medial or lateral direction and
disturb the mobilization of the joint
Understand principles related to materials, fit, and safety: *Materials* - ANS-1. low
temperature thermoplastic
-width preference
-perforated vs non perforated
-highly elastic vs stiff
2. Hybrids (orficast)
3. Plaster of Paris
4. Taping: kinesiotape
5. Neoprene
Understand principles related to materials, fit, and safety: *Fit* - ANS--molding contours:
use of skin creases as guidelines for boundaries
-ID bony prominence and take care to dome out or avoid these areas
-reduce pressure to skin through long lever (long splint)
-support arches both longitudinal and transverse with proper alignment
-if using forces, ensure bone being mobilized is perpendicular to the outrigger
-should rise 2/3 up limb supported
Understand principles related to materials, fit, and safety: *Safety* - ANS--check for
latex free materials
-skin precautions
-pressure precautions
-nerve irritation
-blood vessel irritation
-perfusion: capillary refill
-cognitive status influence compliance
-sensory status
-ability to don/doff
*Neurodegenerative Conditions: GB, MS, ALS, PD* - ANS-- Describe priorities and role
of OT
- Apply precautions for treatment based on disease condition
- Apply specific strategies to enhance performance
- Know guidelines for exercise and strengthening
- Understand patient education needs
, Guillian Barre Syndrome: What is it? - ANS--Everyone has weakness
-It's attack on the bodies nerves
-Quadraplegia (LE & UE weakness)
-Areflexia
-Parasthasia
-Sensory loss
-Sphincter involvement
-Oropharyngeal weakness
-Pain (neurogenic & neuropathic)
-Respiratory failure
-Oculomotor weakness
-Ataxia
-speech & swallowing
-Usually are continent in bowel and bladder
-weakness proximal more than distal
-quadraparesis
-respiratory failure
-sensory loss
Guillian Barre Syndrome: Role of OT (Overall/Acute Care) - ANS--Identified roles of OT
treatment: ADL, IADL, Driving, Return to work
◼ Evidence for OT specific interventions are lacking
Acute Care:
-maintaining ROM
-positioning/splinting
-PROM/AROM
-Electronic aides of daily living
-communication strategies (led by SLP)
-Positioning that they don't get over stretched in that time
-can utilize the iPhone
Guillian Barre Syndrome: Precautions - ANS-None Given
Guillian Barre Syndrome: Specific Strategies to Enhance Performance - ANS-Proximal
Weakness and Distal Mobility
Guillian Barre Syndrome: Guidelines for Exercise and Strengthening -
ANS--Strengthening: allows client to learn to use muscles
-Repair from nerve comes from body
*Orthotics* - ANS-- Know the general categories to describe orthotics and the purpose
of each type
- Recommend orthotics for painful joints, tissue protection and immobilize for healing
- Understand principle of splinting fewest joints possible
- Describe appropriate angle of pull (90 degree) and rationale
- Understand principles related to materials, fit, and safety
What is the purpose for splinting? - ANS-1. Support a painful joint
2. Immobilize
3. Protect healing or damaged tissue
4. Provide stability
5. Restrict unwanted motion
6. Substitute for weak/absent muscles
7. Prevent contractures
8. Correct contractures
9. Increase passive motion
10. Modify tone
Primary Purpose: Immobilization (static) orthosis - ANS-Primary Purpose: provide
support, stabilization, protection or immobilization
-Communicate purpose to patient
-can be for fractures
-serial static orthosis/casting
Ex: hand based thumb spica, short opponents, short thumb (HFO)
Primary Purpose: Serial static orthosis/casting - ANS-"Low load", prolonged duration
stretch, remolding or refabricaiton of orthosis/cast as ROM increases
-communicate purpose to patient 10 to 15 minutes four times a day 10 to 15 degree at a
time
-If wear longer than 10 to 15 it can become more painful
Primary Purpose: Mobilization static orthosis - ANS-*-Anything used to stretch/facilitate
motion
-Purpose is to promote ROM using screws, velcro, hinges*
-includes nonelastic components such as screws, Velcro, turnbuckles, or hinges used to
promote ROM
-adjustments can be made easy by the user typically
,Primary Purpose: Mobilization elastic orthosis - ANS-*-Use moving parts to permit,
control, or restore movement with components such as rubber bands, elastic or springs
*
Ex: dynamic dorsal block, Kleinert (WHFO)
-Radial nerve palsy orthotics (WHFO)
Primary Purpose: Peripheral nerve injuries orthotics - ANS-1. Keep denervated muscles
from remaining in an overstretched position
Ex: prevent wrist drop
2. Prevent joint contractures (Nerve damage, so muscles cant fire like they are
supposed to)
3. Prevent development of substitution patterns
4. Maximize function
Primary Purpose: Status post burn orthotic fabrication - ANS--based on direction and
line of pull of scar
-where is the scar?
-dorsal hand burns have specific protocols due to close proximity to extensor tendons
-can use scar inserts to elongate tissue
-may begin using 5 days (7-10 is recommended) post grafting
Recommend orthotics for painful joints, tissue protection and immobilize for healing -
ANS-- Immobilizer orthotic is best for pain especially CMC thumb arthritis (thumb spica)
- Resting hand orthotic: burns for skin protection and maintenance and pain
- See notes for list of orthotics and specific associated conditions
Understand principle of splinting fewest joints possible - ANS-- You do not want to
immobilize joints unless absolutely necessary. It can cause more harm that good in
terms of decreasing joint mobility, increasing stiffness and potential contractures
Persevering:
muscle strength
muscle integrity
bone intensity
Describe appropriate angle of pull (90 degree) and rationale - ANS-- The direction and
magnitude of the forces applied to a joint or finger are important when applying force to
increase passive ROM. The direction of pull must be at a 90-degree angle to the axis of
the joint and perpendicular to the axis of rotation.
,-As ROM increases adjustments can be made to the outrigger to maintain the
90-degree angle. You don't want the line of pull to be in a medial or lateral direction and
disturb the mobilization of the joint
Understand principles related to materials, fit, and safety: *Materials* - ANS-1. low
temperature thermoplastic
-width preference
-perforated vs non perforated
-highly elastic vs stiff
2. Hybrids (orficast)
3. Plaster of Paris
4. Taping: kinesiotape
5. Neoprene
Understand principles related to materials, fit, and safety: *Fit* - ANS--molding contours:
use of skin creases as guidelines for boundaries
-ID bony prominence and take care to dome out or avoid these areas
-reduce pressure to skin through long lever (long splint)
-support arches both longitudinal and transverse with proper alignment
-if using forces, ensure bone being mobilized is perpendicular to the outrigger
-should rise 2/3 up limb supported
Understand principles related to materials, fit, and safety: *Safety* - ANS--check for
latex free materials
-skin precautions
-pressure precautions
-nerve irritation
-blood vessel irritation
-perfusion: capillary refill
-cognitive status influence compliance
-sensory status
-ability to don/doff
*Neurodegenerative Conditions: GB, MS, ALS, PD* - ANS-- Describe priorities and role
of OT
- Apply precautions for treatment based on disease condition
- Apply specific strategies to enhance performance
- Know guidelines for exercise and strengthening
- Understand patient education needs
, Guillian Barre Syndrome: What is it? - ANS--Everyone has weakness
-It's attack on the bodies nerves
-Quadraplegia (LE & UE weakness)
-Areflexia
-Parasthasia
-Sensory loss
-Sphincter involvement
-Oropharyngeal weakness
-Pain (neurogenic & neuropathic)
-Respiratory failure
-Oculomotor weakness
-Ataxia
-speech & swallowing
-Usually are continent in bowel and bladder
-weakness proximal more than distal
-quadraparesis
-respiratory failure
-sensory loss
Guillian Barre Syndrome: Role of OT (Overall/Acute Care) - ANS--Identified roles of OT
treatment: ADL, IADL, Driving, Return to work
◼ Evidence for OT specific interventions are lacking
Acute Care:
-maintaining ROM
-positioning/splinting
-PROM/AROM
-Electronic aides of daily living
-communication strategies (led by SLP)
-Positioning that they don't get over stretched in that time
-can utilize the iPhone
Guillian Barre Syndrome: Precautions - ANS-None Given
Guillian Barre Syndrome: Specific Strategies to Enhance Performance - ANS-Proximal
Weakness and Distal Mobility
Guillian Barre Syndrome: Guidelines for Exercise and Strengthening -
ANS--Strengthening: allows client to learn to use muscles
-Repair from nerve comes from body
