ANKLE FOOT ORTHOSIS INTRODUCTION  To support weight  Proper alignment  Control range and rate of motion  Aids in support

, balance and gait ANKLE FOOT ORTHOSIS € Plastic metal or cobo € Custom-molded € Can interchange shoe, but maintain proper heel height € Ban may cause peroneal neve impingement METAL VS PLATE Consideration: € Edema/swelling € Sensation/skin integrity € Weight limit € Heat € Cosmesis € Shoe choice Carbon fiber/composite € Light weight € Cosmetic € DFA ( Dorsiflexion assist) € Plantarflexion stop € Costly € Difficult to modify Challenge is to allow PF in LR with adequate DF stop for SLS( Strenghthening Light System). Strong but not too rigid STURDY SHOE  It is pre-requisite to most orthosis  It hs an attachment to the shoe by means of stirrup or caliper METAL & METAL/ PLASTIC DESIGN OF STURDY SHOE Components: Shoe or foot attachment € Stirrup- good anatomic alignment € Caliper- pivot at heel, foot and ankle € Shoe insert (foot plate) STIRRUP  Steel is the most common form of attachment to the shoe  It is reverted to the shank of shoe underneath the malleoli  It provide permanent attachment between the uprights and the shoe 2 TYPES OF STIRRUP 1. Split Stirrup 2. Solid Stirrup

CALF BANDS AND CUFFS € It is sufficient to mild dorsiflexors weakness.CALIPER  A round tube placed in the heel of the shoe  It allows easy shoe interchangeability with minimum weight. slight upright is located medially.paralysis and instability Varus/ Valgus Controls € VALGUS: strap attached to shoe medially. secure orthosis to the limb provides a reaction point for the application of force. laterally and posteriorly € Its calf adds rigidity to the orthosis. . is commonly in foot drop which restrict PF but allow unlimited DF  DF (anterior) stop . is used in weak PF providing reverse function in restricting DF but allow PF LIMITED MOTION STOP  It is often prescribed when there is extensive involvement of the ankle musculature  It allows 5 degrees plantarfelxion and dorsiflexion  As patient dorsiflexes the anterior gap closes to prevent motion FREE MOTION ANKLE JOINT  Used not only to restrain movement of PF and DF while providing only mediolateral control ANKLE HIP/ STOP  Double adjustable ankle joint  Adjustable for ROM and degree of stop METALS AND METAL/ PLASTIC DESIGN Ankle Joint Assist € Uses springs to assist motion € Contraindicated for severe spasticity . UCBL  University of California Biomechanics Laboratory  Rigid plastic total contact design  Hindfoot midfoot correction  Heel cup extends proximal to inframalleolus area and distally to the metatarsal heads  Its side walls provides maximal control and support to the foot ANKLE AND JOINT CONTROL  Ankle joint have stop and assist to allow for predetermined ROM or free motion ANKLE STOP  A limited stop may be set in the ankle joint to allow predetermined ROM  PF (posterior) stop. buckles around lateral upright € VARUS: opposite UPRIGHTS. maintains proper alignment of the uprights.

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