ORTHOSES (M)

1/ The rocker sole can be used to increase bending forces and ease forward
propulsion( reduce ). also used to offloads areas of low planter pressure (high).

2/ Mild rocker sole reduces enough motion at the first metatarsophalangeal

joint. Replace some of the motion lost due to the use of a soft toe plate steel
shank ( rigid).

3/ Toe rocker sole increase weight bearing proximal to the metatarsal heads,
Provides stable midstance and reduces the need for toe plantarflexion on toe-
off. (dorsiflexion)

4/ the mild rocker sole reduce pressure under the metatarsal heads, and assist
gait by easing and increasing forward propulsion.

5/ In principlss of orthotic ,Orthoses should be functional during all phases

of gait. Allow joint movement wherever possible and appropriate.

6/ A wedge is used to help correct flexible deformities of the midfoot and

forefoot (hindfoot). A wedge may be external or internal.

7/ The rocker sole is one of the most commonly prescribed shoe

modifications. the basic function of a rocker sole is to rock the foot From
heel-strike to toe-off without requiring the shoe to bend.

8/ Heel to_toe rocker sole increases heel _ strike forces on the calcaneus,
talus, and tibia (decreases) . Heel to _ toe rocker sole aid in replacement of
motion lost due to the use of a solid ankle Afo.
9/ Heel to-toe rocker sole is appropriate for a patient who has undergone
ankle (arthrodesis). Heel teo rocker sole is allowed for patients who are
experiencing balance issue because this rocker sole has shortest mid stance
(contraindicated)

10/ A metatarsal bar Is an internal modification and is indicated in

metatarsalgia in cases (external) , The bar can be used for forefoot pain
associated with pes cavus .

11/ Double rocker sole makes Unload at midfoot area , Double rocker sole
tend to increase plantar pressure at the midfoot (reduce) .

12/ Heel-to-toe rocker sole is thicker than a mild rocker sole, and has a more
severe rocker angle at heel only. (heel and toes)

13/ Bar with flat surface Placed Posterior to metatarsal heads to relief
Pressure from MT heads .The metatarsal bar is Typically 0,25 inch thick

14/ The orthotic hip joint should be in a position that allows the patient to
sit up right at 90 degrees .The orthotic knee joint shouldn't be centered over
the prominence of the medial femoral condyle.

15/ A flare is an extension and provide stabilization , is not designed to

correct deformity only but to control side to side motion .

16/ Footwear with rocker soles are best known for helping to redistribute
plantar pressures during gait. they also have clinically relevant effects, on
balance and gait.
17/ A lateral heel flare will act as an outrigger ,give the foot wider base of
support and increase the patient's sensation that the ankle is rolling laterally
(decreases) . flare can be add at the heel only or it can run the entire length of
shoe.

18/ Orthotic use only as indicated and for as long as necessary. Orthotic
prevent joint movement wherever possible and appropriate. (allowed)

19/ Heel cushion is a silicone pad with a central extra soft pad. it used to relief
of pressure under painful point .

20/ Metatarsal pad Relief of the pain in the forefoot by distributing the
weight bearing forces to an area proximal to the metatarsal heads. Relief of
pain can be achieved in forefoot by external modification as sesamoid insert.
(internal)

21/ Hallux rigidus occurs when the joint of second teo is stiffens (first). The
mild rocker sole is characterized by a sever rocker angle at both heel and toe.
(mild)

22/ patient compliance will be enhanced if the orthosis comfortable,

functional ,and cosmetic. most orthosis utilize a 2 point system to insure
proper positioning of the limb within the orthosis. (3 point)

23/ The Negative heel rocker sole has a mild heel rocker angle ,and a
significant toe rocker Angle .

24/ A negative heel rocker sole is a bad modification for patients who feel
unstable (good) . Bony prominent with unequal weight bearing will cause
Ulcer.
25/Double rocker sole is a mild rocker sole, which the anterior section of
the sole has been removed (middle) . giving the appearance of 2 rocker soles
one at the forefoot and other under the hindfoot.

26/In toe-only rocker sole: the rocker angle at the toe is significant, The
midstance on this shoe extends to the posterior end of the sole.

27/Toe rocker sole increase weight bearing proximal to the metatarsal heads,
Provides stable midstance and reduces the need for toe plantarflexion on toe-
off. ( dorsiflexion)

28/severe rocker angle at the toe and No heel rock. The purpose of the severe
rocker sole is to: Eliminate weight-bearing forces on the midfoot . (fore foot)

29/TOE ONLY rocker sole Indications include hallux rigidus and metatarsal
head ulcers ,diabetic neuropathy. This rocker sole is suitable for patients with
balance and/or proprioception problems.

30/A metatarsal pad can be placed inside the shoe posterior to the 3,4,5
metatarsal heads as internal modification (2,3,4) . Transfer the weight from
MT head of the 1 Metatarsal head to the shaft and the other metatarsal heads.
( sesamoid ‫(تخص ال‬

1. D 2. A 3. A 4. C 5. C 6. B 7. C 8. B 9. A 10. B

11. A 12. A 13. C 14. A 15. C 16. C 17. B 18. A 19. C 20. A

21. D 22. A 23. C 24. B 25. B 26. C 27. A 28. A 29. C 30. D