552 EXAM 2 STUDY GUIDE
*Orthotics*6-6ans---
6Know6the6general6categories6to6describe6orthotics6and6the6purpose6of6each6type
-6Recommend6orthotics6for6painful6joints,6tissue6protection6and6immobilize6for6healing
-6Understand6principle6of6splinting6fewest6joints6possible
-6Describe6appropriate6angle6of6pull6(906degree)6and6rationale
-6Understand6principles6related6to6materials,6fit,6and6safety
What6is6the6purpose6for6splinting?6-6ans--1.6Support6a6painful6joint
2.6Immobilize
3.6Protect6healing6or6damaged6tissue
4.6Provide6stability
5.6Restrict6unwanted6motion
6.6Substitute6for6weak/absent6muscles
7.6Prevent6contractures
8.6Correct6contractures
9.6Increase6passive6motion6
10.6Modify6tone
Primary6Purpose:6Immobilization6(static)6orthosis6-6ans--
Primary6Purpose:6provide6support,6stabilization,6protection6or6immobilization6
-Communicate6purpose6to6patient6
-can6be6for6fractures
-serial6static6orthosis/casting6
Ex:6hand6based6thumb6spica,6short6opponents,6short6thumb6(HFO)
Primary6Purpose:6Serial6static6orthosis/casting6-
6ans--"Low6load",6prolonged6duration6stretch,6remolding6or6refabricaiton6of6orthosis/
cast6as6ROM6increases
-
communicate6purpose6to6patient6106to6156minutes6four6times6a6day6106to6156degree6at6a6
time
-If6wear6longer6than6106to6156it6can6become6more6painful
Primary6Purpose:6Mobilization6static6orthosis6-6ans--*-Anything6used6to6stretch/
facilitate6motion
-Purpose6is6to6promote6ROM6using6screws,6velcro,6hinges*
-
includes6nonelastic6components6such6as6screws,6Velcro,6turnbuckles,6or6hinges6used6to6
promote6ROM
,-adjustments6can6be6made6easy6by6the6user6typically
Primary6Purpose:6Mobilization6elastic6orthosis6-6ans--*-
Use6moving6parts6to6permit,6control,6or6restore6movement6with6components6such6as6rub
ber6bands,6elastic6or6springs6*
Ex:6dynamic6dorsal6block,6Kleinert6(WHFO)
-Radial6nerve6palsy6orthotics6(WHFO)
Primary6Purpose:6Peripheral6nerve6injuries6orthotics6-6ans--
1.6Keep6denervated6muscles6from6remaining6in6an6overstretched6position6
Ex:6prevent6wrist6drop
2.6Prevent6joint6contractures6(Nerve6damage,6so6muscles6cant6fire6like6they6are6suppose
d6to)
3.6Prevent6development6of6substitution6patterns6
4.6Maximize6function
Primary6Purpose:6Status6post6burn6orthotic6fabrication6-6ans---
based6on6direction6and6line6of6pull6of6scar
-where6is6the6scar?
-dorsal6hand6burns6have6specific6protocols6due6to6close6proximity6to6extensor6tendons6
-can6use6scar6inserts6to6elongate6tissue
-may6begin6using656days6(7-106is6recommended)6post6grafting
Recommend6orthotics6for6painful6joints,6tissue6protection6and6immobilize6for6healing6-
6ans---6Immobilizer6orthotic6is6best6for6pain6especially6CMC6thumb6arthritis6(thumb6spica)
-6Resting6hand6orthotic:6burns6for6skin6protection6and6maintenance6and6pain
-6See6notes6for6list6of6orthotics6and6specific6associated6conditions
Understand6principle6of6splinting6fewest6joints6possible6-6ans---
6You6do6not6want6to6immobilize6joints6unless6absolutely6necessary.6It6can6cause6more6ha
rm6that6good6in6terms6of6decreasing6joint6mobility,6increasing6stiffness6and6potential6cont
ractures
Persevering:6
muscle6strength
muscle6integrity
bone6intensity
Describe6appropriate6angle6of6pull6(906degree)6and6rationale6-6ans---
6The6direction6and6magnitude6of6the6forces6applied6to6a6joint6or6finger6are6important6whe
n6applying6force6to6increase6passive6ROM.6The6direction6of6pull6must6be6at6a690-
degree6angle6to6the6axis6of6the6joint6and6perpendicular6to6the6axis6of6rotation.6
-As6ROM6increases6adjustments6can6be6made6to6the6outrigger6to6maintain6the690-
degree6angle.6You6don't6want6the6line6of6pull6to6be6in6a6medial6or6lateral6direction6and6dis
turb6the6mobilization6of6the6joint
,Understand6principles6related6to6materials,6fit,6and6safety:6*Materials*6-6ans--
1.6low6temperature6thermoplastic6
-width6preference6
-perforated6vs6non6perforated
-highly6elastic6vs6stiff
2.6Hybrids6(orficast)
3.6Plaster6of6Paris
4.6Taping:6kinesiotape
5.6Neoprene
Understand6principles6related6to6materials,6fit,6and6safety:6*Fit*6-6ans---
molding6contours:6use6of6skin6creases6as6guidelines6for6boundaries6
-ID6bony6prominence6and6take6care6to6dome6out6or6avoid6these6areas
-reduce6pressure6to6skin6through6long6lever6(long6splint)
-support6arches6both6longitudinal6and6transverse6with6proper6alignment
-if6using6forces,6ensure6bone6being6mobilized6is6perpendicular6to6the6outrigger6
-should6rise62/36up6limb6supported
Understand6principles6related6to6materials,6fit,6and6safety:6*Safety*6-6ans---
check6for6latex6free6materials6
-skin6precautions6
-pressure6precautions6
-nerve6irritation6
-blood6vessel6irritation6
-perfusion:6capillary6refill
-cognitive6status6influence6compliance6
-sensory6status
-ability6to6don/doff
*Neurodegenerative6Conditions:6GB,6MS,6ALS,6PD*6-6ans---
6Describe6priorities6and6role6of6OT
-6Apply6precautions6for6treatment6based6on6disease6condition
-6Apply6specific6strategies6to6enhance6performance
-6Know6guidelines6for6exercise6and6strengthening
-6Understand6patient6education6needs
Guillian6Barre6Syndrome:6What6is6it?6-6ans---Everyone6has6weakness
-It's6attack6on6the6bodies6nerves
-Quadraplegia6(LE6&6UE6weakness)6
-Areflexia
-Parasthasia
-Sensory6loss
-Sphincter6involvement6
-Oropharyngeal6weakness
-Pain6(neurogenic6&6neuropathic)
-Respiratory6failure6
, -Oculomotor6weakness
-Ataxia6
-speech6&6swallowing
-Usually6are6continent6in6bowel6and6bladder
-weakness6proximal6more6than6distal6
-quadraparesis
-respiratory6failure6
-sensory6loss
Guillian6Barre6Syndrome:6Role6of6OT6(Overall/Acute6Care)6-6ans---
Identified6roles6of6OT6treatment:6ADL,6IADL,6Driving,6Return6to6work
◼6Evidence6for6OT6specific6interventions6are6lacking
Acute6Care:
-maintaining6ROM
-positioning/splinting6
-PROM/AROM
-Electronic6aides6of6daily6living6
-communication6strategies6(led6by6SLP)
-Positioning6that6they6don't6get6over6stretched6in6that6time
-can6utilize6the6iPhone
Guillian6Barre6Syndrome:6Precautions6-6ans--None6Given
Guillian6Barre6Syndrome:6Specific6Strategies6to6Enhance6Performance6-6ans--
Proximal6Weakness6and6Distal6Mobility
Guillian6Barre6Syndrome:6Guidelines6for6Exercise6and6Strengthening6-6ans---
Strengthening:6allows6client6to6learn6to6use6muscles
-Repair6from6nerve6comes6from6body
-therapeutic6strengthening6does6not6facilitate6nerve6repair6
-allows6client6to6learn6optimal6use/control6of6muscles6while6nerves6are6repairing
-AROM:6initially6low6weight6with6low6repetitions6
-progress6in6repetitions6before6increasing6weights
-protect6the6joints/muscles6that6are6weak6and6hyporeflexive6
*-exercise6to6exhaustion6will6delay6recovery*
-progress6to6task6specific6training6(function)6as6soon6as6able
Guillian6Barre6Syndrome:6Patient6Education6Needs6-6ans--
Should6leave6with6very6little6residual6effects
Amyotrophic6Lateral6Sclerosis6(ALS):6What6is6it?6-6ans---
ALS6is6a6progressive6neuro6degenerative6disease6and6it6is6fatal
-Diagnosis6to6death6is6about626years
*Orthotics*6-6ans---
6Know6the6general6categories6to6describe6orthotics6and6the6purpose6of6each6type
-6Recommend6orthotics6for6painful6joints,6tissue6protection6and6immobilize6for6healing
-6Understand6principle6of6splinting6fewest6joints6possible
-6Describe6appropriate6angle6of6pull6(906degree)6and6rationale
-6Understand6principles6related6to6materials,6fit,6and6safety
What6is6the6purpose6for6splinting?6-6ans--1.6Support6a6painful6joint
2.6Immobilize
3.6Protect6healing6or6damaged6tissue
4.6Provide6stability
5.6Restrict6unwanted6motion
6.6Substitute6for6weak/absent6muscles
7.6Prevent6contractures
8.6Correct6contractures
9.6Increase6passive6motion6
10.6Modify6tone
Primary6Purpose:6Immobilization6(static)6orthosis6-6ans--
Primary6Purpose:6provide6support,6stabilization,6protection6or6immobilization6
-Communicate6purpose6to6patient6
-can6be6for6fractures
-serial6static6orthosis/casting6
Ex:6hand6based6thumb6spica,6short6opponents,6short6thumb6(HFO)
Primary6Purpose:6Serial6static6orthosis/casting6-
6ans--"Low6load",6prolonged6duration6stretch,6remolding6or6refabricaiton6of6orthosis/
cast6as6ROM6increases
-
communicate6purpose6to6patient6106to6156minutes6four6times6a6day6106to6156degree6at6a6
time
-If6wear6longer6than6106to6156it6can6become6more6painful
Primary6Purpose:6Mobilization6static6orthosis6-6ans--*-Anything6used6to6stretch/
facilitate6motion
-Purpose6is6to6promote6ROM6using6screws,6velcro,6hinges*
-
includes6nonelastic6components6such6as6screws,6Velcro,6turnbuckles,6or6hinges6used6to6
promote6ROM
,-adjustments6can6be6made6easy6by6the6user6typically
Primary6Purpose:6Mobilization6elastic6orthosis6-6ans--*-
Use6moving6parts6to6permit,6control,6or6restore6movement6with6components6such6as6rub
ber6bands,6elastic6or6springs6*
Ex:6dynamic6dorsal6block,6Kleinert6(WHFO)
-Radial6nerve6palsy6orthotics6(WHFO)
Primary6Purpose:6Peripheral6nerve6injuries6orthotics6-6ans--
1.6Keep6denervated6muscles6from6remaining6in6an6overstretched6position6
Ex:6prevent6wrist6drop
2.6Prevent6joint6contractures6(Nerve6damage,6so6muscles6cant6fire6like6they6are6suppose
d6to)
3.6Prevent6development6of6substitution6patterns6
4.6Maximize6function
Primary6Purpose:6Status6post6burn6orthotic6fabrication6-6ans---
based6on6direction6and6line6of6pull6of6scar
-where6is6the6scar?
-dorsal6hand6burns6have6specific6protocols6due6to6close6proximity6to6extensor6tendons6
-can6use6scar6inserts6to6elongate6tissue
-may6begin6using656days6(7-106is6recommended)6post6grafting
Recommend6orthotics6for6painful6joints,6tissue6protection6and6immobilize6for6healing6-
6ans---6Immobilizer6orthotic6is6best6for6pain6especially6CMC6thumb6arthritis6(thumb6spica)
-6Resting6hand6orthotic:6burns6for6skin6protection6and6maintenance6and6pain
-6See6notes6for6list6of6orthotics6and6specific6associated6conditions
Understand6principle6of6splinting6fewest6joints6possible6-6ans---
6You6do6not6want6to6immobilize6joints6unless6absolutely6necessary.6It6can6cause6more6ha
rm6that6good6in6terms6of6decreasing6joint6mobility,6increasing6stiffness6and6potential6cont
ractures
Persevering:6
muscle6strength
muscle6integrity
bone6intensity
Describe6appropriate6angle6of6pull6(906degree)6and6rationale6-6ans---
6The6direction6and6magnitude6of6the6forces6applied6to6a6joint6or6finger6are6important6whe
n6applying6force6to6increase6passive6ROM.6The6direction6of6pull6must6be6at6a690-
degree6angle6to6the6axis6of6the6joint6and6perpendicular6to6the6axis6of6rotation.6
-As6ROM6increases6adjustments6can6be6made6to6the6outrigger6to6maintain6the690-
degree6angle.6You6don't6want6the6line6of6pull6to6be6in6a6medial6or6lateral6direction6and6dis
turb6the6mobilization6of6the6joint
,Understand6principles6related6to6materials,6fit,6and6safety:6*Materials*6-6ans--
1.6low6temperature6thermoplastic6
-width6preference6
-perforated6vs6non6perforated
-highly6elastic6vs6stiff
2.6Hybrids6(orficast)
3.6Plaster6of6Paris
4.6Taping:6kinesiotape
5.6Neoprene
Understand6principles6related6to6materials,6fit,6and6safety:6*Fit*6-6ans---
molding6contours:6use6of6skin6creases6as6guidelines6for6boundaries6
-ID6bony6prominence6and6take6care6to6dome6out6or6avoid6these6areas
-reduce6pressure6to6skin6through6long6lever6(long6splint)
-support6arches6both6longitudinal6and6transverse6with6proper6alignment
-if6using6forces,6ensure6bone6being6mobilized6is6perpendicular6to6the6outrigger6
-should6rise62/36up6limb6supported
Understand6principles6related6to6materials,6fit,6and6safety:6*Safety*6-6ans---
check6for6latex6free6materials6
-skin6precautions6
-pressure6precautions6
-nerve6irritation6
-blood6vessel6irritation6
-perfusion:6capillary6refill
-cognitive6status6influence6compliance6
-sensory6status
-ability6to6don/doff
*Neurodegenerative6Conditions:6GB,6MS,6ALS,6PD*6-6ans---
6Describe6priorities6and6role6of6OT
-6Apply6precautions6for6treatment6based6on6disease6condition
-6Apply6specific6strategies6to6enhance6performance
-6Know6guidelines6for6exercise6and6strengthening
-6Understand6patient6education6needs
Guillian6Barre6Syndrome:6What6is6it?6-6ans---Everyone6has6weakness
-It's6attack6on6the6bodies6nerves
-Quadraplegia6(LE6&6UE6weakness)6
-Areflexia
-Parasthasia
-Sensory6loss
-Sphincter6involvement6
-Oropharyngeal6weakness
-Pain6(neurogenic6&6neuropathic)
-Respiratory6failure6
, -Oculomotor6weakness
-Ataxia6
-speech6&6swallowing
-Usually6are6continent6in6bowel6and6bladder
-weakness6proximal6more6than6distal6
-quadraparesis
-respiratory6failure6
-sensory6loss
Guillian6Barre6Syndrome:6Role6of6OT6(Overall/Acute6Care)6-6ans---
Identified6roles6of6OT6treatment:6ADL,6IADL,6Driving,6Return6to6work
◼6Evidence6for6OT6specific6interventions6are6lacking
Acute6Care:
-maintaining6ROM
-positioning/splinting6
-PROM/AROM
-Electronic6aides6of6daily6living6
-communication6strategies6(led6by6SLP)
-Positioning6that6they6don't6get6over6stretched6in6that6time
-can6utilize6the6iPhone
Guillian6Barre6Syndrome:6Precautions6-6ans--None6Given
Guillian6Barre6Syndrome:6Specific6Strategies6to6Enhance6Performance6-6ans--
Proximal6Weakness6and6Distal6Mobility
Guillian6Barre6Syndrome:6Guidelines6for6Exercise6and6Strengthening6-6ans---
Strengthening:6allows6client6to6learn6to6use6muscles
-Repair6from6nerve6comes6from6body
-therapeutic6strengthening6does6not6facilitate6nerve6repair6
-allows6client6to6learn6optimal6use/control6of6muscles6while6nerves6are6repairing
-AROM:6initially6low6weight6with6low6repetitions6
-progress6in6repetitions6before6increasing6weights
-protect6the6joints/muscles6that6are6weak6and6hyporeflexive6
*-exercise6to6exhaustion6will6delay6recovery*
-progress6to6task6specific6training6(function)6as6soon6as6able
Guillian6Barre6Syndrome:6Patient6Education6Needs6-6ans--
Should6leave6with6very6little6residual6effects
Amyotrophic6Lateral6Sclerosis6(ALS):6What6is6it?6-6ans---
ALS6is6a6progressive6neuro6degenerative6disease6and6it6is6fatal
-Diagnosis6to6death6is6about626years
