Module 7 Clinical Assessment 3 B Foot Orthotic

Module 7 Clinical Assessment 3 B: Foot Orthotic Treatment Plan Lower Limb Orthotics I College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 1 gg

References • Hsu, Michael, Fisk. AAOS Atlas of Orthoses & Assistive Devices, 4 th edition, Chs 23 and 25. • Lusardi and Nielson. Orthotics and Prosthetics in Rehabilitation, 2 nd edition, Ch 9. • Various images from the internet College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 2 gg

Objectives At the completion of this unit, the student should be capable of: • • Explaining the importance of the evaluation to the formulation of a foot orthotic treatment plan. Comparing and contrasting the various image capture techniques used for foot orthoses. Comparing and contrasting the different designs of foot orthoses. Composing a patient education document specific for a foot orthosis. College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 3 gg

Orthotic Treatment • • A. Evaluation B. Capture Technique C. Designs of Foot Orthoses D. Patient Education Document College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 4 gg

A. Evaluation • Comprehensive patient assessments are the cornerstone of successful orthotic treatment. • Comprehensive patient assessments provide the evidence upon which the treatment plan is based and subsequently assessed. College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 5 gg

A. Evaluation Patient Views • Three patient views: – Non-weight bearing – Static weight bearing – Dynamically • Important aspects of a foot evaluation – – – – Skin condition Shape of the foot Range of motion Muscle strength Function in gait Shoe wear Biomechanical Exam Form College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 6 gg

A. 1. Evaluation • Skin – – – Callus Dry Thin and fragile Lost or impaired sensation Intact or open College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 7 gg

A. 2. Evaluation • Foot shape – Cavus – Planus – Forefoot shapes College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 8 gg

A. 3. Evaluation • Range-of-motion – Talocrural – Rear foot = Subtalar – Midfoot = Transverse Tarsals – Forefoot = MTP of First Ray College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 9 gg

A. 4. Evaluation • Manual Muscle Testing – Dorsiflexors – Plantarflexors – Inverters – Everters College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 10 gg

A. 5. Evaluation • Gait Analysis – – – Comparison of left and right Heel rocker, ankle rocker, toe rocker Ankle motion Subtalar motion MTP motion College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 11 gg

A. 6. Evaluation • Shoe Wear – Mid-sole compression – Medial and lateral wall breakdown College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 12 gg

B. Impression-Taking Techniques • Slipper Cast – STJ palpation • Foam Box – STJ palpation – MASS technique – OOS technique • Circumferential Cast – Visual alignment • CAD CAM College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 13 gg

C. Design: Classifications • Purpose – Accommodative – Corrective – Supportive • Materials – Soft – Semi-rigid – Rigid College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 14 gg

C. Design: Length • A. Full – Pros = rear, mid & forefoot control, no migration, no edge pressure – Cons = transferability, shoe fit • B. Toe sulcus – Pros = rear, mid & forefoot control, transferability – Cons = shoe fit, distal edge pressure • C. Proximal metatarsal heads – Pros = rear & mid-foot control, transferability – Cons = forefoot uncontrolled, distal edge pressure College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 15 gg

D. Patient Education Document Patient should always be given verbal and written instructions regarding the orthosis that is being fitted Academy Patient Education Brochure for Foot Orthoses College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 16 gg

The End College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 17 gg

Pedorthic Program of Study This workforce product was funded by a grant awarded by the U. S. Department of Labor’s Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U. S. Department of Labor. The U. S. Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. Produced 2016. HOPE Careers Consortium is a partnership of five institutions of higher education that is building exciting new programs that will provide valuable career education and training in the Orthotics, Prosthetics, and Pedorthics (O&P) sector. The five institutions are: Baker College—Flint, Michigan; Century College—White Bear Lake, Minnesota; Oklahoma State University Institute of Technology—Okmulgee, Oklahoma; Spokane Falls Community College—Spokane, Washington; and St. Petersburg College—St. Petersburg, Florida. Although the authoring institution of this educational resource has made every effort to ensure that the information presented is correct, the institution assumes no liability to any party for any loss, damage, or disruption caused by errors or omissions. Except where otherwise noted, this work by St. Petersburg College is licensed under the Creative Commons Attribution 4. 0 International License. To view a copy of this license, click on the following link: Creative Commons Licenses 4. 0. College of Health Sciences Orthotics & Prosthetics - St. Petersburg College 18 gg