Grand Pracs

Soft Collar

Soft Collar

- most comfortable of the available cervical collars

- this type of cervical orthosis does little to restrict motions

- kinesthetic function of only

- the collar is usually a narrow block of foam rubber material covered with stockinette or knitted material, and it is closed around the neck with velcro

- it is used primarily as a comfortable reminder to the patient to limit exaggerated neck movements

Reinforced Collar

- has an outer plastic/semi regid frame and an inner soft pad or closed cell foam shell that interfaces with the skin

- functions:

• mechanical restriction

• sensory feedback

• retains body heat which may aid healing of soft tissue and reduce muscle spasm

Philadelphia Collar

- designed to control motion

- composed of:

• rigid anterior and posterior plastic strips that covers more part of the head and neck

• terminates superiorly over the mandible and occiput

• terminates inferiorly at at the thorax

- functions:

• limit neck motions and retains body heat

• greater restriction against cervical flexion and extension

• more selective adjustment of head position than soft collar

Cuirass

- extend superiorly over the chin, mandible and occiput

- inferiorly may extend up to 1 inc above IAS or further downward towards the inferior coastal margin

Minerva

- orthosis that encloses the skull

- it also includes: forehead band and body jacket

- light weights than the halo vest; no pins (no “invasive” support)

- less restriction of motion compared to halo vest

Halo

- provides greatest control of all cervical appliances

- composed of:

• halo ring

• distraction rods

• shoulder bars

• distal fixation

- functions:

• rigidly fixates the head with respect to thorax

• spinal stabilization

• reduces the load of the head

Sterno Occipital Mandibular Immobilizer

- composed of:

• occipital support

• anterior upright

- can be easily applied even when patient is in supine position

- control flexion, rotation, extension (although significantly less)

- modified version: polyethylene and dacron skull strap substitute mandibular support

- modification in spina jacket for increasing control over the vertebral column

Posterior Appliance

- composed of:

• sternal plate

• one or two upright anteriorly

• mandibular support

• interscapular plate

• one or two uprights posteriorly

• occipital support

• axillary straps for added stability

- functions:

• restrict flexion and extension of the head and cervical spine by forces from the mandible and occiput

• limits lateral flexion and rotation by forces at the mandibular and occipital support

• relieve of weight from the head

Chairback

- components:

• lumbosacral posterior uprights

• pelvic and thoracic band

• full front abdominal support

- functions:

• restrict trunk flexion and extension

Knight

- components:

• lumbosacral posterior uprights

• pelvic and thoracic band

• full front abdominal support

• lateral uprights

- functions:

• restrict flexion, extension, and lateral flexion

Williams

- components:

• pelvic and thoracic band

• lateral uprights

• oblique lateral uprights

• abdominal pads

- functions:

• restrict extension and lateral flexion

Taylor

- components:

• TLS posterior uprights

• intrascapular band

• full front abdominal support

• axillary straps

- functions:

• restrict flexion and extension

Knight Taylor

- components:

• TLS posterior uprights

• intrascapular band

• full front abdominal support

• axillary straps

• lateral uprights

- functions:

• restrict flexion, extension, and lateral flexion

Cowhorn

- components:

• pelvic and thoracic band

• posterior uprights

• lateral uprights

• abdominal support

• cowhorn extension

- functions:

• restrict flexion, extension (lumbar only), lateral flexion, and rotation

Ant. Hyperextension (Jewett or CASH)

- components:

• anterior and lateral torso grame

• lateral, sternal, suprapubic, and thoracolumbar pads

- functions:

• restrict flexion

Plastic Body Jacket

- restrict all motion of the trunk

- provides maximum/highest orthotic immobilization and control of the spine

Sacroiliac Orthosis

- provides anterior and lateral containment and assists in the restriction of some pelvic flexion and extension

- compresses the pelvis

Milwaukee

- control or correct spinal curvature

- for curves above T7 and 25-40 degrees superior to T8

Boston and Wilmington

- prevent curve progression

- stabilize the spine

- for curves below T8 and 25-35 degrees with apex of T7

Miami

- to reduce and prevent the progression of thoracolumbar and thoracic curves

- for curves of 25-35 degrees with apex T7 or lower

NYOH

- to reduce and prevent the progression of curves

- for low thoracic curve

Shoe Inserts

- permits the pt. to transfer the orthosis from shoe to shoe

- may also reduce the gait unsteadiness

Tapered Heels

- reduces impact shock and shear, thus protecting painful or insensitive feet

- limits longitudinal arch and prevent pes planus

University of California Biomechanics Laboratory Foot Orthosis

controls hindfoot valgus and limits subtalar motion.

Metatarsal Pad

- it provides support to the arches

- reduces the pressure on the ball of the foot, and sometimes on the arches

Metatarsal Bar

at a late stance, the bar transfers stress from the MTP joints to the metatarsal shaft.

Rocker Bar

reduces the distance the wearer must travel during stance phase, improving late stance, as well as shifting load from the MTP joints to the metatarsal shaft.

Heel Wedge

- alters alignment of the rear foot

- realigns pes valgus and pes varus

Flare

- not intended to correct deformity but to control motion

- provide support for the foot to prevent it from collapsing to the ground

Solid Ankle Cushion Heel

absorb more impact and limit ankle and tarsal motion better; it will make the transition between heel strike to foot-flat slower.

Thomas Heel and Reverse Thomas Heel

produce inversion of the forefoot.

Finger Orthosis (DIP)

- limit the motion

• either static or dynamic

• volar, dorsal, or joint crossed

Finger Orthosis (PIP)

- provide three point static control to prevent certain position and allow movement in the opposite position

- the combination of static control in both surfaces immobilizes the finger

Universal Cuff

- can be used associate to devices (e.g. spoon assistive device)

- accommodates eating utensils and writing instruments, assisting with daily functions

Wrist Cock Up Splint

- maintain the wrist in the neutral or mildly extended position

- immobilizes the wrist while allowing MCP flexion and thumb mobility

- allows for functional mobility/activities

Dorsal Wrist Cock Up Splint

- stronger mechanical support of wrist and freeing up some of the palmar pressure for sensory input

- distributes pressure over the larger dorsal wrist surface area

- better tolerated by edematous hand

Resting Hand Splint

- immobilizes to reduce symptoms during wrist movements like radial and ulnar deviation

- retard further deformity

Thumb Spica Splint

- help stabilize CMC, MCP, and IP joints

- resists flexion, extension, abduction, adduction, and opposition of the thumb

Antispasticity Splint

- allows space for the fingers and thumb to move (finger spreader)

- provides holding position to the certain joints (cones)

Dynamic Finger Extension Splint

- immobilizes the wrist in functional position

- passively extend the MCP to 0

- permits full active MCP flexion and unrestricted IP motion

Dynamic Wrist Extension Splint

- passively extends the wrist while allowing wrist flexion

- to prevent contracture of unopposed, innervated wrist flexors

Dynamic Ulnar Nerve Splint

- passively flex the 4th and 5th MCPs

- prevent shortening of the MCP collateral ligament

- promote active IP flexion

Capener Splint

- passively extend the PIP’

- allows active IP flexion

- provide stability to PIP

Anti Microstomial Splint

- apply stretch to tissues surrounding the oral cavity while permitting speech

- to prevent contracture of lip and buccal tissues

Static Dorsal Elbow Orthosis

Shoulder Slings

Humeral Fracture Brace

Airplane Splint

Foot Plate

- provides best control of the foot because internal modifications can be incorporated

- permits interchanging of shoes

- facilitates donning

Stirrup

- types:

• solid - provides maximum stability of the orthosis to the shoe; not movable

• split - 3 segments: 1 sole plate, 2 calipers; simplifies donning and doffing of orthosis

Foot Control (Valgus/Varus Correction Strap)

for varus or valgus correction of the foot

Posterior Leaf Spring

- address weak dorsiflexion

- resists plantarflexion at heel strike and swing

Solid Ankle Foot Orthosis

- excellent stability anterior and posterior

- for plantarflexion spasticity, genu recurvatum, and knee instability

Spiral

- controls all motion, allows leg to rotate in transverse plane

- mediodistal

Hemispiral

- greater control in equinovarus (club foot) foot

- laterodistal

Ankle Foot Orthosis with Flange

provides maximum valgus or varus control.

Ground Reaction Ankle Foot Orthosis

proximal portion influences knee throughout gait.

Orthotic Oregon System

with corrugations, and BICAAL ankle joints.

Tone Reducing Ankle Foot Orthosis

modify reflex hypertonicity by constant pressure to plantarflexors and inverters

Single Upright Orthosis

has thigh and pretibial cuffs made of molded plastic.

Scott Craig Orthosis

for paraplegic patient L1 level or higher.

Supracondylar Knee Ankle Foot Orthosis

- resists recurvatum and provide mediolateral stability

- limits subtalar motion and immobilizes ankle into slight equinus

- cannot be used bilaterally

THKAFO

- LSO + KAFO

- very difficult to done and cumbersome = poor pt. compliance

Chopat Brace

foam padded infrapatellar strap encircles the knee below the patella.

Palumbo

- elastic sleeve with patella cutout

- 2 rubber straps provide tension to the crescent shaped patellar pad and elastic counterforce strap to maintain pad position and prevent axial rotation of the device

Swedish Knee Cage

- for genu recurvatum

- has 2 anterior and 1 posterior straps

CARS UBC Orthosis

- for genu valgum/varum

- support is provided by lateral/medial telescoping rods with straps in the opposite sides respectively

Lerman Multigamentous Knee Control Orthosis

both utilize elastic straps that encircle the leg and thigh and provide forces to provide rotational control.

Hip Orthosis

- usual design address adductor spasticity

- also used by patient that had hip replacement during convalescence

Patellar Tendon Bearing Orthosis

pressure on the patellar tendon and tibial flare.

Ischial Weight Bearing Orthosis

pressure is on the ischial tuberosity.

Patten Bottom

for elimination of weight bearing.

Dennis Browne Splint

correct angular and rotational deformities.

A frame

correct angular and rotational deformities.

Torsion Shaft Orthosis

correct angular and rotational deformities.

Van Rosen Splint

for hip control.

ILFELD Splint

for hip control.

Pavlik Harness

for hip control.

Trilateral Orthosis

to prevent and counter the impairments of LCPD.

Toronto Orthosis

to prevent and counter the impairments of LCPD.

Scottish Rite Orthosis

to prevent and counter the impairments of LCPD.

Standing Frame

- initial use: 8-15 months

Swivel Walker

for both children and adult

Parapodium

- initial use: 2-5 years

- it permits the wearer to sit

- may keep the knees locked while the child unlock the hip for leaning forward

Reciprocating Gait Orthosis

- initial use: 3-6 years

- provide contralateral hip extension with ipsilateral hip flexion