O&P - 5 - UE Orthoses

complex, variable

functional activities carried out by the UE are more _______ and ______ compared to the LE

mobile

UE joints must be stable to transmit forces but also very _______

task specific

because there is such a wide range of UE tasks, many appliances are ___________

paralysis/weakness, stroke

_________ is one of the primary underlying presentations that requires UE orthoses, with the leading cause being _____

• paralysis/weakness

• post-injury / post-surgery

• pain

• position correction

the four indications for UE orthoses are:

splint classification system

traditional UE nomenclature by form and joint was not precise enough and a bit confusing, so now orthoses are named based on the ______________________

• articular/non-articular

• location

• direction

• purpose

the 4 descriptors used in the splint classification system SCS are:

articular

SCS _________ orthoses cross one or more joints

FALSE; articular is implied if absent

T/F: if a UE orthosis doesn’t say articular or non-articular, non-articular is implied

non-articular

SCS __________ orthoses do not cross a joint but stabilize the body segment to which they are applied

location

SCS _________ describes the specific body part or articular surface included in the orthosis that is the target of treatment

direction

SCS ________ describes the primary route of force and how it is controlling

purpose

SCS ________ is either immobilization, mobilization, or restriction

immobilization

____________ means putting a structure in anatomic or most comfortable resting position, restraining the joint that it crosses

static

immobilization UE orthoses are ______ orthoses

mobilization

__________ means moving or stretching specific soft tissues or joints to facilitate change

serial static, static progressive, dynamic

mobilization UE orthoses can be ________, _______, or _________orthoses

restriction

_________ means limiting or blocking an aspect of motion, potentially allowing motion in one direction while preventing in another

static, dynamic

restriction UE orthoses can be _______ or _______ orthoses

symptom relief, protect

the main purposes of immobilization orthoses are to provide __________ and ________ the area

tissue length, contracture, fracture

immobilization can also help maintain ____________ to prevent ________, preserve joint alignment, and maintain reduction of ________

tissue length

the main purpose of mobilization orthoses is to change __________

soft tissue contractures, adhesions, musculotendon restrictions

mobilization orthoses can be used to elongate ________________, ______________ and ____________

increased

mobilization orthoses can provide (decreased/increased) resistance to exercise

corrective forces

mobilization orthoses can apply _________ to manage deformities

healing

restriction orthoses can limit motion during _______ while still allowing some motion

functional

restriction orthoses assist in __________ use of the hand

TRUE

T/F: static orthoses are the most common

immobilization, restriction

the purposes for static orthoses can be ________ or ________

FALSE; can be articular or non-articular

T/F: static orthoses are articular orthoses

serial static

__________ orthoses are a series of non-adjustable static orthoses

mobilization

the purpose of serial static orthoses is _____________

tension LLPS

serial static orthoses are made to put the target tissue in _______ and worn for extended periods of time

static progressive

______________ orthoses are a single orthosis that is adjustable, applying a low load force at end range in one position over a period of time

mobilization

the purpose of static progressive orthoses is ___________

progressive adjustments

force is altered on static progressive orthoses through _______________

dynamic

_________ orthoses use mobilizing forces that are elastic to get LLPS and mobilize tissue

outrigger

the base of a dynamic orthosis allows for the attachment of _________ components that help apply forces as 90 degrees for effectiveness

static

(dynamic/static) LLPS is preferred when the joint end feel is hard

static

(dynamic/static) LLPS is used for long standing contractures

static

(dynamic/static) LLPS tension produces ROM changes more quickly

dynamic

(dynamic/static) LLPS tension produces ROM changes more slowly

dynamic

(dynamic/static) LLPS may be more tolerable

dynamic

(dynamic/static) LLPS is better earlier on when tissues are still healing

dynamic

(dynamic/static) orthoses may substitute for missing muscle function

tendons

dynamic orthoses are commonly used to protect repaired ________ while healing

inflammatory and proliferative

static orthoses are typically used in the ___________ phase/s of healing

late inflammatory, proliferative, remodeling

serial static orthoses are typically used in the ___________ phase/s of healing

proliferative, remodeling

static progressive orthoses are typically used in the ___________ phase/s of healing

proliferative

dynamic orthoses are typically used in the ___________ phase/s of healing

1 week, immobilization

the inflammatory phase usually lasts ______, and orthoses usually serve the purpose of __________

1-6 weeks, mobilization

the proliferation phase usually lasts ________, and orthoses usually serve the purpose of ________

proliferation

collagen is generated in the ________ phase

remodeling

collagen is organized in the __________ phase

6 week, serial static, static progressive

remodeling usually happens after ______, and _______ and _______ orthoses can be used

circumferential

____________ orthoses encompass the entire circumference of the involved body part or limb segment

gutter

_________ orthoses include either the radial or ulnar portion of the limb on one side

cuff

______ orthoses are a sling or loop

thumb spica

___________ orthoses are a conical shape to immobilize the thumb and adjacent structures

THERMOPLASTIC

____________ is typically the material used for custom UE orthotics

FALSE; relatively fast

T/F: custom UE thermoplastic orthotics have a slow turn-around time to be made

TRUE

T/F: custom UE thermoplastic orthotics can be molded directly on a patient’s limb

surgery, traumatic injury

shoulder orthoses are most often prescribed to support or immobilize the shoulder after ________ or ___________

• sling type immobilizers

• articulated abduction stabilizers

• non-articular splint

the broad categories of shoulder orthoses are: (3)

sling-style

the traditional __________ shoulder orthoses support the shoulder in a non-stressful rest position and reduce inferior pull of the weight of the arm

adduction and internal rotation

traditional sling type shoulder orthoses put the shoulder in ______ and ________

abduction sling

an ___________ shoulder orthosis is used after rotator cuff repair

vascularity

abduction sling shoulder orthoses improve ___________ of surgical tissues

contractures

sling shoulder orthoses can cause elbow or GH _____________

shoulder sublux

there are shoulder orthoses that resist ____________ that are used after stroke

stiffness

elbows are particularly prone to _________ after trauma

immobilize motion, mobilize elbow

elbow orthoses are most commonly used to ___________ or __________ - a balance

articulated

__________ elbow orthoses allow clinicians to set the allowed ROM, or be set at end range for LLPS

non-articulated

___________ elbow orthoses are custom made to immobilize the elbow and extend from the shoulder to the wrist to maximize the lever arm

ulnar neuropathy

____________ can happen after stroke with prolonged elbow flexion

static, dynamic, immobilize, mobilize, restrict

wrist and hand orthoses can be ______ or ________ to __________, _________, or ________ - there’s types for everything

• incr/maintain ROM

• pain

• impaired muscle function

• joint instability

four indications for wrist and hand orthoses are:

TRUE

T/F: small joints are susceptible to trauma when aggressive/forceful stretching is used

immobilization

___________ at the wrist and hand can manage pain in chronic disorders such as OA, carpal tunnel, and chronic joint disorders

median

carpal tunnel syndrome is from compression of the _______ nerve

0 deg of wrist E / neutral

a splint for carpal tunnel should hold the wirst as close to ______________ as possible

confounded

the evidence for carpal tunnel orthoses is ____________ but provides no long term harm

FUNCTIONAL, RESTING

the two main hand positions for orthoses are _________ and _________

grasping an AD

the functional purpose of the functional hand position is _____________

preventing ligament shortening

the functional purpose of the resting hand position is _______________

C

in the functional hand position, the fingers are shaped like the letter ___

L

in the resting hand position, the fingers are shaped like the letter ___

• wrist: 20-30 deg extension

• MCP: 30-45 deg flexion

• PIP: 45 deg flexion

• DIP: relaxed & slightly flexed

the functional position of the hand is:

• wrist: _____________

• MCP: __________

• PIP: ___________

• DIP:__________

• wrist: ~20 deg extension

• MCP: ~90 deg flexion

• PIP: 0 deg extension

• DIP: 0 deg extension

the resting position of the hand is:

• wrist: _____________

• MCP: __________

• PIP: ___________

• DIP:__________

palmar abduction

the position of the thumb for both the resting and functional position of the hand is ______________

fully extended

for the resting position of the hand, keep the IP of the thumb ______________

resting

the (functional/resting) position of the hand provides maintenance of the palmar arch and appropriate adduction of the web space of the thumb

static

(dynamic/static) finger orthoses are typically used for acute injury

static

(dynamic/static) finger orthoses immobilize one or more of the digital joints from MCP to DIP

dynamic

(dynamic/static) finger orthoses provide low load stretching for contracture and counter progressive deformity

prefabricated

finger orthoses are most often __________ and there are so many designs