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Define Orthotics and Prosthetics.
Describe the types of orthoses according to
function.
Discuss the biomechanical principles behind
orthotics and prosthetics.
Differentiate between pre-prosthetic and
Orthotics and Prosthetics prosthetic rehabilitation.
Enumerate the danger signs and drawbacks
of orthotic and prosthetic wear.
An external appliance worn to restrict or
assist motion or to transfer load to one area
to another.
Brace in older terms.
A splint connotes an orthosis intended for
temporary use.
An orthotist is the health care professional
who designs, fabricates, and fits orthoses for
the limb and trunk.
A pedorthist shoes and foot orthoses.
Largest class
Protective Permit patient control on an uncontrollable
segment or on an entire limb
Stabilize joint by preventing unwanted
Corrective motion
Stabilize limbs for weight bearing
Motorized
Stabilization
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Characterized by a motor element designed
to improve function
Replaces lost muscle function
Motor Elements:
Coil or Leaf Spring
Hydraulic Cylinder
Rubber Band and Elastic Straps
Simple design and complex in use Protect or maintain
To realign parts of a limb alignment of a
Relatively high force is required for diseased or injured
correction limb.
Relieves weight or
redistributes the load
on a weight bearing
joint.
1. Forces Forces
Tension
2. Torque Weight
Weight
3. Beam Loading: 3 point Compression
force system
4. Pressure Tolerance of
tissues
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Torque Moment Arm
Tension
Weight
Axis
Moment Arm
Where are the forces acting? What motion will be limited?
A replacement of all or part of the leg or
arm.
It may also be a denture, titanium femoral
head, plastic heart valve, or simply a wig.
A prosthetist is the health care professional
who designs, fabricates, and fits prosthesis.
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1. Moments/ force couples Moments/ force couples
2. Pressure tolerance of tissues
Body weight
(friction, shear, pressure)
3. Alignment of joint axes
4. Stump length related
Ground reaction force
Pressure tolerance of tissues Alignment of joint axes
Trochanter-knee-ankle
alignment
Knee joint posterior to the
greater trochanter and
ankle.
For better stability in
standing.
Pressure tolerant areas are used for
weight bearing and pressure sensitive
areas are avoided.
Stump length related
High level amputation
requires greater
energy expenditure in
PRE-PROSTHETIC GOALS
using prosthesis than
lower level
amputation.
BKA vs. AKA POST- PROSTHETIC GOALS
BEA vs. AEA
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Promote wound healing
Increase strength
Control pain
Test/ Identify muscle sites
Maximize joint ROM
Improve mm site control (if
Assist in psychological already identified)
adjustment to loss
Increase daily living skills
Control stump shaping/ (DLS) independence
shrinkage
☺Physical and Occupational
Orientation Therapy
Control Training ☺Pre-prosthetic program of
Use Training exercise, mobility training &
Daily Living Skill/ post-surgical care
☺Wound Care
Functional Training
☺Psychological counseling
☺Extensive gait training &
instruction in endurance,
balance, mobility & care of the
prosthesis & of the residual
limb
☺On-site selection & custom-
fitting of the prosthesis, with
the involvement of an expert
orthotist & prosthetist
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STRENGTH
Pain
STIFFNESS Pressure sensitive areas
Anesthesia
DURABILITY Nerve impingement/entrapment
Absent Peripheral Pulses
Vascular impingement
DENSITY Brawny Edema
High risk for skin breakdown
EASE OF FABRICATION
Fixed Deformity
Can’t be corrected should be suuported
CORROSION RESISTANCE
Discomfort Difficulty in transfers
Local Pain Psychological and physical dependence
Skin Breakdown Unsightly appearance
Nerve Compression Poor patient compliance
Muscle Atrophy with prolonged use
Decrease pulmonary capacity
Increase in energy expenditure
Difficulty in donning & doffing
