This document provides an overview of orthotics, including: 1. Definitions of key terms like orthosis, orthotist, and pedorthist. 2. A description of the pre-orthotic prescription examination process involving evaluating the patient and identifying functional goals and treatments. 3. Classifications of orthoses based on manufacture, materials used, and biomechanical terminology describing the joints affected and motion control provided. 4. A brief discussion of important mechanical properties to consider for orthotic materials.

1. ORTHOTICS
INTRODUCTION
QURATULAIN MUGHAL
BATCH IV
DOCTOR OF PHYSICAL THERAPY
ISRA UNIVERSITY
1

2. TABLE OF CONTENT
• DEFINITIONS
• PRE-ORTHOTIC PRESCRIPTION EXAMINATION
• CLASSIFICATIONS OF ORTHOSES
• IMPORTANT MECHANICAL PROPERTIES OF
ORTHOTIC MATERIALS
2

3. DEFINITIONS
• ORTHOSIS: (Plural: orthoses) is "an externally applied
device used to modify the structural and functional
characteristics of the neuromuscular and skeletal system
also restrict or assist motion or to transfer load from one
area of the body to another”. Older term brace, is a
synonym.
• ORTHOTIST: Is the health care professional who designs,
fabricates, and fits orthoses.
• ORTHOTICS: (Greek: ορθός, ortho, "to straighten" or
"align") is a specialty within the medical field concerned
with the design, manufacture and application of orthoses.
• PEDORTHIST: is the health care professional who designs,
fabricates, and fits only shoes and foot orthoses.
3

4. PRE-ORTHOTIC PRESCRIPTION
EXAMINATION
1. Examine patient:
• Interview
• Physical examination
• Functional assessment (Biomechanical
analysis)
• Medical records
4

5. 2. Evaluate findings (Identify):
• Pathology
• Impairments
• Functional limitations
• Participation restrictions
• Functional needs
• Client goals
5

6. 3. Identify functional goals
4. Hypothesize— all methods to improve function
• If Orthosis is given then:
a) Develop specific orthotic goals
b) Use biomechanics: How orthoses apply forces
• If Other interventions are given then:
a) Stretching
b) Strengthening
c) CV exercise
d) Functional/gait training
e) Ambulatory aid e.c.t.
6

7. CLASSIFICATIONS OF ORTHOSES
1. Manufacture
2. Materials and components used in
fabrication
3. Biomechanical
terminology
7

8. CLASSIFICATION BY METHOD OF
MANUFACTURE
1. Custom manufactured
• Local manufacturing
• Central manufacturing
2. Prefabricated
• With custom fit (“off the shelf”)
• Without individual fitting (“over the counter”)
8

9. CLASSIFICATION BY TYPES OF
MATERIALS AND COMPONENTS USED
IN FABRICATION
1. Conventional: Primary components and
materials:
• Metal uprights and components
• Uprights attached directly to shoe for most
lower extremity devices
• Leather cuffs; cloth, canvas, or elastic parts
• Made from measurements taken from the
involved limb.
9

10. 2. Molded: Primary components and materials:
• Thermoplastics, thermosetting plastics,
reinforced plastics, and composite materials
• Manufactured over custom mold of client
• Usually total contact design
• Usually made of one piece without moving
parts or joints
• Has a shoe insert that slides into shoe
without attaching for most lower extremity
devices
10

11. 3. Hybrid: Composed of both molded and
conventional materials:
• Limb cuffs, shells, and shoe insert are usually
molded
• Usually has articulations (hinged, moving
joints) that include some nonmolded and
conventional componentry
11

12. Classification by Biomechanical
Terminology
a) Acronym made from the names of the joints
enclosed by the orthosis:
1. Upper Extremity Orthoses
• HdO: Hand orthoses
• WHO: Wrist–hand orthosis
• EWHO: Elbow–wrist–hand orthosis
• EO: Elbow orthosis
• SEWHO: Shoulder–elbow–wrist–hand orthosis
12

13. 2. Lower Extremity Orthoses
• FO: Foot orthosis
• SMO: Supramalleolar orthosis
• AO: Ankle orthosis
• AFO: Ankle–foot orthosis
• KAFO: Knee–ankle–foot orthosis
• KO: Knee orthosis
• HKAFO: Hip–knee–ankle–foot orthosis
• LS-HKAFO: Hip–knee–ankle–foot orthosis with
lumbosacral support
13

14. 3. Spinal Orthoses
• SIO: Sacroiliac orthosis
• LSO: Lumbosacral orthosis
• TLSO: Thoracolumbosacral orthosis
• CTLSO: Cervical thoracolumbosacral orthosis
• CTO: Cervicothoracic orthosis
• CO: Cervical orthosis
14

15. b) Type of biomechanical control exerted by the
orthosis on the limb and joints:
• Free: No control is exerted, and the joint is
free to move in a designated plane.
• Assist: Assists motion by applying an external
force to increase the range, velocity, or force
of a desired motion (eg, a spring, elastic band,
motor, pneumatic force, muscle electrical
stimulation).
• Resist: Resists unwanted motion by applying a
force to decrease the velocity or force of an
undesirable movement.
15

16. • Stop: Stop or limit motion at a joint. The
prescription must indicate the specific motion to
be stopped and when the stop is to occur in the
range of motion (ROM) (eg, an AFO with a
plantarflexion stop at 0°. This orthosis allows the
ankle to plantarflex only to neutral or 0°.)
• Hold: Controls and eliminates all motion at a joint
in all planes. The prescription must indicate the
specific joint position for the hold (eg, AFO to
hold the ankle at 5° dorsiflexion [df] and subtalor
neutral). When the hold is at the ankle, it is often
described as a solid ankle orthosis (eg, AFO-SA at
5° df).
16

17. • Variable: May be used with the terms stop, resist, or
assist to indicate the need for an adjustable system,
with the desired ROM specified (eg, a KO with a
variable stop set at 90° flexion stop and –20° extension
stop).
• Lock: An optional mechanism that when engaged or
“on” holds or locks the joint in a fixed position. When
the lock is disengaged, movement is permitted.
• Deweighting-Weight: An orthotic design that reduces
axial loading through part of a limb. The prescription
includes the amount of loading to be carried by the
orthosis as a percent of normal limb loading
• Relieving: (eg, AFO to reduce axial loading of the
calcaneous 15%).
17

18. Important Mechanical Properties of
Orthotic Materials
• Strength
• Brittleness
• Ductility
• Stiffness
• Elasticity
• Plasticity
• Viscoelasticity
• Hardness
• Density
• Durability or fatigue resistance
• Corrosion resistance
18

19. THANK YOU
19