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Orthopaedic Equipment

Orthopaedic Equipment. EO 002.12. Learning Objectives. The physical therapist technician will be able to: Fit a patient with a variety of orthopaedic equipment including: Splints Braces Orthoses Tape Gait aids Adjust various orthopaedic equipment

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Orthopaedic Equipment

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  1. Orthopaedic Equipment EO 002.12

  2. Learning Objectives • The physical therapist technician will be able to: • Fit a patient with a variety of orthopaedic equipment including: • Splints • Braces • Orthoses • Tape • Gait aids • Adjust various orthopaedic equipment • Educate patients on the proper use of various orthopaedic equipment

  3. Orthopaedic Equipment • A variety of structural devices designed to stabilize, protect, and/or correct orthopaedic disorders • Mainly used in the branch of health care known as orthopaedics • Medical specialty dealing with the musculoskeletal system • Usually limit or prevent movement, or hold a body part in a certain position to prevent further injury or deformation, and allow healthy and normal healing/development to occur

  4. Orthopaedic Equipment • Common forms of orthopaedic equipment include: • Splints • Braces • Orthoses • Tape • Gait Aids: • Wheelchairs • Canes • Crutches • Walkers

  5. Splints • A device used for support or immobilization of limbs or of the spine • Involves application of a support held in place by an elastic bandage • Usually used in emergency situations • Allows for the natural swelling that occurs during the acute inflammatory phase of an injury • Are easily removed for inspection of the injury site • Disadvantages include lack of patient compliance resulting in increased motion at the injury site

  6. Braces • Protect, stabilize, support and correct injuries or abnormal alignment during the process of rehabilitation and recovery • Meant to correct or support an injured limb or torso for an indefinite period of time • Usually applied to tears and sprains, but may occasionally be utilized in the rehabilitation of broken bones • Most often for therapeutic use and it is meant to be used for a longer time

  7. Orthoses • Orthopaedic appliances used to support, align, prevent, or correct deformities, or to improve function of movable parts of the body • Includes braces and splints • Are often custom made to the patients body

  8. Athletic Tape • Limits the abnormal or excessive movement of a structure while also providing support • Often used after an injury such as a sprain or strain • Also used to apply compressive forces to an injury site • Requires detailed knowledge anatomy and biomechanics • Used in conjunction with the rehabilitation program whose goals are to restore ROM, strength and motor control.

  9. Tape Continued . . . • Tape is used for: • Prevention • Assessment • Therapy/Rehabilitation • Taping requires the knowledge of: • Origin and insertion of the target tissue • Direction of the target tissue • The role of the target tissue

  10. Taping Continued . . . • For successful taping, there are some basic skills and knowledge that are required: • Knowledge of anatomy and biomechanics • Knowledge of the mechanisms of common injuries • An ability to determine the appropriate technique for a given injury • Knowledge of basic taping techniques • Therefore, taping is a specialized skill that requires further education and training

  11. Gait Aids • Devices designed to assist walking or improve impaired mobility • Type of aid based on the patient’s weight bearing status, conditioning, functionality and needs • Provide gait aids for: • Weight bearing • Balance • Motor pattern • Confidence • Endurance

  12. Gait Aid Function • Gait aids can: • Decrease pain • Decrease weight bearing on involved limbs • Allow for compensation when there are decreases in: • Coordination • Endurance • Balance • Strength

  13. Wheelchairs • A mobile chair used by individuals who have impairments that limit their ability to walk • The right wheelchair should maximize patient mobility and functional potential as well as prevent co-morbidity and restriction of remaining functional capabilities • Wheelchairs are used either as primary or secondary means of mobility: • Primary-patients are mobile mainly by a wheelchair • Secondary- patients use the wheelchair for longer distances or for longer endurance tasks

  14. Canes • A device used to help with ambulation • Improves balance by increasing a person’s base of support • Unloads the leg opposite to the hand the cane is in by up to 25% • Many different shapes and sizes depending on the sought purpose • i.e. Quad cane has increased base size for more stability

  15. Quad Cane

  16. Crutches • Type of gait aid used to help people who have suffered an injury to one of their feet, knees, ankles, or legs • If both sides are injured, a wheelchair is usually prescribed • Can cause nerve injuries to the axilla if used improperly • Axillary crutches are usually used temporarily for acute conditions (6-8 weeks) • Forearm crutches are usually used for more chronic conditions

  17. Walkers • Primarily used when a patient has difficulty balancing or is at risk of falling • Significantly diminishes the weight borne on the affected extremity • The fewer the wheels, the more the stability the walker provides • More commonly used in the very frail and elderly population

  18. Principles of Gait Aids

  19. Gait Cycle • There are two major parts to a full gait cycle of one step: • The stance part (60%); and • The swing part (40%) • The full cycle of one step is subdivided into four phases (in order of occurrence): • Heel strike • Mid-stance • Push-off • Mid-swing

  20. Gait Cycle Continued . . . • A complete cycle is from heel strike to heel strike • The period at the end of the stance phase of one leg and the beginning of the stance phase of the other leg is called the “double support” period as both extremities support the body

  21. Base of Support (BOS) • Refers to the area beneath an object or person that includes every point of contact that the object or person makes with the supporting surface • These points of contact may be body parts e.g. feet or hands, or they may include things like crutches or the chair a person is sitting in • Important concept to understand when trying to determine a patient's ability to balance

  22. Base of Support

  23. BOS With A Walker

  24. BOS With Crutches

  25. BOS A Cane

  26. Which side should the cane go on? Injured Leg Weight Bearing Swing Through Phase

  27. Same Side? Small BOS Swing Through Phase Injured Leg Weight Bearing

  28. Opposite Side? Bigger BOS Injured Leg Weight Bearing Swing Through Phase

  29. Weight Bearing Orders: • Will be directed by the physician • Ensure weight bearing orders are provided and understood: • NWB- Non-weight bearing: no weight on affected leg • PWB- Partial-weight bearing: usually half of body weight on affected leg • WBAT-Weight bearing as tolerated: on affected leg with-in pain free limits • FWB-Full weight bearing on affected leg

  30. Gait Patterns • 4 Point: • A slow gait pattern in which one crutch is advanced forward and placed on the floor, followed by advancement of the opposite leg • Then the remaining crutch is advanced forward followed by the opposite remaining leg • Requires the use of two assistive devices (crutches or canes) • Provides maximum stability with three points of support while one limb is moving

  31. Continued . . . • 3 Point: • Both crutches and involved leg are advanced together, then uninvolved leg is advanced forward • Requires use of two assistive devices (crutches or canes) or a walker • Indicated for use with involvement of one extremity

  32. Continued . . . • 2 Point: • One crutch and opposite extremity move together followed by the opposite crutch and extremity • Requires use of two assistive devices (canes or crutches) • Allows for natural arm and leg motion during gait, good support and stability from two opposing points of contact

  33. Continued . . . • Swing-to-Gait: • Both crutches are advanced forward together • Weight is shifted onto hands for support and both legs are then swung forward to meet the crutches • Requires the use of two crutches or a walker • Indicated for individuals with limited use of both lower extremities and trunk instability

  34. Continued . . . • Swing-Through-Gait: • Both crutches are advanced forward together • Weight is shifted onto the hands for support and both legs which are swung forward beyond the point of crutch placement • Requires the use of two crutches • Not as safe as swing-to gait

  35. Common Gait Abnormalities • Abnormalities of a normal gait pattern are caused by several factors: • Structural factors include extremity length differences, joint or soft-tissue factors like contractures • Neuromuscular factors • Central nervous system disorders • Peripheral nervous system disorders • Pain

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