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OBJECTIVES

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At the end of this chapter, all students are expected to:

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  1. Use biomechanical orthotic terminology appropriately.

  2. Discuss the materials and processes used by orthotists to fabricate orthoses.

  3. Describe the process by which an orthoses is obtained for a client.

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Physical Therapy students are expected to:

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  1. Develop orthotic goals to address a client's impairments and functional limitations identified during preorthotic prescription examinations.

  2. Design an orthosis using biomechanical principles of orthotic force application (as discussed in Chapter 2) to achieve the orthotic goals.

  3. Collaborate with physician, orthotist, other health-care providers, and the client to prescribe an orthosis to achieve the orthotic goals and improve client function.

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CASE STUDIES

Harry Green is a 67-year-old African American retired widower who suffered a thrombotic cerebral vascular accident (stroke) with right hemiparesis. Mr. Green's case is described in Chapter 2.

Anne O'Callahan is a 55-year-old second grade teacher who has right knee pain and osteoarthritis that is interfering with her ability to stand, walk, and climb steps. Ms. O'Callahan's case is described in Chapter 11.

Luis Sanchez is an 11-year-old middle school student with cerebral palsy and spastic diplegia. Luis's case is described in Chapter 11.

Case Study Activities

All Students:

  1. Identify the impairments and functional problems that may be improved with an orthosis, ambulatory aid, or assisted device. Suggest ambulatory aids or assistive devices that may improve the client's function.

  2. Identify and discuss various patient factors that will influence orthotic prescription in addition to the specific need or purpose for the orthosis (eg, body size and weight, activity level).

  3. Discuss ways that you can improve client acceptance of the appliance and adherence to using the orthosis during functional activities.

Physical Therapy Students:

  1. List and describe functional goals for each client. Which functional goals will require that the patient be fit with an orthosis in order to achieve the goal? Provide justification for your decisions.

  2. Describe and discuss the type of orthosis that you would recommend. Write specific goals for the orthosis. Relate each orthotic goal to the patient's impairments.

  3. Describe the biomechanical methods of orthotic force application that you would select to achieve the orthotic goals that you identified for the client. That is, do you want to use methods to

    1. Limit or prevent unwanted or abnormal movement?

    2. Assist insufficient movement?

  4. Use biomechanical terminology to name the orthosis that you recommend for the client.

  5. Discuss the types of orthoses and the different materials that could be used to fabricate the orthosis prescribed for the client. Discuss advantages and disadvantages of the different types of orthoses that could be used to accomplish the orthotic goals.

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DEVELOPING AN ORTHOTIC PRESCRIPTION

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Orthoses should improve the quality of daily life by improving or maintaining an individual's ability to perform functional activities. An orthosis has a favorable effect on a client's ability to function when it makes tasks possible ...

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