Ankle Foot Orthosis covers a lot of territory. Common usage indicates an insert for the shoe to support the foot and alter pressure. An orthotic is an orthopedic device, orthosis, that is applied externally to a jointed limb (i.e. wrist/hand/finger-WHFO; ankle foot AFO Ankle Splints, knee, elbow,etc.). Their design purpose provides support, stability, prevention of deformity or replacement of lost function. There are a variety of orthoses available depending on the diagnosis and physical needs of the individual. Contracture Management Ankle Foot Orthosis
Some examples are listed below for Lower Extremity, Upper Extremity and Spinal Orthoses:
Lower Limb Orthotics include:
Insoles (this is the most common use of of the word “orthotic”). These inserts are necessary for diabetic shoes and usually are pre-fabricated and molded to the patient with a heat gun. The most common materials used are high or low-density plastazote, Pe-lite, leather, PPT and EVA. These materials are used depending on the patient’s degree of foot deformity.
Functional Foot Orthoses
Another common use of “orthotics” refers to thin, lightweight polypro shoe inserts or Ankle Foot Orthosis. These “AFO Orthotics” as they are commonly referred are available pre-fabricated and sometimes require minor trimming. They are available with “full” and “partial” foot pads. hinged and semi-rigid. Drop Foot responds well to this orthotic application. Custom orthotics of this type are contoured to the entire foot and used to reduce abnormal motion or abnormal position of the foot. Also, they are used to control abnormal motion or position of the lower limb. The orthotist will take a medical evaluation, biomechanical examination, ranges of motion, muscle activity. The AFO can be made from an impression or cast of the foot. A thermoplastic material will be molded to the shape of a positive cast of the foot. AFO’s are prescribed for several conditions, which include stroke, cerebral palsy, spina bifida, multiple sclerosis, paraplegia, polio or ankle and foot deformity. AFO Types include: Rigid ankle foot orthosis (molded AFO); Hinged ankle foot orthosis; Posterior leaf spring ankle foot orthosis; PTB- ankle foot orthosis ( PTB- patellar tibia bearing); Floor reaction ankle foot orthosis; Conventional ankle foot orthosis.
Ankle Foot Orthosis Foot Brace
Multi Podus * Boots for contracture management, wound care, heel decubitus relief and “Night Splints” are both common pre-fabricated orthotics. Medicare approved codes are L-4396 with a variety of ICD-9 codes available. The SADMERC’s specify a minimum of 10 degrees of contraction must be documented. The same L-4396 code applies with a diagnosis of plantar fasciitis using ICD-9 code, 728.71. This orthotic was invented by L’Nard, now “RCAI”; “RCAI” owns the Trade Mark “ Multi Podus *”; however, common usage throughout the industry has made it part of the Public Domain. All segments of the industry refer to this type boot as “ multi podus *”. For more information review LG Night Splint that Works! and LG Multi Podus * boots for bed and ambulation with Fast Lock ambulation pad. Dura Boot Duraboot
Knee Orthosis Brace
There are many different types of knee orthoses available. Therefore, to decide which knee orthosis is effective the orthotist has to understand the normal biomechanics, pathology and kinematics of the knee. Also, he must take into consideration range of motion, muscle strength, laxity of ligament, skin condition and sensation. Various knee orthoses are available: those that support an injured knee or ligament weakness; Post-operative (after surgery); Functional knee orthosis (stabalizes, corrects, prevents & supports the deformity of the knee joint); Contracture Mangement Type type Knee Orthosis: see LEEDer Group Medicare approved knees: L1832 and L1847 Air.
Knee Ankle Foot Orthosis
The KAFO is commonly used to treat symptoms due to spina bifida, cerebral palsy, paraplegia, polio, trauma or neuromuscular dystrophy. Different types of knee joint systems will be used for KAFO’s depending on the patient´s deformity. It could be a free knee joint for stability or a drop lock for knee control. However, in some cases a dial lock system is used for patients with knee flexion contracture.
Hip-Knee-Ankle-Foot-Orthosis
HKAFO consists of a trunk section connected to KAFO’s by two lateral hip joints. The joints system is usually associated with locks but in some cases it is a free hip joint. While wearing, the patient will be able to walk with the help of a walker or forearm crutches.
Spinal Orthotics
Includes LSO, LumboSacral Orthosis, TLSO, Thoracic Lumbosacral Orthosis
As should now be clear: Orthosis, orthoses, orthotics…the terms describe multiple devices(foot splints, back braces, brace, etc.) used in the treatment of conditions associated with traumatic injuries, chronic disease, and immobility, including joint contractures, Contracture Management, pressure sores and more.
(* Multi Podus® is a registered U.S. Trademark of “Restorative CareofAmerica, Inc” and is used herein with permission. No affiliation or endorsement by “RCAI” should be inferred.) podis