Shoes

The most commonly used orthotics are shoes which we wear in our daily lives. Shoes transfer body weight to the ground and protect the foot from the terrain and the weather. For the patient with an orthopedic disorder, footwear has two additional purposes:

(a) Reducing pressure on sensitive structures by redistributing force toward pain-free areas

 (b) serving as the foundation for AFOs and more extensive bracing

Foot Orthoses(FO)

FO is inserted inside the shoe, an internal modification fixed in the shoe, or an external modification attached to the sole or heel.

Internal modification: They are made of soft materials, such as rubber or viscoelastic plastics, to reduce impact shock and shear, thus protecting painful or insensitive feet. Some examples are the metatarsal pad and scaphoid pad(It is positioned (middle) medial and plantar to the longitudinal arch. Scaphoid pad (right) glued to the inside of the shoe.

External modification: It involves material that can be added to the exterior of the shoe, such as a Rocker sole, A heel wedge, Sole wedges, or heel lift (It is a non-compressible lightweight material that provides slight plantarflexion and corrects for a leg length discrepancy of more than 1 cm; up to 1 cm can be accommodated inside a low-quarter shoe.)

Ankle-Foot Orthoses

The AFO is made of a shoe and a plastic or metal component with a footplate foundation, whether thermoplastic or carbon fiber. Some best AFO are Posterior leaf spring ankle-foot orthosis, Conventional ankle-foot orthosis with stirrup attachment, ToeOFF ankle-foot orthosis, Ypsilon ankle-foot orthosis and Plastic hinged ankle-foot orthoses.

Knee-Ankle-Foot Orthoses

The person with extensive paralysis/paresis or limb deformity can use KAFOs, which consist of a shoe, foundation, ankle control, foot control, knee control, and superstructure Two examples of knee joints (left and middle) and a drop ring lock (right).

Hip-Knee-Ankle-Foot Orthoses.

HKA FOs are not used very often because they are much more cumbersome to do than KAFOs, and if the hip joints are locked, they restrict gait to the swing-to or swing-through pattern. To pelvic band fitted when the patient is standing may be uncomfortable when the wearer rotates the pelvis when sitting. After injury or surgery, such as a total hip replacement, a hip rehabilitation orthosis can be used to minimize hip motions during healing,90 although preventing dislocation is not assured

Trunk-Hip-Knee-Ankle-Foot Orthoses

Patients who require more stability than provided by HKAFOs may be fitted with THKAFOs, which incorporate a lumbosacral orthosis attached to HKAFOs. The THKAFO is typically prescribed for those with SCI who require trunk control. Because the THKAFO is very difficult to do and is heavy, it is seldom worn after the client is discharged from the rehabilitation facility.