Ankle-foot orthoses (AFOs) are external devices that attach to the lower leg and foot to improve function by controlling motion and providing support. The main components are a calf band, medial and lateral bars that articulate with ankle joints, and a stirrup that anchors to the shoe. There are 5 types of artificial ankle joints prescribed according to muscle strength: free ankle, dorsiflexion stop, plantarflexion stop, fixed dorsiflexion stop, and fixed hinge. AFOs are used to treat drop foot and other conditions involving muscle weakness, deformities, or instability by maintaining proper foot and ankle positioning during gait.
This presentation is very beneficial for those who are in the field of prosthetics & orthotics. I have covered the basics of prosthetic foot, its mechanisms & its types. I have mentioned advanced prosthetic foot also. Hope this will help you all.
This presentation is very beneficial for those who are in the field of prosthetics & orthotics. I have covered the basics of prosthetic foot, its mechanisms & its types. I have mentioned advanced prosthetic foot also. Hope this will help you all.
Over the past decade, technology and research have greatly expanded the functionality and aesthetics of prosthetic feet. Today, amputees have a wide array of feet from which to choose. Various models are designed for activities ranging from walking, dancing and running to cycling, golfing, swimming and even snow skiing.
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
A complete description of the lower limb orthosis is available in the following presentation with an in depth understanding of the same.It covers the ankle foot orthosis,Knee orthosis the knee ankle foot orthosis and hip orthosis.
Over the past decade, technology and research have greatly expanded the functionality and aesthetics of prosthetic feet. Today, amputees have a wide array of feet from which to choose. Various models are designed for activities ranging from walking, dancing and running to cycling, golfing, swimming and even snow skiing.
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
A complete description of the lower limb orthosis is available in the following presentation with an in depth understanding of the same.It covers the ankle foot orthosis,Knee orthosis the knee ankle foot orthosis and hip orthosis.
This is a surgeons experience in prison, living under difficult situations, treating desperate patients, who had no where else to go. The studies conducted, discoveries made and new modalities invented.
Orthoses, an integral part of assistive technology, are specially made splints which are being used to align abnormal joints or muscles. These are never bought from ready made shops. Each and every pediatric orthosis should be made by qualified orthoticians. In selected cases, orthoses should be made after taking a POP cast. In a developing child, the orthoses should be changed after every six to nine months and for older children, the splint should be changed after every 9-15 months. Most of the orthoses require modifications so consult your orthotician after every three months or as recommended. Please note, a faulty orthosis always harm the child.
We at ICD, Delhi provide orthotic support to the following condition whenever there is a need
CTEV (Club Feet)
Cerebral palsy
Spina bifida
Erb’s palsy
Brain injury
Spinal cord injury
Post-polio paralysis
Meningomyelocele
Arthrogryposis
Congenital Hip dislocation
Genu recurvatum / Genu varum / Genu valgum
Flat feet / Hallux valgus / Flexed wrist / thumb in palm, etc
Orthotic aids are an integral part of habilitation / rehabilitation therapy. It helps
• To correct and/or prevent deformity
• To provide a base of support
• To facilitate training in skills
• To improve the efficiency of gait
• To improve function
At ICD New Delhi , we have
• Provision for Orthoses for Lower Limbs
• Provision for Orthoses for neck, spine and trunk
• Provision for Orthoses for Upper Limbs
presentation is about Orthosis and prosthesis. It gives Classification of Orthosis. It describes structure, function, Indication and uses of Orthosis. Also describes different types of Prostheses, their parts and function.
Orthosis
The aim of orthotics is to increase the efficiency of function during acute or long-term injury. This includes soft-tissue and bony injury, as well as changes as a result of neurological changes. They can be an effective adjunct alongside physiotherapy techniques such as muscle strengthening and stretches, gait and balance retraining and reach and grasp strategies.
Definition :An orthosis is generally an individually designed or customised device, which is applied to the external part of the body to provide support and protection for that particular area of the body. It uses integrates biomechanical principles to realign joints and reduce pain. The design, materials and function of the orthosis are based on a patient assessment, including their medical history, biomechanical principles and the individual needs of the user.
Commonly prescribed orthoses include:
Foot Orthoses (FOs), for various foot, leg or postural problems; there is significant variety in terms of their design and manufacturing methods[1][2]
Ankle Orthoses (AOs) and Knee Orthoses (KOs), for joint protection, pain reduction or support after surgery
Ankle-Foot Orthoses (AFOs) and Knee-Ankle-Foot Orthoses (KAFOs), to improve mobility, support rehabilitation and biomechanical goals
Various upper-limb orthoses, to provide positional and functional support to the upper limb
Fracture orthoses, modern alternative to plaster or fibreglass casts
Spinal Orthoses, to correct or control spinal deformities and injuries and to provide immobilisation or support to spinal injuries
Advantages
Lower limb: Influence both swing and stance phase of gait[10].
Prevent or correct deformity and reduce pain during weight-bearing
Improve the efficiency of gait and maintain balance
Improve base of support / lateral support
Reduce need for compensation of ipsilateral and contralateral limbs and secondary pain
To facilitate training in skills
Upper limbs: Can be used after an injury to prevent further injury, or reduce pain by supporting an injured limb.
Prevent or correct deformity reducing pain and maximising function in reach and grasp tasks.
Improve the efficiency of reach and grasp tasks
Offload an injured limb to allow healing
Reduce need for compensation of ipsilateral and contralateral limbs and secondary pain
Improve role of the upper limb in maintaining balance
Spine: Stabilise spinal fractures to allow the patient to return to some normal activities (although they may be restricted) and protect the spinal cord
And It's Principles
Classification of Orthosis
Types Of Orthosis
Upper Limb Orthosis
Spinal Orthosis
Lower Limb Orthosis
Possible Complications
Loss of sensation (check skin regularly- risk of pressure areas)
Compensations in ipsilateral or contralateral limbs.
Impact on spasticity (is the patient utilising spasticity to allow some function in absence of muscle strength?)
Complications of casting at incorrect angle: Foot deformitie, increased knee flexion in stanc
Flat feet can have a destructive effect to the body. Learn about the cause of flat feet and various treatment options including HyProCure extra-osseous talotarsal stabilization.
what is crouch gait and its Physiotherapy rehabilitation
this type gait mostly seen in spastic diaplegic Cerebral palsy child least common in quadriplegic C P , and hemiplegic C P
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Lower-limb orthotics
A lower-limb orthotic is an external device applied (or
attached) to a lower-body segment to improve
function by controlling motion, providing support
through stabilizing gait, reducing pain through
transferring load to another area, correcting flexible
deformities, and preventing progression of fixed
deformities.
3. The Ankle-Foot Orthosis is a boot to which
an ankle joint is fixed through the stirrup.
There are metal uprights(medial and
lateral bars) ascending up to the calf
region.
The components are:
Proximal calf band with leather straps
Medial and lateral bars articulating with
medial and lateral ankle joints help in
control of plantar and dorsiflexion.
Stirrups anchor the uprights to the shoe.
4. There are 5 types of artificial ankle joints fit to the
AFO, prescribed according to the power of the
muscles controlling the ankle. They are:
1. Free ankle :
5.
6.
7.
8.
9. Ankle-Foot orthosis is prescribed for,
1. Muscle weakness affecting the ankle and sub talar joint.
2. Prevention or correction of deformities of foot and ankle.
3. Reduction in appropriate weight bearing forces.
Dorsiflexor muscle paralysis
Ankle foot paralysis
Spasticity
Limited weight bearing
10.
11. We use several different types of AFOs to treat drop
foot in patients. Some of them are custom and
require a mold of the foot, ankle and leg. Others are
prefabricated. The goal is to provide patients with a
comfortable AFO that will give them the most normal
gait possible.
12. Often useful for some
patients who have
instability of the knee
along with their foot
drop.
13. This stops plantar flexion and also
stops or limits dorsiflexion. These
are used for drop foot patients
with a nearly complete loss of
dorsiflexion strength and who
also have an unstable knee. It is a
bit bulky, but gives a tremendous
amount of control.
14. 3.Short Leg AFO with Fixed Hinge (doesn’t flex at ankle
joint)
Good choice for patients who
have drop foot and also have a
very flat foot. This AFO keeps the
foot at 90 degrees to the leg. It
can also help control unwanted
inward rotation of the foot, which
can commonly accompany drop
foot in stroke patients
15. This is one of the best AFOs
for patients with mild to
moderate drop foot and a flat
or unstable foot.
16. A plantar flexion stop AFO acts to
stop plantar flexion by not letting
the foot point downward. This
type of AFO has a hinge that
allows for normal dorsiflexion.
Effective, for patients with more
severe drop foot.