This document defines orthotics as external devices that apply forces to the body to control motion or maintain proper positioning. It classifies orthotics by region of the body and function. The principles of orthotics include using forces like rigidity or springs to limit or assist movement according to Jordan's three point system. Orthotics are made of materials like plastic, metal, or leather and are used temporarily or permanently to relieve pain, correct deformities, protect injuries, and improve function. Contraindications include infections and devices that limit normal motion or interfere with clothing. Disadvantages can include skin problems, weakness, increased adjacent joint motion, and dependence.
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.
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.
Wheelchair is truly is mobility orthosis.
A properly prescribed wheelchair can be useful device in reintegrating a person with a disability into the community.
Wheelchair is truly is mobility orthosis.
A properly prescribed wheelchair can be useful device in reintegrating a person with a disability into the community.
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
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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.
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Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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3. Definition
Derived from the greek worth ORTHO meaning straight,
upright or correct.
It is a mechanical device fitted to the body to maintain it
in an anatomical and functional position.
It is an external device design to apply, distribute or
remove forces to or from the body in a controlled manner
to perform one or both the basic function of –
1) control body motion
5. Regional Classification
They are classified according to the anatomical area fitted with the
orthosis:
Cervical Orthosis
Head-Cervical Orthosis
Head–Cervical-Thoracic Orthosis
Sacral Orthosis
Lumbo-Sacral Orthosis
Thoraco Lumbo- Sacral Orthosis
7. Functional Classification
Supportive: It stabilises the joints and supports the body in
its anatomical position,
e.g. Calipers
Functional: It stabilises the joint and also makes up for lost
function,
E.g. Foot drop splint in common peroneal nerve palsy
Corrective: To correct deformities
E.g. Club foot boot in CTEV
8. Protective: To protect a part of the body during its
healing.
E.g. rigid four post collar for fracture cervical
vertebrae.
Prevent substitution of function:
In a full length caliper, substitution of hip flexors by
Abductors or adductors of hip and other similar trick
movements are prevented.
Orthosis which strengthen certain group of muscle
E.g. Tenodesis Splint
9. Relief of pain:
e.g. Lumbosacral corset supports lower back,
preventing painful movement.
Prevent weight bearing:
A weight relieving orthosis, prescribed for conditions
like fracture calcaneum will take weight away from
injured site into proximal site like the patellar tendon
bearing area.
10. Principles of Orthosis
PRINCIPLE OF JORDAN:
The basic mechanical principle of orthotic correction is
the “Three Point System of Jordan”.
This system applies corrective or assistive forces,
which are implemented at the surface of the orthosis
through the skin and are transmitted to the underlying
soft tissues and bones.
To remain stable, the body has to have one point
of pressure opposed by two equal points of
counter pressure in such a way that F1 = F2 + F3.
11. General Principles
Use of forces:
Orthosis utilises forces to limit or assist movements
for example.
a. Rigid material spanning a joint prevents motion,
e.g posterior tube splint
b. A spring in a joint is stressed by one motion and
then recoils to assist, the opposite desired motion.
E.g. leaf spring orthosis
12. Limitation of movement: Limiting motion may reduce pain.
Correcting a mobile deformity: a flexible deformity may be
corrected by an orthosis. Corrective forces must be balanced
according to principle of jordan.
Fixed deformity: if the fixed deformity is accommodated by an
orthosis, it will prevent the progression of deformity.
Adjustability: orthotic adjustability is indicated for children to
accommodate their growth and for patients with progressive or
resolving disorders.
13. Maintenance and cleaning: the orthosis should be simple
to maintain and clean.
Application: the design should be simple for easy donning
and doffing.
Sensation: An orthotic device does not provide sensation,
in fact it often covers skin areas and decreases sensory
feedback.
Gravity: Gravity plays an important role in upper limb
orthosis, especially in those joints where the heaviest
movement masses are present.
14. Comfort: The Orthosis should be comfortable. Pressure
should be distributed over the largest area possible.
Utility: the Orthosis must be useful and serve a real purpose.
A well functioning opposite extremity is a major deterrent to
the use of an upper extremity orthosis as most activities
can be performed with the good hand.
If the orthosis does not add significance to their function,
the patients typically discontinue its use.
Cosmesis: Cosmesis is important especially in hand
orthosis. A functional but unsightly orthosis is often rejected if
the patient values appearance over function.
15. Types of orthosis
Temporarily orthosis: Used for certain time after
injury or operation.
Permanent orthosis: Used for ever when there is
muscle weakness, paralysis or deformity cannot be
corrected.
Static orthosis: does not allow movement.
Dynamic orthosis : allows movement.
16. MATERIALS
An orthosis can be constructed from metal, plastic,
leather, synthetic fabrics, or any combination.
Plastic materials are the materials most commonly
used in the orthotic industry.
17. Indications and clinical
implications
To relief pain.
To limit motion (immobilization after surgery, after traumatic injury, Compression # management
& Kinesthetic reminder to avoid certain movements).
To correct deformity e.g. Scoliosis management
To relieve symptoms of a disease by supporting or assisting the MSk & neural systems.
To reduce axial loading, mechanical unloading
To improve function in a certain segment of the body.
Assist and improve movement and function
Reduce muscle tone.
Protect against injury.
Provide proprioceptive feedback.
Provide rest
18. Contraindications
Skin infections
When the muscle power is very much affected by the weight of the
orthosis.
In case of severe deformity which cannot be accommodated in the
orthosis.
If it limits the movement at other normal joints
Where the orthosis interferes grossly with clothing or limits other functions
Lack of motivation or other psychological problems
Very young or old patients
19. Disadvantages
Loss of skin integrity due to compressive forces
Weakening of axial muscles
Increased movements at ends of immobilised segments
Physical and psychological dependence.
Osteopenia
Lack of cosmesis