Enrollment Limitations: Lab participation (Days 3 & 4) is limited to 24 attendees, to ensure adequate supervision and instruction.
This course is divided into 2 parts in order to offer the didactic session to an unlimited audience of therapists, orthotists, and physicians. Part II is open to the same disciplines.
Part 1 is a didactic study and review of foot and ankle biomechanics and pathomechanics, with application to orthotic design modifications to optimize foot and lower extremity function. Orthotic design selection is discussed in the context of recent developments in the study of the development of, and the kinetics of gait. Rationale for various orthotic interventions and posting principles is supported by a current literature review. Part I enrollment is unlimited.
Participants in Part 1 will receive:
- A detailed course manual
- A 4-piece Assessment Tool set
- A 2-hour LE Assessments video
Part II features a series of lab sessions that are designed to provide participants with a supervised introduction to relevant lower extremity musculoskeletal assessment procedures, and to the use of Aquaplast-T to fabricate a variety of splints.
Participants in Part II will receive:
- A set of handouts
- An illustrated splinting manual
Course ObjectivesParticipants completing this course are expected to be able to:
Describe, in plane-based terminology, the motions of the joints and various bones of the foot in the open and closed kinetic/kinematic chains.
Discuss the relationship between joint alignment and related muscle function in terms of joint axis inclination, muscle and loading force vectors, lever arm, and resultant moment.
Describe the associations in joint function between the segments of the lower extremity closed-kinetic chain.
Apply the findings obtained in a foot and ankle assessment to orthotic modifications, including posting and enclosure.
Explain the principle of relative flexibility as it applies to orthotic intervention.
Discuss muscle length and related capacity for contractile force generation.
Accurately diagnose a variety of foot deformities common to children [and adults] with CNS dysfunction, according to their specific joint deviations and plane-based descriptors.
Explain the physiologic transformation of muscle and connective tissues in the context of chronic coactivation, and relate this problem to orthotic hypoextensibility management options.
Explain the rationale for using the R-Wrap orthoses and the Flexcast in managing foot deformity.
Apply principles of kinetics in gait to orthotic design selection.
Discuss the problem of choosing one orthotic design to address all management problems for this patient population.
Describe orthotic designs that can promote calf muscle strengthening.
Explain the principle of targeting as a management strategy, and that of reducing or introducing degrees of freedom, and apply these principles to orthotic selection.
For Part II Attendees:
Achieve novice skill level in musculoskeletal assessment of the ankle and foot in the open and closed chains.
Achieve novice skill in fabrication of Aquaplast-T® splints.
Anticipated Course Schedule
Part I: Day 1
8:00 Register and settle in 8:30 Review of Anatomy and Function of the Subtalar and Midtarsal Joints Using Plane-Based Terminology 10:00 Break 10:30 The Maturation of the Biomechanics of the Closed Kinetic Chain 12:00 Lunch and library time 1:00 Ideal Ankle, STJ and MTJ Kinematics and Kinetics in Gait 2:30 Break 3:00 Pathomechanics of Triceps Surae Hypoextensibility and Various Foot Design Problems: Implications for Posting Splints and Orthoses 4:30 Name That Foot Deformity! 5:00 Questions / discussion / Adjourn at 5:00 >5:00 Independent Study - Library is open.
Part I: Day 2
8:00 Continental breakfast / library time 8:30 Kinesiologic and Physiologic Requirements for Optimum Muscle Function 9:00 Pathophysiology: Muscle Transformation in the Presence of Chronic Recruitment. 9:30 Proximal Musculoskeletal Assessments Relevant to Splinting the Lower Extremity: Pelvic obliquity, Hamstrings Length Test, Thigh/Foot Angle 10:00 Break 10:30 Ankle and Foot: Musculoskeletal Assessments Review 12:00 Lunch, library - Normal Gait video (optional) 1:00 Development of Walking and the Load-bearing Foot 1:30 Kinetics in Gait: Implications for Orthotic Selection 2:30 Break 4:30 3:30 Resume Orthotic Design Review 4:45 Questions / discussion / If you are leaving, please turn in your course evaluation >5:00 Independent Study - Library is open. Lab participants, bring shorts tomorrow.
Part II: Day 1 - LAB SESSIONS (Must complete Part I to attend)
8:00 Register/Arrive and settle in. 8:15 LAB: Open-chain Foot and Ankle Assessment Procedures 10:00 Break 10:30 LAB: Resume Foot and Ankle Assessments 12:30 Lunch (provided) 1:00 LAB: Resume Foot and Ankle Assessments 2:00 LECTURE: Splinting Tiny Feet: From NICU to Preschool (typically presented by Debbie Strobach, PT, MS) 3:00 Break 3:15 Resume "Splinting Tiny Feet" with Live Demo 4:30 LAB: Gripping the Foot for Splinting – Rehearsing the Molding Process 5:30 Adjourn
Part II: Day 2 - LAB SESSIONS (Must complete Part I to attend)
8:00 Arrive and settle in. 8:15 8:30 Review of Materials Used for Splinting 9:00 LAB: Handling the Material for the Initial Mold Demos and Practicum: 9:30 Foot Splint Variations 11:30 Foot Section—Hinged AF splint 12:00 Lunch on premises 12:30 Shaft and Assembly—Hinged AF Splint 2:30 Knee Hyperextension Splint and Hinged Rear-Entry Splint 5:15 Clean-up / Turn in Course Evals 5:30 Adjourn
Enrollment Limitations: Lab participation (Days 3 & 4) is limited to 24 attendees, to ensure adequate supervision and instruction..
Video Recording policy: Videotaping of this program is prohibited. Audiotaping for personal review is permitted with permission from the Instructor.