Download - pendahuluan ortesa
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PENDAHULUAN ORTOSIS
Pembimbing : dr. Fatchur Rochman, Sp. KFR (K)
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ORTOSIS
• Suatu alat bantu/alat terapi dalam bidang Kedokteran Fisik dan Rehabilitasi yang dalam penggunaannya diletakkan secara kontak langsung dengan permukaan luar bagian/segmen tubuh tertentu untuk meningkatkan fungsi bagian/segmen tubuh tersebut
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TUJUAN
• Menstabilkan sendi atau segmen yang lemah atau lumpuh
• Men-support sendi atau segmen yang rusak atau sakit
• Membatasi atau menambah gerak di seluruh sendi
• Mengkontrol gerakan abnormal atau spastik• Unload distal segments
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• Tahun 2700 SM bangsa Mesir ortosis
untuk melindungi bagian tubuh tertentu dari
trauma atau cegah kerusakan lebih lanjut
• Abad pertengahan baju perang ortosis
spinal
• Ambroise Paree, ahli bedah Perancis pionir
ortosis dan prostesis
• Lorenz Heister, abad 15 ortosis spinal
pertama
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• Hugh Owen Thomas, abad 19 , ahli
bedah Ortopedi ortosis servikal
• Abad 20 pengembangan ortosis
pencegahan dan pengurangan
dampak poliomyelitis
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Penggunaan ortosis :
• Keputusan medis
• Berdasarkan indikasi
• Diresepkan oleh dokter yang kompeten
kinesiologi, biomekanika anatomi,mekanisme penyakit,
neurofisiologis dan patomekanika yang mendasari disabilitas penderita,
sifat fisika materi/ bahan ortosis
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Penggunaan ortosis…Dr.IKFR harus paham :
• Kondisi fisik pasien
gaya hidup pasien
• Kepribadian pasien
kemandirian ADL
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Kriteria ideal ortosis• Menghasilkan pola gerakan senormal
mungkin dan pencegahan gerakan abnormal yang tidak dikehendaki
• Stabilitas sendi akurat• Penggunaan energi seminimal mungkin• Distribusi gaya yang baik• Kenyamanan dalam pemakaian
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Kriteria ideal ortosis…
• Mudah dipakai dan dilepas oleh penderita sendiri
• Biaya terjangkau, tidak cepat rusak, secara kosmetis baik serta mudah untuk diperbaiki dan dimodifikasi
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Orthotic prescription
Should include :• Medical diagnosis• Current impairment and any disability (e.g.
flaccid drop foot)• Type of orthosis (e.g. plastic ankle-foot orthosis
[AFO] with flexible ankle held in neutral position)• Orthotics goal
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Jenis Ortosis1. Statik
- Rigid
- Memberi support tanpa gerakan
- Mengistirahatkan segmen/bagian tubuh pasca
trauma, bedah
- Mengistirahatkan sendi dan tendon
- Khas mengikuti bentuk yang mengakomodasi
posisi statik yang ada
- Dapat dibuat tidak mengikuti bentuk
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Jenis Ortosis…
2. Dinamik- Memberikan/mengakomodasi gerakan pada derajat
tertentu
- Meregangkan kontraktur
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Ortosis fungsional :
- Memperbaiki fungsi
- Digunakan pada pasien dengan disfungsi
sisa yang permanen pasca cedera, kondisi
pemulihan lambat, penyakit kronis.
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Terima Kasih
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Orthoses constructed from :
• Metal• Plastic• Leather• Synthetic fabrics• Any combination
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• Metal orthoses :– Adjustable– But heavy– Not cosmetically pleasing– Commonly used metal include : stainless steel
and aluminium alloys
– Stainless Steel : – widely used in prefabricated joint, metal up
right, metal band and cuffs, springs and bearing. Relatively inexpensive, easy to work with, and fatigue-resistant ; however :
– Heavy, needs expensive alloys to prevent corrosion
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Aluminium alloys :• corrosion resistant• have high strength-to-weight
ratio• commonly used in upper limb
orthoses because of its lightweight nature.
• static loading strength is good• lower endurance limit compared
to steel
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Leather
Type : Cattle hides – vegetable-tanned for texture to prevent skin irritationRecommanded for shoe construction because :Conduct heat well, absorp water from the moist air surrounding the foot, draw prespiration away, stretch as the shoe becomes moist
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Plastic• Lighter• Can provide a closer fit (it can be molded,
extruded, laminated, or hardened into any desired form)
• Unaffected by fluids• Radioluscent• Not adjustable in length• Not as durable as metal (hence not commonly
used as joints)• Classified into : thermosetting and
thermoplastic materials
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Thermosetting
• Develop a permanent shape when heat and pressure are applied
• Cannot be softened when reheated• More difficult to use than thermoplastic• Cause more body irritation / allergic
reaction• Epoxy resin• Polyurethane foam
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Thermoplastic• Soften (and become moldable) when heated
and harden when cooled• Divided into Low – High temperature
LOW-temperature thermoplastics(Orthoplast, Aquaplast, Bioplastics, Glassona, Hexcelite, Kay-splint, Lightcast, Polysar, Warm-N-Form)
• Can be molded at temp just above body temp (<80⁰C or <180 ⁰F), be shaped directly to the body without cast,
• Can be fabricated easily and rapidly• Mainly used in upper limb (low stress activity)
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HIGH temperature thermoplastics(acrylic, polyethylene, polypropylene, polycarbonate, acrylonitrile-
butadiene-styrene [ABS] and the group of vinyl polymers and copolumers include PVC, PVA, polyvinyl acetate)
• Require up to 150-160⁰ C (300-350⁰ F) to become moldable
• Must be shape over a plaster replica/cast• Creep resistant (not easily change in shape
w continued stress and heat)• Ideal for long-term or permanent use
especially when high stress is anticipated (e.g. in lower limb orth. and in spastic limbs)
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