PENDAHULUAN

ORTOSIS

Pembimbing : dr. Fatchur Rochman, Sp. KFR (K)

 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
 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
• 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
• Hugh Owen Thomas, abad 19 , ahli
bedah Ortopedi  ortosis servikal

• Abad 20  pengembangan ortosis 

pencegahan dan pengurangan
dampak poliomyelitis
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
 Penggunaan ortosis…
Dr.IKFR harus paham :
• Kondisi fisik pasien

gaya hidup pasien

• Kepribadian pasien

kemandirian ADL
 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
 Kriteria ideal ortosis…

• Mudah dipakai dan dilepas oleh penderita

sendiri

• Biaya terjangkau, tidak cepat rusak,

secara kosmetis baik serta mudah untuk
diperbaiki dan dimodifikasi
 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
Jenis Ortosis
1. 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

Jenis Ortosis…
2. Dinamik
- Memberikan/mengakomodasi gerakan pada derajat
tertentu

- Meregangkan kontraktur
Ortosis fungsional :
- Memperbaiki fungsi
- Digunakan pada pasien dengan disfungsi
sisa yang permanen pasca cedera, kondisi
pemulihan lambat, penyakit kronis.
Terima Kasih
 Orthoses constructed from :
• Metal
• Plastic
• Leather
• Synthetic fabrics
• Any combination
• 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
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
 Leather

Type : Cattle hides –

 vegetable-tanned for texture
 to prevent skin irritation
Recommanded 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
 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
 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
 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)
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)