97-578: Orthotics ( Greek : Ορθός , romanized : ortho , lit. 'to straighten, to align') is a medical specialty that focuses on the design and application of orthoses , sometimes known as braces, calipers, or splints. An orthosis is "an externally applied device used to influence the structural and functional characteristics of the neuromuscular and skeletal systems ." Orthotists are medical professionals who specialize in designing orthotic devices such as braces or foot orthoses. Orthotic devices are classified into four areas of
194-577: A basis for coinages: anthropology , photography , telephony , isomer , biomechanics , cinematography , etc. Together with Latin words , they form the foundation of international scientific and technical vocabulary ; for example, all words ending in -logy ('discourse'). There are many English words of Greek origin . Greek is an independent branch of the Indo-European language family. The ancient language most closely related to it may be ancient Macedonian , which, by most accounts,
291-430: A continuous "L" shape, with the upright part behind the calf and the lower part under the foot, however, this only offers the rigidity of the material. AFOs made of polypropylene are still called "DAFO" (dynamic ankle-foot orthosis), "SAFO" (solid ankle-foot orthosis) or "Hinged AFO". DAFOs are not stable enough to transfer the high forces required to balance the weak plantar flexors when standing and walking, and SAFOs block
388-558: A fairly stable set of consonantal contrasts . The main phonological changes occurred during the Hellenistic and Roman period (see Koine Greek phonology for details): In all its stages, the morphology of Greek shows an extensive set of productive derivational affixes , a limited but productive system of compounding and a rich inflectional system. Although its morphological categories have been fairly stable over time, morphological changes are present throughout, particularly in
485-560: A faster, more convenient cursive writing style with the use of ink and quill . The Greek alphabet consists of 24 letters, each with an uppercase ( majuscule ) and lowercase ( minuscule ) form. The letter sigma has an additional lowercase form (ς) used in the final position of a word: In addition to the letters, the Greek alphabet features a number of diacritical signs : three different accent marks ( acute , grave , and circumflex ), originally denoting different shapes of pitch accent on
582-468: A foot lifter orthosis is not suitable as it only compensates for the functional deviations caused by weakness of the dorsiflexors. Patients with paralysis after stroke who are able to walk have the option of analysing the gait pattern in order to determine the optimal function of an orthosis. One way of assessing is the classification according to the "N.A.P. Gait Classification", which is a physiotherapeutic treatment concept. According to this classification,
679-606: A foot lifter orthosis, adjustable functional elements for setting the resistance can be included, which make it possible to adapt the passive lowering of the forefoot (plantar flexion) to the eccentric work of the dorsal flexors during loading response. In cases where the muscle group of the plantar flexors is supplied with wrong impulses from the central nervous system, which leads to uncertainty when standing and walking, an unconscious compensatory gait can occur. When configuring an orthosis functional elements that can restore safety when standing and walking must be used in these cases;
776-540: A foreign language. It is also often stated that the historical changes have been relatively slight compared with some other languages. According to one estimation, " Homeric Greek is probably closer to Demotic than 12-century Middle English is to modern spoken English ". Greek is spoken today by at least 13 million people, principally in Greece and Cyprus along with a sizable Greek-speaking minority in Albania near
873-493: A good safety function, the knee joint remains mechanically locked during the swing phase while walking. Patients with locked knee joints have to manage the swing phase with a stiff leg, which only works if the patient develops compensatory mechanisms, such as by raising the body's center of gravity in the swing phase ( Duchenne limping) or by swinging the orthotic leg to the side ( circumduction ). Stance phase control knee joints and locked joints can both be mechanically "unlocked" so
970-799: A leg length discrepancy, equivalent to replacing a missing part of a limb. Another example is the replacement of the forefoot after a forefoot amputation . This treatment is often made from a combination of a prosthesis to replace the forefoot and an orthosis to replace the lost muscular function (ortho prosthesis). An orthotist is a specialist responsible for the customising, manufacture, and repair of orthotic devices (orthoses). The manufacture of modern orthoses requires both artistic skills in modeling body shapes and manual skills in processing traditional and innovative materials— CAD / CAM , CNC machines and 3D printing are involved in orthotic manufacture. Orthotics also combines knowledge of anatomy and physiology, pathophysiology , biomechanics and engineering. In
1067-404: A result of the paralysis. Functional leg length differences caused by paralysis can be compensated for by using orthosis. For the quality and function of a paralysis orthosis, it is important that the orthotic shell is in total-contact with the patient's leg to create an optimal fit, which is why a custom-made orthotic is often preferred. As reducing the weight of an orthosis significantly lessens
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#17327729586701164-520: A result, the dynamics of the orthosis take place exactly where dictated by the patient's anatomy. Since the dynamics of the orthosis are executed via the orthotic joints, it is possible to manufacture the orthotic shells as stable and torsion-resistant, which is necessary for the quality and function of the orthosis. The orthosis thus offers the necessary stability to regain the security that has been lost due to paralysis when standing and walking. In addition, an orthosis can be individually configured through
1261-449: A stroke are often treated with an ankle-foot orthosis (AFO), as after a stroke stumbling can occur if only the dorsiflexors are supplied with incorrect impulses from the central nervous system. This can lead to insufficient foot lifting during swing phase of walking, and in these cases, an orthosis that only has functional elements to support the dorsiflexors can be helpful. Such an orthosis is also called drop foot orthosis. When configuring
1358-487: Is a condition typified by a weakness of voluntary movement, or by partial loss of voluntary movement or by impaired movement. When used without qualifiers, it usually refers to the limbs, but it can also be used to describe the muscles of the eyes ( ophthalmoparesis ), the stomach ( gastroparesis ), and also the vocal cords ( vocal cord paresis ). Neurologists use the term paresis to describe weakness, and plegia to describe paralysis in which all voluntary movement
1455-412: Is a risk of stumbling, and the patient cannot influence the shock absorption when walking (gait phase, loading response), as the eccentric work of the dorsiflexors is limited. After initial heel contact the forefoot either slaps too quickly on the floor via the heel rocker, which creates an audible noise, or the foot does touch the floor with forefoot first, which disrupts gait development. Paralysis of
1552-509: Is according to the "Amsterdam Gait Classification", which describes five gait types. To assess the gait pattern, the patient is viewed directly, or via a video recording, from the side of the leg being assessed. At the point when the leg is mid-stance the knee angle and the contact of the foot with the ground are assessed. The five gait types are: Patients with paralysis due to cerebral palsy or traumatic brain injury are usually treated with an ankle-foot orthosis (AFO). Although in these patients
1649-804: Is also found in Bulgaria near the Greek-Bulgarian border. Greek is also spoken worldwide by the sizable Greek diaspora which has notable communities in the United States , Australia , Canada , South Africa , Chile , Brazil , Argentina , Russia , Ukraine , the United Kingdom , and throughout the European Union , especially in Germany . Historically, significant Greek-speaking communities and regions were found throughout
1746-773: Is an Indo-European language, constituting an independent Hellenic branch within the Indo-European language family. It is native to Greece , Cyprus , Italy (in Calabria and Salento ), southern Albania , and other regions of the Balkans , Caucasus , the Black Sea coast, Asia Minor , and the Eastern Mediterranean . It has the longest documented history of any Indo-European language, spanning at least 3,400 years of written records. Its writing system
1843-399: Is an AFO that only has one functional element for lifting the forefoot in order to compensate for a weakness in the dorsiflexors. If other muscle groups, such as the plantar flexors, are weak, additional functional elements must be taken into account, making a drop foot orthosis unsuitable for patients with weakness in other muscle groups. In 2006, before these new technologies were available,
1940-479: Is an Indo-European language, but also includes a number of borrowings from the languages of the populations that inhabited Greece before the arrival of Proto-Greeks, some documented in Mycenaean texts ; they include a large number of Greek toponyms . The form and meaning of many words have changed. Loanwords (words of foreign origin) have entered the language, mainly from Latin, Venetian , and Turkish . During
2037-406: Is carried out to determine strength levels. The degree of paralysis is given for each muscle group on a scale from 0 to 5, with the value 0 indicating complete paralysis (0%) and the value 5 indicating normal strength (100%). The values between 0 and 5 indicate a percentage reduction in muscle function. All strength levels below five are called muscle weakness . The combination of strength levels of
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#17327729586702134-519: Is protected and promoted officially as a regional and minority language in Armenia, Hungary , Romania, and Ukraine. It is recognized as a minority language and protected in Turkey by the 1923 Treaty of Lausanne . The phonology , morphology , syntax , and vocabulary of the language show both conservative and innovative tendencies across the entire attestation of the language from the ancient to
2231-888: Is sometimes called aljamiado , as when Romance languages are written in the Arabic alphabet. Article 1 of the Universal Declaration of Human Rights in Greek: Transcription of the example text into Latin alphabet : Article 1 of the Universal Declaration of Human Rights in English: Proto-Greek Mycenaean Ancient Koine Medieval Modern Paresis In medicine, paresis ( / p ə ˈ r iː s ɪ s , ˈ p æ r ə s ɪ s / )
2328-526: Is spoken by at least 13.5 million people today in Greece, Cyprus, Italy, Albania, Turkey , and the many other countries of the Greek diaspora . Greek roots have been widely used for centuries and continue to be widely used to coin new words in other languages; Greek and Latin are the predominant sources of international scientific vocabulary . Greek has been spoken in the Balkan peninsula since around
2425-763: Is still used internationally for the writing of Ancient Greek . In Greek, the question mark is written as the English semicolon, while the functions of the colon and semicolon are performed by a raised point (•), known as the ano teleia ( άνω τελεία ). In Greek the comma also functions as a silent letter in a handful of Greek words, principally distinguishing ό,τι ( ó,ti , 'whatever') from ότι ( óti , 'that'). Ancient Greek texts often used scriptio continua ('continuous writing'), which means that ancient authors and scribes would write word after word with no spaces or punctuation between words to differentiate or mark boundaries. Boustrophedon , or bi-directional text,
2522-650: Is the Greek alphabet , which has been used for approximately 2,800 years; previously, Greek was recorded in writing systems such as Linear B and the Cypriot syllabary . The alphabet arose from the Phoenician script and was in turn the basis of the Latin , Cyrillic , Coptic , Gothic , and many other writing systems. The Greek language holds a very important place in the history of the Western world. Beginning with
2619-549: Is the best possible approximation of the physiological gait pattern. In the case of paralysis due to multiple sclerosis , the degree of strength of the six major muscle groups of the affected leg should be determined as part of the physical examination in order to determine the necessary functions of an orthosis, just as in the case of diseases or injuries to the spinal/peripheral nervous system. However, patients with multiple sclerosis may experience muscular fatigue as well. The fatigue can be more or less pronounced and, depending on
2716-418: Is therefore limited, as even with high degrees of strength, disturbances to the gait pattern can occur due to the incorrect control of the central nervous system. In ambulatory patients with paralysis due to cerebral palsy or traumatic brain injury , the gait pattern is analysed as part of the physical examination in order to determine the necessary functions of an orthosis. One way of classifying gait
2813-495: The Eastern Mediterranean , in what are today Southern Italy , Turkey , Cyprus , Syria , Lebanon , Israel , Palestine , Egypt , and Libya ; in the area of the Black Sea , in what are today Turkey, Bulgaria , Romania , Ukraine , Russia , Georgia , Armenia , and Azerbaijan ; and, to a lesser extent, in the Western Mediterranean in and around colonies such as Massalia , Monoikos , and Mainake . It
2910-516: The Indo-Iranian languages (see Graeco-Aryan ), but little definitive evidence has been found. In addition, Albanian has also been considered somewhat related to Greek and Armenian, and it has been proposed that they all form a higher-order subgroup along with other extinct languages of the ancient Balkans; this higher-order subgroup is usually termed Palaeo-Balkan , and Greek has a central position in it. Linear B , attested as early as
3007-535: The International Committee of the Red Cross published in its 2006 Manufacturing Guidelines for Ankle-Foot Orthoses, with the aim of providing people with disabilities worldwide standardized processes for the production of high-quality, modern, durable and economical devices. Because new technologies are not widely used, AFOs are often made from polypropylene-based plastic, mostly in the shape of
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3104-492: The nominal and verbal systems. The major change in the nominal morphology since the classical stage was the disuse of the dative case (its functions being largely taken over by the genitive ). The verbal system has lost the infinitive , the synthetically -formed future, and perfect tenses and the optative mood . Many have been replaced by periphrastic ( analytical ) forms. Pronouns show distinctions in person (1st, 2nd, and 3rd), number (singular, dual , and plural in
3201-470: The 3rd millennium BC, or possibly earlier. The earliest written evidence is a Linear B clay tablet found in Messenia that dates to between 1450 and 1350 BC, making Greek the world's oldest recorded living language . Among the Indo-European languages, its date of earliest written attestation is matched only by the now-extinct Anatolian languages . The Greek language is conventionally divided into
3298-486: The Greek alphabet since approximately the 9th century BC. It was created by modifying the Phoenician alphabet , with the innovation of adopting certain letters to represent the vowels. The variant of the alphabet in use today is essentially the late Ionic variant, introduced for writing classical Attic in 403 BC. In classical Greek, as in classical Latin, only upper-case letters existed. The lower-case Greek letters were developed much later by medieval scribes to permit
3395-425: The Greek language are often emphasized. Although Greek has undergone morphological and phonological changes comparable to those seen in other languages, never since classical antiquity has its cultural, literary, and orthographic tradition been interrupted to the extent that one can speak of a new language emerging. Greek speakers today still tend to regard literary works of ancient Greek as part of their own rather than
3492-495: The Greek language was the Cypriot syllabary (also a descendant of Linear A via the intermediate Cypro-Minoan syllabary ), which is closely related to Linear B but uses somewhat different syllabic conventions to represent phoneme sequences. The Cypriot syllabary is attested in Cyprus from the 11th century BC until its gradual abandonment in the late Classical period, in favor of the standard Greek alphabet. Greek has been written in
3589-629: The Greek verb have likewise remained largely the same over the course of the language's history but with significant changes in the number of distinctions within each category and their morphological expression. Greek verbs have synthetic inflectional forms for: Many aspects of the syntax of Greek have remained constant: verbs agree with their subject only, the use of the surviving cases is largely intact (nominative for subjects and predicates, accusative for objects of most verbs and many prepositions, genitive for possessors), articles precede nouns, adpositions are largely prepositional, relative clauses follow
3686-685: The Greek-Albanian border. A significant percentage of Albania's population has knowledge of the Greek language due in part to the Albanian wave of immigration to Greece in the 1980s and '90s and the Greek community in the country. Prior to the Greco-Turkish War and the resulting population exchange in 1923 a very large population of Greek-speakers also existed in Turkey , though very few remain today. A small Greek-speaking community
3783-535: The United States, while orthotists require a prescription from a licensed healthcare provider, physical therapists are not legally authorized to prescribe orthoses. In the U.K., orthotists will often accept referrals from doctors or other healthcare professionals for orthotic assessment without requiring a prescription. Orthoses are offered as: Both custom-fabricated products and semi-finished products are used in long-term care and are manufactured or adapted by
3880-404: The acute during the late 20th century, and it has only been retained in typography . After the writing reform of 1982, most diacritics are no longer used. Since then, Greek has been written mostly in the simplified monotonic orthography (or monotonic system), which employs only the acute accent and the diaeresis. The traditional system, now called the polytonic orthography (or polytonic system),
3977-402: The ancient language; singular and plural alone in later stages), and gender (masculine, feminine, and neuter), and decline for case (from six cases in the earliest forms attested to four in the modern language). Nouns, articles, and adjectives show all the distinctions except for a person. Both attributive and predicative adjectives agree with the noun. The inflectional categories of
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4074-506: The ankle joint as static functional elements would completely block the dorsiflexion, which would have to be compensated for by the upper body, resulting in an increased energy cost when walking. The functional element's resistance to protect against unwanted dorsiflexion should be able to be adapted according to the weakness of the plantar flexors. In the case of very weak plantar flexors, the functional element's resistance against undesired dorsiflexion must be very high in order to compensate for
4171-421: The ankle joint in terminal stance and a loss of energy while walking. The center of gravity of the body lowers towards the end of the stance phase and the knee of the contralateral leg is flexed excessively. With each step, the center of gravity must be raised above the leg by straightening the excessively flexed knee. Since the plantar flexors originate above the knee joint, they also have a knee-extension effect in
4268-558: The body according to the international classification system (ICS): orthotics of the lower extremities , orthotics of the upper extremities , orthotics for the trunk , and orthotics for the head. Orthoses are also classified by function: paralysis orthoses and relief orthoses. Under the International Standard terminology, orthoses are classified by an acronym describing the anatomical joints they support. Some examples include KAFO, or knee-ankle-foot orthoses, which span
4365-454: The care of patients with weakness in other muscle groups, as these patients require additional functional elements to be taken into account. Initial contact with the heel should be achieved by lifting the foot through the orthosis, and if the dorsiflexors are very weak, control of the rapid drop of the forefoot should be taken over by dynamic functional elements that allow for adjustable resistance of plantar flexion . Orthoses should be adapted to
4462-556: The case of significant weakness, knee flexion when walking must be controlled by functional elements that mechanically secure the knee joint during the early stance phases between loading response and mid stance. Stance phase control knee joints which lock the knee in the early stance phases and release it for knee flexion during the swing phase can be used here, with these joints, a natural gait pattern can be achieved despite mechanically securing against unwanted knee flexion. In these cases, locked knee joints are often used, and while they have
4559-409: The dorsiflexors – if the dorsiflexors are weak, an orthosis should lift the forefoot during the swing phase in order to reduce the risk of the patient stumbling. An orthosis that has only one functional element for lifting the forefoot in order to compensate for a weakness in the dorsiflexors is also known as a drop foot orthosis. An AFO of the drop foot orthosis type is therefore not suitable for
4656-417: The dynamics of the lower extremities as little as possible to preserve the remaining functionality of the muscles. In the case of paralysis due to disease or injury to the spinal/peripheral nervous system, a physical examination is needed to determine the strength levels of the affected leg's six major muscle groups and the orthosis's necessary functions. According to Vladimir Janda, a muscle function test
4753-404: The early 19th century that was used for literary and official purposes in the newly formed Greek state. In 1976, Dimotiki was declared the official language of Greece, after having incorporated features of Katharevousa and thus giving birth to Standard Modern Greek , used today for all official purposes and in education . The historical unity and continuing identity between the various stages of
4850-479: The elements should be integrated into one orthotic joint. The necessary dynamics and resistance to movements in the ankle can be adapted via adjustable functional elements in the ankle joint of the orthosis, which allows it to compensate for muscle weaknesses, provide safety when standing and walking, and still allow as much mobility as possible. For example, adjustable spring units with pre-compression can enable an exact adaptation of both static and dynamic resistance to
4947-419: The energy needed to walk with it, the use of light weight and highly resilient materials such as carbon fiber , titanium and aluminum is indispensable for the manufacture of a custom-made orthosis. The production of a custom-made orthotic also allows the integration of orthotic joints, which means the dynamics of the orthotic can be matched exactly with the pivot points of the patient's anatomical joints. As
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#17327729586705044-618: The epics of Homer , ancient Greek literature includes many works of lasting importance in the European canon . Greek is also the language in which many of the foundational texts in science and philosophy were originally composed. The New Testament of the Christian Bible was also originally written in Greek. Together with the Latin texts and traditions of the Roman world , the Greek texts and Greek societies of antiquity constitute
5141-410: The first standing exercises, and this makes the work of mobilizing the patient at an early stage easier. With the right functional elements that maintain physiological mobility and provide security when standing and walking, the necessary motor impulses to create new cerebral connections can occur. Clinical studies confirm the importance of orthoses in stroke rehabilitation. Patients with paralysis after
5238-401: The flexible part of the forefoot). It is now possible to combine the required rigidity of the orthotic shells with the dynamics in the ankle, with this, other new technologies, and the possibility of producing lightweight but rigid orthoses, new demands have been made of orthotics: A custom-made AFO can compensate for functional deviations of muscle groups, it should be configured according to
5335-452: The following periods: In the modern era, the Greek language entered a state of diglossia : the coexistence of vernacular and archaizing written forms of the language. What came to be known as the Greek language question was a polarization between two competing varieties of Modern Greek: Dimotiki , the vernacular form of Modern Greek proper, and Katharevousa , meaning 'purified', a compromise between Dimotiki and Ancient Greek developed in
5432-428: The foot, the ankle joint, the lower leg, the knee joint, the thigh or the hip joint belong to the category of orthoses for the lower extremities. Paralysis orthoses are used for partial or complete paralysis, as well as complete functional failure of muscles or muscle groups, or incomplete paralysis ( paresis ). They are intended to correct or improve functional limitations or to replace functions that have been lost as
5529-449: The front to determine if the foot is inverted , if it is the letter "a" is added to the gait. This is associated with a varus deformity of the knee. If instead the patient stands on the inner edge of the foot (eversion), which is associated with a valgus deformity of the knee, the letter "b" is added to the gait type. Patients are thus classified as gait types 1a, 1b, 2a or 2b. The goal of orthotic fitting for patients who are able to walk
5626-439: The functional deviation of the dorsiflexors in order to correct the shock absorption of the heel rocker lever during loading response, but should not block plantar flexion of the ankle joint as this leads to excessive flexion in the knee and hip and an increase in the energy needed for walking. This is why static functional elements are not recommended when there are newer technical alternatives. Functional elements in paralysis of
5723-399: The functional deviations this causes. Adjustable functional elements allow the resistance to be adjusted exactly to the weakness of the muscle, and scientific studies recommend adjustable resistance in patients with paralysis or weakness of the plantar flexors. Functional elements in paralysis of knee extensors and hip extensors – in the case of weak knee extensors or hip extensors ,
5820-403: The gait pattern is assessed in the mid-stance phase and described as one of four possible gait types. This assessment is a two step process, in the first step, the patient is viewed from the side of the leg to be assessed, either directly or via a video recording. In gait type 1 the knee angle is hyperextended, while in type 2 the knee angle is flexed. In the second step the patient is viewed from
5917-439: The infinitive entirely (employing a raft of new periphrastic constructions instead) and uses participles more restrictively. The loss of the dative led to a rise of prepositional indirect objects (and the use of the genitive to directly mark these as well). Ancient Greek tended to be verb-final, but neutral word order in the modern language is VSO or SVO. Modern Greek inherits most of its vocabulary from Ancient Greek, which in turn
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#17327729586706014-450: The knee can be flexed to sit down. AFO is the abbreviation for ankle-foot orthoses, which is the English name for an orthosis that spans the ankle and foot. In the treatment of paralyzed patients, they are mainly used when there is a weakness of the dorsiflexors or plantar flexors . Through the use of modern materials, such as carbon fibers and aramid fibers, and new knowledge about processing these materials into composite materials,
6111-494: The knee in pre-swing. Paralysis of the hip extensors – the hip extensors help control of the knee against unwanted flexion when walking between loading response and mid-stance. The functional elements of an orthosis ensure the flexion and extension movements of the ankle, knee and hip joints. They correct and control the movements and secure the joints against undesired incorrect movements, and help avoid falls when standing or walking. Functional elements in paralysis of
6208-490: The knee, ankle, and foot; TLSO, or thoracic-lumbar-sacral orthoses, supporting the thoracic , lumbar and sacral regions of the spine . The use of the International Standard is promoted to reduce the widespread variation in the description of orthoses, which is often a barrier to interpreting research studies. The transition from an orthosis to a prosthesis can be fluid. An example is compensating for
6305-467: The late 15th century BC, was the first script used to write Greek. It is basically a syllabary , which was finally deciphered by Michael Ventris and John Chadwick in the 1950s (its precursor, Linear A , has not been deciphered and most likely encodes a non-Greek language). The language of the Linear B texts, Mycenaean Greek , is the earliest known form of Greek. Another similar system used to write
6402-451: The load data. An ankle joint based on new technology is the connection between the foot shell and the lower leg shell and at the same time contains all the necessary adjustable functional elements of an AFO. Depending on the combination of the degree of paralysis of the dorsiflexors or plantar flexors , different functional elements to compensate for their weakness can be integrated into the ankle joint; if both muscle groups are affected,
6499-431: The measured degree of muscle weakness. Studies show the positive effects of these new technologies. It is of great advantage if the resistances for these two functional elements can be set separately. An AFO with functional elements to compensate for a weakness of the plantar flexors can also be used for slight weakness of the knee-securing muscle groups, the knee extensors and the hip extensors . A drop foot orthosis
6596-640: The membership of Greece and Cyprus in the European Union, Greek is one of the organization's 24 official languages . Greek is recognized as a minority language in Albania, and used co-officially in some of its municipalities, in the districts of Gjirokastër and Sarandë . It is also an official minority language in the regions of Apulia and Calabria in Italy. In the framework of the European Charter for Regional or Minority Languages , Greek
6693-546: The mobility of the ankle joint. A "Hinged AFO" only allowed for the compensation that could be achieved with the orthotic joints of the time, for example, they commonly block plantar flexion, as the joints cannot simultaneously transmit the large forces that are required to compensate for muscle deviations while also offering the necessary dynamics. Greek language Greek ( Modern Greek : Ελληνικά , romanized : Elliniká , [eliniˈka] ; Ancient Greek : Ἑλληνική , romanized : Hellēnikḗ )
6790-441: The modern period. The division into conventional periods is, as with all such periodizations, relatively arbitrary, especially because, in all periods, Ancient Greek has enjoyed high prestige, and the literate borrowed heavily from it. Across its history, the syllabic structure of Greek has varied little: Greek shows a mixed syllable structure, permitting complex syllabic onsets but very restricted codas. It has only oral vowels and
6887-409: The muscle groups determines the type of orthosis (AFO or KAFO) and the functional elements necessary to compensate for restrictions caused by the reduced muscular strength levels. Paralysis may be caused by injury to the spinal or peripheral nervous system after spinal cord injury , or by diseases such as spina bifida , poliomyelitis and Charcot-Marie-Tooth disease . In these patients, knowledge of
6984-415: The muscles are not paralyzed but being sent the wrong impulses from the brain, the functional elements used in the orthotics are the same for both groups. The compensatory gait is an unconscious reaction to the lack of security when standing or walking that usually worsens with increasing age; if the right functional elements are integrated into the orthosis to counter this, and maintain physiological mobility,
7081-399: The noun they modify and relative pronouns are clause-initial. However, the morphological changes also have their counterparts in the syntax, and there are also significant differences between the syntax of the ancient and that of the modern form of the language . Ancient Greek made great use of participial constructions and of constructions involving the infinitive, and the modern variety lacks
7178-536: The objects of study of the discipline of Classics . During antiquity , Greek was by far the most widely spoken lingua franca in the Mediterranean world . It eventually became the official language of the Byzantine Empire and developed into Medieval Greek . In its modern form , Greek is the official language of Greece and Cyprus and one of the 24 official languages of the European Union . It
7275-706: The older periods of Greek, loanwords into Greek acquired Greek inflections, thus leaving only a foreign root word. Modern borrowings (from the 20th century on), especially from French and English, are typically not inflected; other modern borrowings are derived from Albanian , South Slavic ( Macedonian / Bulgarian ) and Eastern Romance languages ( Aromanian and Megleno-Romanian ). Greek words have been widely borrowed into other languages, including English. Example words include: mathematics , physics , astronomy , democracy , philosophy , athletics , theatre, rhetoric , baptism , evangelist , etc. Moreover, Greek words and word elements continue to be productive as
7372-404: The orthosis must take over the stability and stance phase control when walking. Different knee-securing functional elements are needed depending on the weakness of these muscles. In order to compensate for functional deviations with slightly weakness of these muscle groups, a free moving mechanical knee joint with the mechanical pivot point behind the anatomical knee pivot point can be sufficient. In
7469-541: The orthotic it is important to understand that the muscle groups are not paralyzed, but are controlled by the brain with wrong impulses, and this is why a muscle function test can lead to incorrect results when assessing the ability to stand and walk. An important basic requirement for regaining the ability to walk is that the patient trains early on to stand on both legs safely and well balanced. An orthosis with functional elements to support balance and safety when standing and walking can be integrated into physical therapy from
7566-444: The orthotist or by trained orthopedic technicians according to the prescription. In many countries the physician or clinician defines the functional deviations in his prescription, e.g. paralysis ( paresis ) of the calf muscles ( M. Triceps Surae ) and derives the indication from this, e.g. orthotic to restore safety when standing and walking after a stroke . The orthotist creates another detailed physical examination and compares it with
7663-407: The patient data through a function and load calculation so that it meets the functional and load requirements. In calculating or configuring an AFO, variants are optimally matched to individual requirements for the functional elements of the ankle joint, for the stiffness of the foot shell, and for the shape of the lower leg shell. The size of these components is selected by matching their resilience to
7760-415: The patient's medical history, fatigue can be taken into account by using a standardized six-minute walking test. According to Vladimir Janda the muscle function test is carried out in combination with the six-minute walk test in the following steps: This sequence of muscle function test and six-minute walk test is used to determine whether muscular fatigue can be induced. If the test reveals muscular fatigue,
7857-440: The plantar flexors – If the plantar flexors are weak, the muscles of the forefoot lever are either inadequately activated or not activated at all. The patient has no balance when standing and has to support themself with aids such as crutches . The forefoot lever required for energy-saving walking in the gait phases from mid-stance to pre-swing cannot be activated by the plantar flexors. This leads to excessive dorsiflexion in
7954-400: The plantar flexors – in order to compensate for a weakness of the plantar flexors , the orthosis has to transfer large forces that the strong muscle group would otherwise take over. These forces are transmitted in a similar way to a ski boot during downhill skiing via the functional elements of the foot part, ankle joint and lower leg shell. Dynamic functional elements are preferable for
8051-408: The plantar flexors, leading into hyperextension of the knee, or when initial contact is with the forefoot and not the heel in order to prevent the knee-flexing effect of the heel rocker. Paralysis of the knee flexors – if the knee flexors are weak, it is more difficult to flex the knee in pre-swing. Paralysis of the hip flexors – if the hip flexors are weak, it is more difficult to flex
8148-526: The prescription from the physician. The orthotist describes the configuration of the orthosis, which shows which orthotic functions are required to compensate for the functional deviation of the neuromuscular or skeletal system and which functional elements must be integrated into the orthosis for this. Ideally, the necessary orthotic functions and the functional elements to be integrated are discussed in an interdisciplinary team between physician, physical therapist , orthotist and patient. All orthoses that affect
8245-562: The right motor impulses are sent to create new cerebral connections. The goal of an orthotic is the best possible approximation of the physiological gait pattern. In the case of paralysis after a stroke , rapid care with an orthosis is necessary. Often areas of the brain are affected that contain "programs" for controlling the musculoskeletal system. With the help of an orthosis, physiological standing and walking can be relearned, preventing long term health consequences caused by an abnormal gait pattern. According to Vladimir Janda, when configuring
8342-426: The severity, can lead to considerable restrictions in everyday life. Persistent stress, such as from walking, causes a deterioration in muscle function and has a significant effect on the spatial and temporal parameters of walking, for example by significantly reducing the cadence and walking speed. Fatigue can be measured as muscle weakness . When determining the strength levels of the six major muscle groups as part of
8439-408: The stance phase. Paralysis of the knee extensors – if the knee extensors are weak, there is an increased risk of falling when walking, as between loading response to the mid-stance the knee extensors control knee flexion inadequately, or not at all. To control the knee, the patient develops compensatory mechanisms that lead to an incorrect gait pattern, for example by exaggerated activation of
8536-405: The strength levels and measured fatigue should be included in the planning of an orthosis, and when determining the functional elements. Paralysis of the dorsiflexors – weakness of the dorsiflexors results in a drop foot . The patient's foot cannot be sufficiently lifted during the swing phase while walking, as the necessary concentric work of the dorsiflexors can not be activated. There
8633-406: The strength levels of the large muscle groups is necessary to configure the orthotic for the necessary functions. Paralysis caused by diseases or injuries to the central nervous system (e.g. cerebral palsy , traumatic brain injury , stroke , and multiple sclerosis ) can cause incorrect motor impulses that often result in clearly visible deviations in gait. The usefulness of muscle strength tests
8730-437: The stressed vowel; the so-called breathing marks ( rough and smooth breathing ), originally used to signal presence or absence of word-initial /h/; and the diaeresis , used to mark the full syllabic value of a vowel that would otherwise be read as part of a diphthong. These marks were introduced during the course of the Hellenistic period. Actual usage of the grave in handwriting saw a rapid decline in favor of uniform usage of
8827-403: The use of orthosis joints. In this way, the combination of the orthotic joints and the adjustability of the functional elements can be adjusted to compensate for any existing functional deviations that have resulted from the muscle weakness. The goal of a high-quality orthotic fitting is to adjust the functional elements so precisely that the orthosis provides the necessary support while restricting
8924-423: The weight of orthotics has been reduced significantly. In addition to the weight reduction, these materials and technologies have created the possibility of making some areas of an orthosis so rigid that it can take over the forces of the weakened muscles (e.g. the connection from the ankle joint to the frontal contact surface on the shin), while at the same time leaving areas requiring less support very flexible (e.g.
9021-574: Was a distinct dialect of Greek itself. Aside from the Macedonian question, current consensus regards Phrygian as the closest relative of Greek, since they share a number of phonological, morphological and lexical isoglosses , with some being exclusive between them. Scholars have proposed a Graeco-Phrygian subgroup out of which Greek and Phrygian originated. Among living languages, some Indo-Europeanists suggest that Greek may be most closely related to Armenian (see Graeco-Armenian ) or
9118-568: Was also used as the official language of government and religion in the Christian Nubian kingdoms , for most of their history. Greek, in its modern form, is the official language of Greece, where it is spoken by almost the entire population. It is also the official language of Cyprus (nominally alongside Turkish ) and the British Overseas Territory of Akrotiri and Dhekelia (alongside English ). Because of
9215-557: Was also used in Ancient Greek. Greek has occasionally been written in the Latin script , especially in areas under Venetian rule or by Greek Catholics . The term Frankolevantinika / Φραγκολεβαντίνικα applies when the Latin script is used to write Greek in the cultural ambit of Catholicism (because Frankos / Φράγκος is an older Greek term for West-European dating to when most of (Roman Catholic Christian) West Europe
9312-580: Was under the control of the Frankish Empire ). Frankochiotika / Φραγκοχιώτικα (meaning 'Catholic Chiot') alludes to the significant presence of Catholic missionaries based on the island of Chios . Additionally, the term Greeklish is often used when the Greek language is written in a Latin script in online communications. The Latin script is nowadays used by the Greek-speaking communities of Southern Italy . The Yevanic dialect
9409-673: Was written by Romaniote and Constantinopolitan Karaite Jews using the Hebrew Alphabet . In a tradition, that in modern time, has come to be known as Greek Aljamiado , some Greek Muslims from Crete wrote their Cretan Greek in the Arabic alphabet . The same happened among Epirote Muslims in Ioannina . This also happened among Arabic-speaking Byzantine rite Christians in the Levant ( Lebanon , Palestine, and Syria ). This usage
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