CFO CFO Therapeutic Outcomes & Follow-Up 2 — Questions and Answers
Question 1: Which outcome assessment tool is recommended for measuring pain and function in patients receiving knee orthotics for osteoarthritis?
- Oswestry Disability Index
- WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) (Correct answer)
- Upper Extremity Functional Index
- Modified Ashworth Scale
Correct answer: WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index)
The WOMAC is a validated, disease-specific tool that measures pain, stiffness, and physical function in patients with knee and hip osteoarthritis.
Question 2: A patient with a new custom KAFO returns complaining the device causes skin breakdown at the proximal thigh band. What is the first corrective step?
- Discontinue use permanently
- Pad the offending area and adjust band positioning to relieve pressure (Correct answer)
- Switch to a prefabricated KAFO immediately
- Prescribe antibiotics
Correct answer: Pad the offending area and adjust band positioning to relieve pressure
Skin breakdown at a banding interface requires padding the pressure area and repositioning the band to redistribute load before resuming use.
Question 3: What does a 'gait analysis during follow-up' primarily help the fitter evaluate?
- The patient's insurance coverage
- Whether the orthosis is achieving the intended biomechanical correction during functional activity (Correct answer)
- The durability of the top cover material
- The patient's compliance with home exercise
Correct answer: Whether the orthosis is achieving the intended biomechanical correction during functional activity
Follow-up gait analysis reveals whether the orthotic is achieving its biomechanical goals (e.g., controlling pronation, reducing drop foot) during actual walking.
Question 4: When a patient reports their orthotic has 'broken in' and feels flat after 12 months, what is the recommended clinical action?
- Reassure the patient this is normal and requires no intervention
- Evaluate material wear and consider refabrication or component replacement (Correct answer)
- Add more shoe inserts over the top
- Recommend a different shoe brand
Correct answer: Evaluate material wear and consider refabrication or component replacement
A 'flat' orthotic indicates material fatigue and loss of corrective geometry, necessitating clinical evaluation and likely refabrication to restore function.
Question 5: Which patient-reported outcome measure specifically evaluates lower limb function and is frequently used in orthotic follow-up care?
- SF-36 Mental Health Component only
- Lower Extremity Functional Scale (LEFS) (Correct answer)
- Visual Analog Scale for upper limb pain
- Neck Disability Index
Correct answer: Lower Extremity Functional Scale (LEFS)
The Lower Extremity Functional Scale (LEFS) is a validated 20-item questionnaire measuring functional ability in patients with lower limb conditions, suitable for orthotic outcomes.
Question 6: A pediatric patient fitted with SMOs for hypotonia returns for a 3-month follow-up. The primary evaluation focus should be:
- Whether the child has outgrown the device and if developmental milestones have progressed (Correct answer)
- Adult BMI calculation
- Insurance expiration dates
- Peer comparison of shoe preferences
Correct answer: Whether the child has outgrown the device and if developmental milestones have progressed
In pediatric orthotic follow-up, growth-related device fit and the child's developmental progress (standing, walking milestones) are the primary clinical focus.
CFO CFO Therapeutic Outcomes & Follow-Up 2
Which outcome assessment tool is recommended for measuring pain and function in patients receiving knee orthotics for osteoarthritis?