CFO Case Analysis & Practical Application 3

Question 1

During a gait analysis, you observe that a patient with a custom foot orthosis exhibits excessive midstance pronation despite a medial rearfoot post. What is the most appropriate next step?

Accepted Answer

Add or increase medial forefoot posting to address forefoot varus

Answer

Persistent midstance pronation despite rearfoot posting often indicates an unaddressed forefoot varus that requires medial forefoot correction.

Question 2

A patient with a leg length discrepancy of 12 mm presents with chronic low back pain. The fitter confirms the discrepancy is structural. What is the standard orthotic approach?

Accepted Answer

Begin with a heel lift of approximately one-half the measured discrepancy

Answer

Standard practice is to start with roughly half the discrepancy to allow the musculoskeletal system to adapt before progressing to full correction.

Question 3

A patient's custom orthosis causes pain under the first metatarsal head two weeks after dispensing. On inspection, the medial forefoot post appears too high. Which adjustment is most appropriate?

Accepted Answer

Grind down the medial post to reduce elevation under the first ray

Answer

Reducing the medial post height relieves excessive pressure transferred to the first metatarsal head caused by over-correction.

Question 4

A teenager with Sever's disease (calcaneal apophysitis) is seen for orthotic management. Which feature is most important in the prescribed device?

Accepted Answer

Heel cushioning or slight heel lift to reduce tension on the Achilles insertion

Answer

Heel cushioning and a slight lift reduce compressive and tensile forces at the calcaneal apophysis, alleviating Sever's disease pain.

Question 5

A patient with hallux rigidus is prescribed an orthosis. Which design feature most effectively reduces pain during the propulsive phase of gait?

Accepted Answer

Morton's extension or full-length rigid plate to limit first MTP dorsiflexion

Answer

A Morton's extension or rigid plate prevents painful dorsiflexion at the fused or arthritic first MTP joint during toe-off.

(CFO) Certified Fitter Orthotics Practice Test

(CFO) Certified Fitter Orthotics Practice Test

CFO Case Analysis & Practical Application 3