CO Patient Assessment & Evaluation 2 — Questions and Answers
Question 1: When assessing a patient with foot drop, which gait deviation is most commonly observed?
- Trendelenburg gait
- Steppage gait (Correct answer)
- Scissor gait
- Antalgic gait
Correct answer: Steppage gait
Steppage gait occurs when the patient excessively flexes the hip and knee to clear the foot during swing phase due to weak dorsiflexors.
Question 2: A certified orthotist is evaluating a patient with scoliosis. Which measurement is essential when determining Cobb angle severity?
- Distance between ASIS landmarks
- Angle between endplates of the most tilted vertebrae (Correct answer)
- Sagittal plane curvature at L4-L5
- Rib hump height in centimeters
Correct answer: Angle between endplates of the most tilted vertebrae
The Cobb angle is measured as the angle between lines drawn along the endplates of the most tilted vertebrae above and below the curve apex.
Question 3: During assessment of a diabetic patient, which finding would most urgently require referral before orthotic fitting?
- Mild callus formation on the plantar surface
- Open, non-healing ulcer with signs of infection (Correct answer)
- Reduced plantar sensation to 5.07 monofilament
- Mild hammertoe deformity without skin breakdown
Correct answer: Open, non-healing ulcer with signs of infection
An open, infected wound requires immediate medical management prior to orthotic fitting to prevent further complications or sepsis.
Question 4: When documenting passive range of motion for ankle dorsiflexion with the knee extended, the normal expected value is approximately:
- 0–5 degrees
- 10–20 degrees (Correct answer)
- 20–30 degrees
- 30–40 degrees
Correct answer: 10–20 degrees
Normal passive ankle dorsiflexion with knee extended is approximately 10–20 degrees, reflecting gastrocnemius-soleus flexibility.
Question 5: A patient reports increased medial knee pain when wearing a newly fitted KAFO. The most appropriate first assessment step is to:
- Order new radiographs of the knee
- Check the medial upright alignment relative to the joint axis (Correct answer)
- Replace the knee joint with a free-motion joint
- Recommend the patient use OTC knee sleeve instead
Correct answer: Check the medial upright alignment relative to the joint axis
Medial pain from a KAFO commonly indicates the medial upright is pressing due to misalignment with the anatomical knee joint axis.
Question 6: Which standardized outcome measure is most appropriate for assessing functional mobility in adults using lower limb orthotics?
- Oswestry Disability Index
- Timed Up and Go (TUG) test (Correct answer)
- Berg Balance Scale only for fall risk
- Visual Analog Scale for pain
Correct answer: Timed Up and Go (TUG) test
The Timed Up and Go test measures functional mobility, balance, and fall risk and is widely validated for orthotic users.
Question 7: During a pediatric assessment for an orthotic device, which developmental milestone is critical to confirm before prescribing a dynamic AFO for gait training?
- Ability to crawl independently
- Sufficient voluntary lower extremity motor control to benefit from orthotic assistance (Correct answer)
- Presence of all primary dentition
- Achievement of 20/20 visual acuity
Correct answer: Sufficient voluntary lower extremity motor control to benefit from orthotic assistance
Voluntary lower extremity motor control is essential to ensure the child can actively participate in gait training with the AFO.
CO Patient Assessment & Evaluation 2
When assessing a patient with foot drop, which gait deviation is most commonly observed?