CO Treatment Planning & Protocols 2 — Questions and Answers
Question 1: A patient with post-polio syndrome presents with knee hyperextension during stance phase. Which orthotic intervention is most appropriate?
- Solid ankle AFO with anterior trim line
- Knee-ankle-foot orthosis with posterior offset knee joint (Correct answer)
- Floor-reaction AFO
- Swedish knee cage
Correct answer: Knee-ankle-foot orthosis with posterior offset knee joint
A KAFO with a posterior offset knee joint places the knee joint axis behind the weight-bearing line, providing a knee extension moment to control genu recurvatum.
Question 2: During the treatment planning process, which factor should be evaluated FIRST before selecting an orthotic design?
- Patient's insurance coverage
- Pathomechanics and biomechanical assessment (Correct answer)
- Cosmetic preferences of the patient
- Available materials in the facility
Correct answer: Pathomechanics and biomechanical assessment
Pathomechanical and biomechanical assessment must occur first to identify functional deficits and guide appropriate orthotic intervention.
Question 3: A child with cerebral palsy (spastic diplegia) benefits most from which orthotic treatment goal?
- Maximizing passive range of motion only
- Improving gait pattern and preventing contractures (Correct answer)
- Eliminating all muscle spasticity
- Providing full-time immobilization of lower limbs
Correct answer: Improving gait pattern and preventing contractures
For spastic diplegia, orthotics aim to improve functional gait patterns and prevent secondary musculoskeletal deformities such as contractures.
Question 4: When developing a treatment protocol for a patient with diabetic peripheral neuropathy, which consideration is MOST critical?
- Maximizing ambulation speed
- Pressure distribution and skin integrity (Correct answer)
- Achieving maximum joint ROM
- Reducing orthotic weight to minimum
Correct answer: Pressure distribution and skin integrity
Patients with diabetic neuropathy have impaired sensation, making pressure distribution and prevention of skin breakdown the paramount orthotic concern.
Question 5: A patient requires a cervical orthosis following a C5 fracture that is deemed stable. Which device provides the MOST appropriate immobilization for this scenario?
- Soft foam cervical collar
- Philadelphia collar
- Cervicothoracic orthosis (CTO) (Correct answer)
- Halo vest
Correct answer: Cervicothoracic orthosis (CTO)
A cervicothoracic orthosis provides superior immobilization compared to cervical-only collars by incorporating thoracic fixation, appropriate for stable mid-cervical fractures.
Question 6: Which gait deviation is directly addressed by a plantarflexion stop built into an AFO?
- Contralateral hip drop (Trendelenburg gait)
- Foot drop during swing phase (Correct answer)
- Excessive knee flexion in mid-stance
- Toe-out gait pattern
Correct answer: Foot drop during swing phase
A plantarflexion stop prevents the foot from dropping into plantarflexion during swing, eliminating foot drop and reducing tripping risk.
Question 7: In developing a treatment plan for lateral epicondylitis (tennis elbow), what is the primary mechanical goal of a counterforce brace?
- Immobilize the elbow joint completely
- Reduce forearm muscle bulk
- Decrease tensile forces transmitted to the lateral epicondyle (Correct answer)
- Increase wrist extension strength
Correct answer: Decrease tensile forces transmitted to the lateral epicondyle
A counterforce brace applies circumferential compression to the forearm musculature, redirecting muscle forces and reducing stress at the lateral epicondyle attachment.
CO Treatment Planning & Protocols 2
A patient with post-polio syndrome presents with knee hyperextension during stance phase.
Which orthotic intervention is most appropriate?