COF Cheat Sheet 2026

The 30 highest-yield COF facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A certified orthotic fitter learns that a patient's insurance will not cover the most clinically appropriate device. The fitter should: → Inform the patient of all options including the non-covered device and associated costs
2. When performing a skin check after initial AFO fitting, redness that blanches with pressure and resolves within 20 minutes is classified as: → Normal reactive hyperemia from initial loading
3. Which measurement is taken to determine the correct length of a Lofstrand (forearm) crutch for a patient? → From the floor to 2 inches below the elbow flexed at 15-20 degrees
4. A pharmaceutical company offers to sponsor an orthotic fitter's continuing education in exchange for product endorsements. The fitter should: → Disclose the sponsorship arrangement and evaluate for conflicts of interest
5. In a patient with L3–L4 spinal cord injury, which orthotic option best facilitates community ambulation? → Bilateral KAFOs
6. In Patient Assessment & Measurement, what is the FIRST step a COF professional should take when encountering a new case or situation? → Conduct a comprehensive assessment and gather all relevant information
7. A certified orthotic fitter receives a subpoena requesting patient records for a legal proceeding. The appropriate response is to: → Consult legal counsel and follow applicable HIPAA and state law procedures
8. What material property is MOST critical when selecting thermoplastic materials for pediatric orthoses compared to adult orthoses? → Low-temperature formability to facilitate frequent remolding as the child grows
9. How can a COF demonstrate professionalism? → Respecting and listening to patient needs
10. A patient with a spastic equinovarus foot in cerebral palsy would most likely exhibit which gait deviation during swing phase? → All of the above are common compensations
11. A patient's skin assessment reveals stage 2 pressure injury under a previously worn orthosis. The FIRST step in the fitting process should be: → Document and refer to wound care before refitting
12. Which anatomical landmark is used as the proximal reference point when measuring for a knee-ankle-foot orthosis (KAFO)? → Ischial tuberosity
13. For a child fitted with a Resting Hand Splint following spastic hemiplegia, what wrist and finger position should be maintained? → Wrist 20–30° extension, fingers and thumb in functional alignment
14. Which ligament of the ankle is most commonly injured in an inversion sprain? → Anterior talofibular ligament
15. In Lower Extremity Orthotics, what is the FIRST step a COF professional should take when encountering a new case or situation? → Conduct a comprehensive assessment and gather all relevant information
16. What is the primary role of ligaments? → Connect bones to bones
17. Which neuromuscular condition is characterized by progressive proximal muscle weakness and is most commonly managed with KAFOs to maintain ambulation? → Duchenne muscular dystrophy
18. What is the primary function of the skeletal system? → Support and protect the body
19. When adjusting a thermoplastic AFO for a patient with increased spasticity, the fitter should: → Heat and reform the ankle section to increase dorsiflexion assistance
20. When fitting a pediatric DAFO (dynamic AFO) for a child with cerebral palsy, the foot should be casted in: → Subtalar neutral with forefoot in a plantigrade position
21. Metatarsus adductus in an infant is BEST described as: → Adduction of the forefoot relative to a normally aligned hindfoot
22. Which clinical finding on static foot evaluation most strongly predicts excessive dynamic pronation during gait? → Compensated rearfoot varus with subtalar joint mobility
23. What is one goal of orthotic fitting? → Improve function and support
24. In three-dimensional gait analysis, the 'sagittal plane' primarily captures which type of joint motion? → Flexion and extension
25. What is the function of synovial fluid? → Lubricate joints
26. What is the most important step before fitting any orthotic device? → Conduct a thorough patient assessment
27. Which method improves patient compliance? → Written and verbal instructions
28. What is the function of a steel shank in therapeutic footwear? → Limit forefoot flexion and reduce stress on the metatarsals during propulsion
29. During a lower extremity assessment, a patient demonstrates a positive Thomas test. This finding indicates: → Hip flexor tightness/contracture
30. When a patient lacks decision-making capacity, informed consent for an orthotic intervention should be obtained from: → A legally authorized representative such as a healthcare proxy or guardian