Fitting & Adjustment Techniques Flashcards

When fitting a prefabricated AFO, which measurement is most critical to ensure proper fit at the ankle?

Answer: Malleolar width and ankle circumference

Malleolar width and ankle circumference determine whether the AFO will accommodate bony prominences and prevent pressure sores.

A patient with a custom KAFO reports lateral knee pain after one week of use. The most likely cause is:

Answer: Lateral knee joint aligned too distal

A lateral knee joint positioned too distal creates a valgus moment arm that concentrates pressure on the lateral condyle.

The 'three-point pressure system' in orthotic fitting primarily serves to:

Answer: Correct or accommodate deformity through opposing forces

A three-point pressure system applies a primary corrective force and two counter-forces to achieve controlled alignment.

When adjusting a thermoplastic AFO for a patient with increased spasticity, the fitter should:

Answer: Heat and reform the ankle section to increase dorsiflexion assistance

Reforming the thermoplastic at the ankle can adjust the angle of set to better manage plantar flexion tone in a spastic limb.

A patient using a wrist-hand orthosis (WHO) complains of numbness in digits 4 and 5. The fitter should first check:

Answer: Pressure over the hypothenar eminence and ulnar styloid

Ulnar nerve compression at the hypothenar eminence or ulnar styloid commonly produces numbness in the ring and little fingers.

During dynamic AFO fitting, the fitter notices the patient's knee hyperextends at midstance. The appropriate adjustment is to:

Answer: Set the AFO in slight dorsiflexion

Setting the AFO in slight dorsiflexion creates a knee flexion moment at midstance, counteracting genu recurvatum.

Which padding material is most appropriate for relieving pressure over a bony prominence in a rigid orthosis?

Answer: Silicone gel pad

Silicone gel pads distribute pressure evenly over bony prominences and resist bottoming out better than foam materials.