Fitting & Adjustment Techniques Flashcards

When fitting a thoracolumbosacral orthosis (TLSO), the superior trim line anteriorly should be positioned:

Answer: Two finger-widths below the sternal notch

Positioning the anterior superior trim line two finger-widths below the sternal notch allows comfortable breathing and prevents impingement during sitting.

A patient with a cervical orthosis reports persistent occipital pressure sores. The best corrective action is to:

Answer: Reduce the height of the posterior occipital pad

Reducing occipital pad height relieves direct contact pressure while maintaining cervical support.

In fitting a scoliosis orthosis (TLSO), the apex pad is placed:

Answer: On the convex side of the curve at the apex level

The apex pad applies a corrective force from the convex side to push the spine toward correction.

When evaluating AFO fit during gait, heel rise during terminal stance indicates:

Answer: The plantar flexion stop is too soft or absent

Premature or excessive heel rise occurs when the plantar flexion stop does not adequately resist push-off forces.

A key step when checking the fit of a custom foot orthosis (CFO) is to:

Answer: Assess the patient standing with the orthosis on a flat surface before in-shoe check

Checking fit on a flat surface first allows visual inspection of contact, alignment, and edge clearance before the orthosis is enclosed in the shoe.

The purpose of a metatarsal pad in an orthotic device is to:

Answer: Unload the metatarsal heads by elevating the metatarsal shafts

A metatarsal pad placed proximal to the metatarsal heads transfers load to the shafts, reducing plantar pressure at the heads.

When a patient with a trans-tibial prosthetic liner develops a proximal pistoning problem, the orthotic fitter assisting with liner management should first assess:

Answer: Residual limb volume with a circumferential tape measure

Volume change in the residual limb is the most common cause of pistoning, making circumferential measurement the first clinical step.