Fitting & Adjustment Techniques Flashcards

When fitting a pediatric DAFO (dynamic AFO) for a child with cerebral palsy, the foot should be casted in:

Answer: Subtalar neutral with forefoot in a plantigrade position

Casting in subtalar neutral with a plantigrade foot provides the corrected alignment needed for an effective DAFO mold.

During a follow-up visit, a patient reports that their hinged AFO clicks during gait. The fitter should first inspect:

Answer: The hinge mechanism for loose hardware or worn bushings

Clicking during gait at a hinged AFO almost always indicates loose screws, worn bushings, or debris in the hinge mechanism.

The purpose of a Thomas heel extension on a foot orthosis is to:

Answer: Extend the medial heel flange to support the sustentaculum tali and medial arch

A Thomas heel extension projects anteriorly and medially under the sustentaculum tali to support the medial longitudinal arch.

When a patient with a transtibial amputation uses a foot orthosis in their prosthetic foot, the primary goal is to:

Answer: Correct valgus or varus foot position within the prosthetic foot shell

An orthotic insert within a prosthetic foot shell can correct foot alignment (varus/valgus) to optimize gait biomechanics.

A patient fitted with a lumbar sacral orthosis (LSO) for low back pain reports increased symptoms when sitting. The fitter should evaluate:

Answer: Lumbopelvic alignment and whether the orthosis accommodates seated posture

An LSO that does not accommodate the postural changes of sitting can increase lumbar loading; re-evaluating fit in the seated position is essential.

The correct procedure for measuring a patient for a prefabricated elbow orthosis includes:

Answer: Measuring circumference at the olecranon and forearm mid-shaft

Circumferential measurements at the olecranon and forearm mid-shaft determine which prefabricated elbow orthosis size will fit without causing pressure or migration.

After fitting a new custom foot orthosis, the recommended break-in schedule for a patient with diabetes and peripheral neuropathy is:

Answer: Wear 1–2 hours on day one, increasing by 1–2 hours per day with daily skin checks

A gradual break-in schedule with daily skin inspection is essential for patients with neuropathy who cannot sense developing pressure injuries.