COF COF Neuromuscular Conditions & Orthotics 2

Question 1

An AFO fabricated with a plantarflexion stop and free dorsiflexion is most appropriate for a patient with:

Accepted Answer

Spastic hemiplegia with equinus tendency

Answer

A plantarflexion stop prevents the foot from dropping into equinus during swing while allowing dorsiflexion during stance, which is ideal for managing spastic equinus in hemiplegia.

Question 2

What is the recommended orthotic management for a patient with a complete C6 spinal cord injury who has preserved wrist extension?

Accepted Answer

Wrist-driven flexor hinge orthosis (tenodesis splint)

Answer

A wrist-driven flexor hinge orthosis uses preserved wrist extension to create a functional three-jaw-chuck pinch grip for C6 SCI patients through the tenodesis effect.

Question 3

In a patient with L3–L4 spinal cord injury, which orthotic option best facilitates community ambulation?

Accepted Answer

Bilateral KAFOs

Answer

An L3–L4 SCI preserves hip flexors and quadriceps but lacks ankle dorsiflexors and reliable knee stability, requiring bilateral KAFOs for functional ambulation.

Question 4

A stroke patient with spastic hemiplegia develops genu recurvatum (knee hyperextension) during stance. The most appropriate AFO modification is:

Accepted Answer

Set the ankle trim line in slight dorsiflexion

Answer

Setting the AFO ankle in slight dorsiflexion creates an anterior tibial moment (knee flexion moment) during stance, counteracting hyperextension of the knee.

Question 5

When prescribing orthoses for a patient with myasthenia gravis, what is the most critical design consideration?

Accepted Answer

Minimal weight to reduce energy expenditure in fatigable muscles

Answer

Myasthenia gravis causes fatigable weakness; lightweight orthoses minimize the additional muscular effort required for ambulation, conserving the patient's limited energy reserves.

(COF) Certified Orthotic Fitter Practice Test

(COF) Certified Orthotic Fitter Practice Test

COF COF Neuromuscular Conditions & Orthotics 2