COF COF Neuromuscular Conditions & Orthotics 1 — Questions and Answers
Question 1: Which orthosis is the primary treatment for foot drop caused by peroneal nerve palsy?
- KAFO
- Solid ankle AFO or articulated AFO with dorsiflexion assist (Correct answer)
- TLSO
- Wrist-hand orthosis
Correct answer: Solid ankle AFO or articulated AFO with dorsiflexion assist
An AFO with a dorsiflexion assist or solid ankle prevents foot drop and provides foot clearance during the swing phase of gait.
Question 2: A child with spastic cerebral palsy and equinus deformity would benefit most from which AFO design?
- Posterior leaf spring AFO
- Solid tone-inhibiting AFO (TIAFO) set at neutral dorsiflexion (Correct answer)
- Articulated AFO with free plantarflexion
- Carbon fiber dynamic response AFO
Correct answer: Solid tone-inhibiting AFO (TIAFO) set at neutral dorsiflexion
A solid tone-inhibiting AFO holds the ankle at neutral dorsiflexion to inhibit spasticity and prevent progressive equinus deformity in children with cerebral palsy.
Question 3: In patients with multiple sclerosis, an orthosis is most likely prescribed for:
- Scoliosis correction
- Foot drop and lower extremity weakness during gait (Correct answer)
- Wrist instability
- Cervical support
Correct answer: Foot drop and lower extremity weakness during gait
MS commonly affects the corticospinal tracts, leading to foot drop and lower extremity weakness managed effectively with an AFO.
Question 4: What is the primary orthotic goal for a patient with post-polio syndrome?
- Increase muscle tone
- Substitute for weakened muscles and reduce energy expenditure during gait (Correct answer)
- Correct spinal curvature
- Prevent heterotopic ossification
Correct answer: Substitute for weakened muscles and reduce energy expenditure during gait
Post-polio syndrome causes progressive weakness; orthoses substitute for lost muscle function to maintain mobility and reduce the metabolic cost of ambulation.
Question 5: A Charcot-Marie-Tooth patient presents with bilateral cavovarus deformity and foot drop. The most appropriate orthosis is:
- Supramalleolar orthosis (SMO)
- Custom-molded solid ankle AFO (Correct answer)
- Prefabricated soft ankle brace
- KAFO with locked knee
Correct answer: Custom-molded solid ankle AFO
A custom-molded solid ankle AFO accommodates the rigid cavovarus deformity while simultaneously controlling foot drop in CMT disease.
Question 6: Which neuromuscular condition is characterized by progressive proximal muscle weakness and is most commonly managed with KAFOs to maintain ambulation?
- Carpal tunnel syndrome
- Duchenne muscular dystrophy (Correct answer)
- Peripheral neuropathy
- Reflex sympathetic dystrophy
Correct answer: Duchenne muscular dystrophy
Duchenne muscular dystrophy causes progressive proximal and eventually distal lower limb weakness, requiring KAFOs to extend ambulatory ability as the disease progresses.
COF COF Neuromuscular Conditions & Orthotics 1
Which orthosis is the primary treatment for foot drop caused by peroneal nerve palsy?