COF Neuromuscular Conditions & Orthotics Flashcards

A patient with Charcot-Marie-Tooth disease presents with bilateral foot drop and cavus foot deformity. Which orthotic feature is MOST critical to address the cavus component?

Answer: Accommodative total contact footbed with rigid lateral heel post

Cavus foot in CMT requires a total contact accommodative footbed with lateral heel posting to redistribute pressure and correct the varus heel position.

Which gait deviation is MOST commonly associated with weak hip abductors in a patient with muscular dystrophy?

Answer: Trendelenburg gait

Trendelenburg gait occurs when weak hip abductors cannot stabilize the pelvis, causing it to drop toward the unsupported side during single-limb stance.

A child with spinal muscular atrophy type II requires standing support. Which orthosis would BEST provide upright positioning while accommodating trunk weakness?

Answer: Hip-knee-ankle-foot orthosis (HKAFO) with trunk support

An HKAFO with trunk support provides the comprehensive skeletal support needed for a child with SMA type II who lacks the trunk and lower extremity strength for independent standing.

In multiple sclerosis, orthotic intervention is complicated by which factor MOST likely to cause rapid changes in fit?

Answer: Fluctuating edema from heat sensitivity

Heat sensitivity (Uhthoff's phenomenon) in MS can cause rapid limb volume changes due to fluctuating edema, requiring adjustable orthotic systems.

A patient with post-polio syndrome develops new weakness in a previously stable limb. The fitter observes recurvatum during stance. Which AFO design addresses this BEST?

Answer: Floor reaction AFO (anterior shell)

A floor reaction (anterior shell) AFO applies an anterior force to the tibia during loading response, preventing knee hyperextension (recurvatum) in patients with weak quadriceps.

When fitting a patient with hereditary spastic paraplegia, the fitter notes strong plantar flexion spasticity. Which trim line modification to an AFO would BEST manage spastic equinus while maintaining function?

Answer: Anterior trim lines brought forward to increase rigidity

Moving the anterior trim lines forward increases AFO rigidity and provides greater resistance against plantarflexion spasticity to maintain the foot in a functional position.

A patient with Friedreich's ataxia presents with progressive scoliosis and lower extremity ataxia. Which orthotic priority should be addressed FIRST?

Answer: AFO to control ataxic gait

Ataxic gait instability poses an immediate fall risk; AFOs providing medial-lateral stability should be prioritized first to ensure safe ambulation.