COF Neuromuscular Conditions & Orthotics Flashcards

A patient with amyotrophic lateral sclerosis (ALS) has wrist extensor weakness affecting hand function. Which orthosis is MOST appropriate to maintain functional grasp?

Answer: Static wrist cock-up splint in 30° extension

A static wrist cock-up splint in 30° extension positions the wrist to optimize tenodesis grasp function when wrist extensors are weak.

During gait analysis of a patient with cerebral palsy (spastic diplegia), the fitter observes jump gait pattern. Which combination is MOST characteristic of jump gait?

Answer: Hip flexion, knee flexion, ankle plantarflexion

Jump gait is characterized by simultaneous hip flexion, knee flexion, and ankle plantarflexion throughout the gait cycle due to spasticity across multiple joints.

Which neurological condition is MOST associated with autonomic dysreflexia that the orthotist must screen for during fitting appointments?

Answer: Spinal cord injury at or above T6

Autonomic dysreflexia occurs in spinal cord injuries at or above T6, where tight orthoses or pressure sores can trigger dangerous hypertensive episodes.

A fitter is working with a patient who has Guillain-Barré syndrome in the recovery phase. The patient has improving but asymmetric strength. What orthotic strategy is MOST appropriate?

Answer: Modular or adjustable AFOs that can be modified as strength returns

Modular or adjustable AFOs allow progressive weaning of support as strength recovers asymmetrically during Guillain-Barré rehabilitation.

A patient with spastic hemiplegia after stroke uses an AFO but reports knee instability during mid-stance. The AFO is set in neutral. What adjustment would MOST improve knee stability?

Answer: Adjust the AFO to 5° of plantarflexion to increase knee extension moment

Setting the AFO in slight plantarflexion creates a ground reaction force that generates a knee extension moment, improving stability in mid-stance.

In a patient with Duchenne muscular dystrophy who is still ambulatory, which orthotic intervention BEST prolongs walking ability?

Answer: Lightweight bilateral AFOs to control foot drop combined with stretching

Lightweight AFOs controlling foot drop, combined with regular stretching, prolong ambulation in DMD by preventing equinus contractures without adding excessive weight.

A patient with peripheral neuropathy from diabetes has a Charcot foot in the consolidation phase. Which orthotic management is MOST appropriate at this stage?

Answer: Charcot Restraint Orthotic Walker (CROW) for protected weight-bearing

The CROW (Charcot Restraint Orthotic Walker) is the definitive orthosis for the consolidation phase of Charcot foot, providing total contact support while allowing protected ambulation.