COF Patient Assessment & Measurement 3 — Questions and Answers
Question 1: When performing a manual muscle test (MMT) for orthotic planning, a grade of 3/5 indicates the muscle can:
- Move through full ROM against gravity with some resistance
- Move through full ROM against gravity only (Correct answer)
- Move through partial ROM with gravity eliminated
- Contract but produce no movement
Correct answer: Move through full ROM against gravity only
An MMT grade of 3/5 means the muscle can complete full range of motion against gravity but cannot overcome any additional resistance.
Question 2: A patient's skin assessment reveals stage 2 pressure injury under a previously worn orthosis. The FIRST step in the fitting process should be:
- Modify the existing orthosis immediately
- Document and refer to wound care before refitting (Correct answer)
- Add padding over the wound area
- Discontinue orthosis use permanently
Correct answer: Document and refer to wound care before refitting
A stage 2 pressure injury requires wound care intervention and documentation before orthotic modification or refitting to prevent further tissue damage.
Question 3: Which measurement is taken to determine the correct length of a Lofstrand (forearm) crutch for a patient?
- From the axilla to the floor minus 2 inches
- From the floor to the olecranon process
- From the floor to 2 inches below the elbow flexed at 15-20 degrees (Correct answer)
- From the wrist to the mid-forearm
Correct answer: From the floor to 2 inches below the elbow flexed at 15-20 degrees
Lofstrand crutch length is measured from the floor to approximately 2 inches below the elbow when flexed at 15-20 degrees, positioning the forearm cuff correctly.
Question 4: During assessment, a patient exhibits clonus at the ankle. This finding suggests involvement of which neurological pathway?
- Lower motor neuron
- Upper motor neuron (Correct answer)
- Peripheral nerve
- Neuromuscular junction
Correct answer: Upper motor neuron
Clonus is a sign of upper motor neuron lesion causing hyperreflexia and loss of descending inhibitory control on the stretch reflex.
Question 5: To measure the circumference of a lower limb for a compression orthosis, measurements should be taken at:
- Random intervals along the limb
- Standard anatomical landmarks at consistent intervals (Correct answer)
- Only the widest point of edema
- The midpoint of the limb only
Correct answer: Standard anatomical landmarks at consistent intervals
Circumferential measurements for compression orthoses must be taken at standard anatomical landmarks and consistent intervals to ensure graduated compression and accurate fitting.
Question 6: A patient reports that their AFO causes discomfort at the posterior heel. Which measurement error most likely caused this?
- Incorrect calf circumference
- Insufficient heel-to-toe length measurement (Correct answer)
- Malleolar width measured too wide
- Incorrect tibial length measurement
Correct answer: Insufficient heel-to-toe length measurement
An insufficient heel-to-toe length measurement results in a footplate that is too short, causing the posterior shell to impinge on the heel.
Question 7: When assessing sensation for orthotic fitting, which test evaluates the patient's ability to detect light touch protective sensation?
- Semmes-Weinstein monofilament test (Correct answer)
- Two-point discrimination test
- Vibration tuning fork test
- Pinprick sharp/dull test
Correct answer: Semmes-Weinstein monofilament test
The Semmes-Weinstein monofilament test uses calibrated filaments to assess protective sensation thresholds, critical for diabetic or neuropathic patients.
COF Patient Assessment & Measurement 3
When performing a manual muscle test (MMT) for orthotic planning, a grade of 3/5 indicates the muscle can: