COF Study Guide 2026

Everything you need to pass the COF exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

📋 COF Exam Format at a Glance

100
Questions
120 min
Time Limit
70%
Passing Score

📚 COF Topics to Study (79)

✍️ Sample COF Questions & Answers

1. Which skeletal maturity indicator is used to determine when bracing for adolescent idiopathic scoliosis can be safely discontinued?
Risser sign grade 4 or 5

The Risser sign grades iliac apophysis ossification from 0 to 5; grades 4 and 5 indicate skeletal maturity, signifying that spinal growth has ceased and the risk of scoliosis progression is minimal, allowing bracing to be discontinued.

2. A 4-year-old with myelomeningocele at L3–L4 has active hip flexors and quadriceps but no ankle control. What is the most likely appropriate orthosis?
AFO with free ankle

With preserved quadriceps and hip flexors but absent ankle musculature, an AFO providing ankle-foot control while allowing knee function is most appropriate.

3. A patient with a spastic equinovarus foot in cerebral palsy would most likely exhibit which gait deviation during swing phase?
All of the above are common compensations

Spastic equinovarus causes foot clearance problems during swing, leading patients to compensate with steppage gait, vaulting on the stance limb, or circumduction of the affected limb.

4. In a child with spastic diplegic cerebral palsy, the PRIMARY goal of AFO prescription is to:
Improve functional mobility, gait efficiency, and energy expenditure

AFOs for children with cerebral palsy are prescribed to normalize gait kinematics, reduce energy expenditure, and maximize functional independence in mobility.

5. An orthotist discovers that a colleague has been billing Medicare for custom orthoses but delivering prefabricated devices. The orthotist's primary ethical obligation is to:
Report the suspected fraud to appropriate authorities

Suspected Medicare fraud must be reported to authorities such as the OIG or CMS, as failure to report known fraud may constitute complicity.

6. Which of the following activities would constitute a violation of patient confidentiality by an orthotic fitter?
Sharing a patient's gait analysis video on social media without consent

Sharing patient images or videos on social media without explicit written authorization is a HIPAA violation and breach of confidentiality.

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Your COF Study Path
1. Learn with Flashcards → 2. Drill Practice Tests → 3. Take the Full Exam Simulation
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