Clinical Application & Fitting Flashcards

A patient presents with L3-L4 paraplegia. Which lower limb orthosis classification best supports ambulation for this patient?

Answer: KAFO (knee-ankle-foot orthosis)

L3-L4 paraplegia causes knee extensor weakness, necessitating a KAFO to provide knee stability and foot clearance during ambulation.

Which of the following is a contraindication for the use of a rigid ankle-foot orthosis (AFO)?

Answer: Significant pitting edema with fluctuating limb volume

Significant fluctuating edema changes limb volume unpredictably, making a rigid AFO ill-fitting and likely to cause pressure injuries.

During prosthetic training, a transfemoral amputee with a microprocessor knee falls during stair descent. The clinician should first evaluate:

Answer: Whether the patient's weight-activation threshold is set correctly

Microprocessor knees rely on correct weight-activation thresholds; improper settings can cause the stance-phase brake to disengage prematurely during stair descent.

For a patient with complete C6 quadriplegia, which upper extremity orthosis best supports functional hand use for ADLs?

Answer: Dynamic wrist-driven flexor hinge orthosis (tenodesis splint)

The tenodesis splint harnesses residual active wrist extension (C6) to drive passive finger flexion, enabling grasp and release for ADLs.

When evaluating prosthetic socket fit in a patient with a mature transtibial residual limb, which finding is most acceptable?

Answer: Mild redness over the patellar tendon resolving within 20 minutes

Mild reactive redness over load-bearing areas that resolves within 20 minutes after removal is considered an acceptable normal response to pressure.

A patient with a unilateral below-knee amputation is issued a liner but returns complaining of folliculitis on the residual limb. The BEST intervention is:

Answer: Instruct on proper liner hygiene and daily cleaning protocol

Folliculitis in liner users typically results from inadequate hygiene; daily cleaning of both the liner and residual limb reduces bacterial colonization.

A scoliosis patient with a 30° Cobb angle (skeletally immature) is prescribed a TLSO. The orthosis should be worn approximately:

Answer: 16-23 hours per day

Evidence supports 16-23 hours per day of TLSO wear to achieve effective curve correction in skeletally immature patients with curves of 25-45°.