CPO Patient Evaluation 2 — Questions and Answers
Question 1: During gait analysis of a transtibial amputee, the practitioner observes lateral trunk bending toward the prosthetic side at midstance. What is the most likely cause?
- Prosthetic foot set in excessive plantarflexion
- Prosthetic socket fit that is too loose mediolaterally
- Prosthetic shank that is too long (Correct answer)
- Excessive dorsiflexion of the prosthetic foot
Correct answer: Prosthetic shank that is too long
A prosthesis that is too long forces the patient to lean toward the prosthetic side to clear the floor during gait.
Question 2: Which outcome measure is specifically designed to assess the functional mobility and transfer ability of prosthetic users?
- Oswestry Disability Index
- Amputee Mobility Predictor (AMP) (Correct answer)
- Berg Balance Scale
- Timed Up and Go (TUG) test
Correct answer: Amputee Mobility Predictor (AMP)
The Amputee Mobility Predictor is validated specifically for amputees and predicts prosthetic mobility potential prior to fitting.
Question 3: A patient with a transfemoral amputation reports phantom limb pain rated 7/10. Which evaluation finding would most directly guide pain management referral?
- Residual limb length measurement
- Pain character, triggers, and duration pattern (Correct answer)
- Skin condition of the contralateral limb
- Current prosthetic suspension method
Correct answer: Pain character, triggers, and duration pattern
Characterizing the phantom pain's quality, frequency, and triggers guides appropriate referral to pain management specialists.
Question 4: When evaluating a patient for an ankle-foot orthosis (AFO), which manual muscle test grade indicates the patient has antigravity strength with full resistance?
- Grade 2
- Grade 3
- Grade 4 (Correct answer)
- Grade 5
Correct answer: Grade 4
Grade 4 indicates the muscle can move through full range of motion against gravity and withstand some but not full resistance.
Question 5: A practitioner is evaluating a patient with diabetic peripheral neuropathy for orthotic intervention. Which sensory test is most critical to document?
- Two-point discrimination threshold
- Semmes-Weinstein monofilament testing (Correct answer)
- Vibration threshold with tuning fork
- Sharp/dull discrimination
Correct answer: Semmes-Weinstein monofilament testing
Semmes-Weinstein monofilament testing at 10g (5.07) identifies loss of protective sensation and guides offloading orthotic prescriptions.
Question 6: During upper extremity prosthetic evaluation, which finding most directly impacts the choice between body-powered and externally powered (myoelectric) control?
- Patient's vocational requirements only
- Residual limb length and available excursion (Correct answer)
- Insurance coverage and patient preference only
- Contralateral limb strength
Correct answer: Residual limb length and available excursion
Residual limb length and available body excursion determine whether sufficient cable excursion exists for effective body-powered control.
Question 7: A child patient's parents report the child is not wearing the prescribed TLSO. Which evaluation step should the practitioner prioritize first?
- Immediately order a new brace
- Evaluate fit, comfort, and the child's understanding of the device's purpose (Correct answer)
- Discharge the patient from care
- Switch to a more rigid orthosis design
Correct answer: Evaluate fit, comfort, and the child's understanding of the device's purpose
Non-compliance is most commonly related to fit issues, discomfort, or lack of patient/family education about the device.
CPO Patient Evaluation 2
During gait analysis of a transtibial amputee, the practitioner observes lateral trunk bending toward the prosthetic side at midstance.
What is the most likely cause?