Device Fitting & Adjustment Flashcards

When fitting a supramalleolar orthosis (SMO), which anatomical landmark is most critical to check for adequate clearance?

Answer: Medial malleolus

The medial malleolus is a prominent bony prominence that requires adequate clearance in an SMO to prevent pressure sores.

A patient reports their TLSO feels too tight after wearing it for two hours. Which initial assessment step is most appropriate?

Answer: Check for erythema and assess trim lines at pressure points

Checking for erythema and evaluating trim lines at pressure points helps identify the specific cause of discomfort before making targeted adjustments.

Which type of ankle joint allows dorsiflexion but blocks plantarflexion in an AFO?

Answer: Posterior stop joint

A posterior stop joint in an AFO limits plantarflexion while allowing dorsiflexion, commonly used for dropfoot with spasticity concerns.

During dynamic alignment of a prosthetic-orthotic device, excessive heel rise at toe-off most likely indicates:

Answer: Too much dorsiflexion resistance

Excessive heel rise at toe-off suggests that dorsiflexion resistance is too great, preventing the heel from staying down through mid-stance.

A child fitted with a KAFO for myelomeningocele is observed with medial knee thrust during stance. The MOST likely cause is:

Answer: Valgus malalignment of the knee joint

Valgus malalignment of the knee joint axis causes the knee to shift medially during weight-bearing, producing a medial thrust.

When adjusting a wrist-hand orthosis (WHO) for a patient with rheumatoid arthritis, wrist position should typically be set at:

Answer: 10-20 degrees extension

A functional wrist position of 10-20 degrees extension is optimal for hand function and reduces joint stress in rheumatoid arthritis patients.

Which padding material is MOST appropriate for lining bony prominences in a rigid orthosis to distribute pressure?

Answer: Closed-cell polyethylene foam

Closed-cell polyethylene foam (e.g., Plastazote) distributes pressure effectively over bony prominences because it conforms and resists bottoming out.