NPTE-PT Gait, Balance, and Orthotics — Questions and Answers

Question 1: A patient with a right transtibial amputation demonstrates lateral trunk bending toward the prosthetic side during stance. What is the MOST likely cause?

Prosthetic foot set too far lateral
Prosthetic socket too loose proximally
Prosthetic shank too long (Correct answer)
Prosthesis aligned in excessive varus

Correct answer: Prosthetic shank too long

Lateral trunk lean toward the prosthetic side during stance is most commonly caused by a prosthetic shank that is too long, causing the patient to lean over it.

Question 2: During the swing phase of gait, a patient with a below-knee brace (AFO) exhibits toe drag. Which AFO adjustment would BEST correct this?

Increase plantarflexion stop resistance
Add a dorsiflexion assist spring (Correct answer)
Reduce the height of the AFO trim lines
Widen the AFO footplate

Correct answer: Add a dorsiflexion assist spring

A dorsiflexion assist spring in the AFO helps lift the foot during swing phase, preventing toe drag caused by inadequate dorsiflexion.

Question 3: Which Berg Balance Scale score BEST indicates a high fall risk in a community-dwelling older adult?

Above 45
41–45
Below 41 (Correct answer)
Exactly 56

Correct answer: Below 41

A Berg Balance Scale score below 41 is associated with a significantly high fall risk in older adults.

Question 4: A patient with L4 nerve root dysfunction will MOST likely require which orthotic device?

Knee-ankle-foot orthosis (KAFO)
Solid ankle AFO
AFO with dorsiflexion assist (Correct answer)
Swedish knee cage

Correct answer: AFO with dorsiflexion assist

L4 innervates the tibialis anterior (dorsiflexors); weakness causes foot drop, best managed with a dorsiflexion-assist AFO.

Question 5: During quiet standing, which system provides the PRIMARY sensory input for balance in a well-lit environment on a firm surface?

Vestibular
Proprioceptive/somatosensory (Correct answer)
Visual
Cerebellar

Correct answer: Proprioceptive/somatosensory

On a firm, stable surface, the proprioceptive/somatosensory system provides the dominant input for balance control.

Question 6: A patient demonstrates a steppage gait pattern. Which muscle group is MOST likely weak?

Hip extensors
Ankle plantarflexors
Ankle dorsiflexors (Correct answer)
Hip abductors

Correct answer: Ankle dorsiflexors

Steppage gait (exaggerated hip and knee flexion during swing) compensates for weak ankle dorsiflexors causing foot drop.

Question 7: Which outcome measure uses a 6-item test including single-leg stance and tandem walking to assess fall risk?

Tinetti POMA (Correct answer)
Dynamic Gait Index (DGI)
Timed Up and Go (TUG)
Functional Reach Test

Correct answer: Tinetti POMA

The Tinetti Performance-Oriented Mobility Assessment (POMA) includes balance and gait subscales, and is widely used to assess fall risk in older adults.

Question 8: A patient post-CVA walks with the pelvis dropping on the unaffected side during stance on the affected leg. This is MOST consistent with weakness of which muscle?

Affected hip adductors
Affected hip abductors (Correct answer)
Unaffected hip extensors
Affected knee extensors

Correct answer: Affected hip abductors

Contralateral pelvic drop (Trendelenburg sign) during single-limb stance on the affected side indicates weakness of the ipsilateral hip abductors.

Question 9: Which component of a KAFO is MOST important for a patient with severe quadriceps weakness who needs to lock the knee during stance?

Posterior offset knee joint
Drop-lock knee joint (Correct answer)
Polycentric knee joint
Free-motion knee joint

Correct answer: Drop-lock knee joint

A drop-lock (ring-lock) knee joint mechanically locks the knee in full extension, providing stability for patients with severe quadriceps weakness.

Question 10: During the Romberg test with eyes closed, a patient sways excessively and nearly falls. This finding MOST suggests dysfunction in which system?

Visual system only
Proprioceptive/vestibular system (Correct answer)
Cerebellar motor coordination
Cognitive processing

Correct answer: Proprioceptive/vestibular system

The Romberg test isolates vestibular and proprioceptive contributions by removing vision; a positive result implicates somatosensory or vestibular dysfunction.

Question 11: A patient with Parkinson's disease demonstrates festinating gait. Which description BEST characterizes this deviation?

Wide-based, ataxic stepping pattern
Shuffling, accelerating steps with forward trunk lean (Correct answer)
Circumduction of the lower extremity during swing
Exaggerated knee and hip flexion during swing

Correct answer: Shuffling, accelerating steps with forward trunk lean

Festinating gait in Parkinson's disease is characterized by short, shuffling steps that accelerate involuntarily with a forward-flexed trunk posture.

Question 12: The normal cadence for an adult walking at comfortable speed is approximately:

60–70 steps/minute
90–120 steps/minute (Correct answer)
130–150 steps/minute
40–55 steps/minute

Correct answer: 90–120 steps/minute

Normal comfortable walking cadence in adults is approximately 90–120 steps per minute (steps, not strides).

Question 13: Which type of AFO is MOST appropriate for a patient who needs mediolateral ankle stability but requires some sagittal plane motion for functional activities?

Solid ankle AFO
Posterior leaf spring AFO
Articulated AFO with motion stops (Correct answer)
Supramalleolar orthosis (SMO)

Correct answer: Articulated AFO with motion stops

An articulated AFO with adjustable motion stops allows some controlled sagittal plane movement while providing mediolateral stability.

Question 14: During gait analysis, loading response (initial double support) is characterized by which combination of joint events?

Hip extension, knee flexion, ankle plantarflexion
Hip flexion, knee extension, ankle dorsiflexion
Hip flexion, knee flexion, ankle plantarflexion (Correct answer)
Hip extension, knee extension, ankle dorsiflexion

Correct answer: Hip flexion, knee flexion, ankle plantarflexion

During loading response, the hip flexes slightly, the knee flexes 15–20° for shock absorption, and the ankle plantarflexes to lower the foot to the floor.

Question 15: A patient with a T6 complete spinal cord injury uses a KAFO with forearm crutches. Which gait pattern is MOST energy-efficient for this patient over short distances?

Swing-to gait
Swing-through gait (Correct answer)
Four-point gait
Reciprocal gait

Correct answer: Swing-through gait

Swing-through gait is the fastest and most energy-efficient pattern for patients with thoracic SCI using bilateral KAFOs and crutches, despite its high-energy demands.

Question 16: Which balance assessment tool specifically examines anticipatory postural adjustments and reactive balance strategies under six sensory conditions?

Berg Balance Scale
Sensory Organization Test (Computerized Dynamic Posturography) (Correct answer)
Functional Reach Test
Clinical Test of Sensory Integration in Balance (CTSIB)

Correct answer: Sensory Organization Test (Computerized Dynamic Posturography)

The Sensory Organization Test (SOT), part of computerized dynamic posturography, systematically assesses balance under six conditions that isolate and manipulate visual, vestibular, and somatosensory inputs.

Question 17: A patient with a painful right knee uses a cane. On which side should the cane be held and why?

Right side to offload the knee directly
Left side to reduce hip abductor demand on the right (Correct answer)
Either side — it makes no functional difference
Right side to improve proprioceptive feedback

Correct answer: Left side to reduce hip abductor demand on the right

The cane is held on the contralateral (left) side so that it contacts the ground simultaneously with the affected leg, reducing the load through the right knee joint.

Question 18: Which gait deviation is MOST commonly associated with excessive foot pronation in the stance phase?

Lateral trunk lean
Medial collapse of the knee (dynamic valgus) (Correct answer)
Hip hiking
Scissor gait

Correct answer: Medial collapse of the knee (dynamic valgus)

Excessive foot pronation during stance causes internal tibial rotation, which is transmitted proximally, resulting in dynamic knee valgus.

Question 19: A reciprocal gait orthosis (RGO) is MOST appropriate for which patient population?

Transfemoral amputees requiring prosthetic alignment
Patients with bilateral lower extremity spasticity post-stroke
Patients with thoracic-level paraplegia for household ambulation (Correct answer)
Patients with hemiplegia and severe foot drop

Correct answer: Patients with thoracic-level paraplegia for household ambulation

The RGO enables reciprocal walking in patients with thoracic paraplegia by linking the hip joints with cables so hip extension on one side drives flexion on the other.

Question 20: The Timed Up and Go (TUG) test uses what threshold score to identify community-dwelling older adults at increased fall risk?

Greater than 10 seconds
Greater than 12 seconds (Correct answer)
Greater than 20 seconds
Greater than 30 seconds

Correct answer: Greater than 12 seconds

A TUG score greater than 12 seconds is commonly used to identify older community-dwelling adults at increased fall risk.

Question 21: During terminal stance, the center of mass moves anterior to the base of support. Which muscle group is MOST critical for controlling forward progression at this point?

Hip extensors
Quadriceps
Ankle plantarflexors (Correct answer)
Hip flexors

Correct answer: Ankle plantarflexors

The ankle plantarflexors (gastrocnemius and soleus) undergo lengthening contraction during terminal stance to control forward progression and generate propulsive force.

NPTE-PT Gait, Balance, and Orthotics

A patient with a right transtibial amputation demonstrates lateral trunk bending toward the prosthetic side during stance.
What is the MOST likely cause?

🃏 NPTE PT Flashcards — Study This Quiz as Flip Cards →

📚 Want to go deeper? Read the Full NPTE PT Study Guide →

What Practice Test Geeks adds beyond an AI chat for NPTE-PT

An AI chatbot can quiz you, but it can't reproduce the exam conditions or keep your record. Here you get:

A timed, full-length NPTE-PT mock exam — 250 questions in 300 minutes with a 65% pass mark, modeled on the official exam's question count and time limit, followed by a score report broken down by exam domain.
A fixed NPTE-PT question bank: the same test every attempt, so your score is comparable from one try to the next instead of changing with every regenerated quiz.
Progress saved on your device: completed tests, scores and missed questions stay in My Progress, so you can retake only what you got wrong.
A printable NPTE-PT cheat sheet you can print or save as a PDF.
NPTE-PT flashcards built from the same question bank.

Start the Timed NPTE-PT Mock Exam →

These practice questions were written with AI tools. They are not real exam questions. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy

Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

fsbpt.org — Score release, eligibility, fees, late registration, test delivery, passing score, test dates, exam information · verified Oct 2026