18567466
| Question | Answer |
| Length of crutch: | 1. substract 16 inches from height 2. measure from 2" below the axilla to a point 6" in front and 2" lateral to the foot 3. supine: from axilla to 6-8" lateral to the heel |
| ______ of elbow flexion is desirable for crutch using. | 20 - 30 deg. |
| A Lofstrand (forearm) crutch should cover ________ of the proximal forearm or ________ below the elbow. | 1/3 of the proximal forearm. or 1-1.5" below the elbow |
| What type of crutches can be used for stair-climbing? | Axillary crutches and forearm crutches |
| Which nerves and blood vessels are the most prone to compression injury if a person uses axillary crutches | 1. radial nerve 2. axillary artery |
| A patient has bilateral LE involvement due to spina bifida and uses axillary crutches to ambulate. Which step pattern do you recommend? | Swing-through (indicated for BLE involvement) |
| Cane measurement: | 6" from the side of toes to the ulnar styloid/wrist crease to allow for 20 - 30 deg elbow flexion. |
| Where should the drive wheels of the WC be for an amputee to accommodate for the change in center of weight? | Drive wheels placed posterior to the backrest. |
| If a patient is hemiplegic and has weak RLE and RUE, how should the w/c be designed to accommodate? | Seat close to ground to allow LE propulsion. |
| Patient fitting for w/c/ has back extensor spasm. Which feature will you recommend? | Tilt-in-space (also for pressure relief) |
| Patient with C5 injury and quadriplegia is unable to maintain upright trunk. How should you modify the backrest? | Reclining back. |
| Your patient is obese and requires a w/c fitting. Recommend the tire, backrest and other features to maximize safety and comfort. | Tire: hard (more durable) Backrest: adjustable (accommodate increased posterior bulk) Reclining feature: accommodate for cardiovascular compromise. Powered chair. |
| Maximal BWS when gait training. | 55% (otherwise, foot won't stay flat) |
| Starting and weaning method for BWS system gait training. | Start at 40% support and decrease in 10% increments. |
| What is the three-point principle for orthotics? | 1. a single force at the area of deformity 2. two additional counterforces 50% each acting in the opposite direction |
| Foot orthosis recommendation: leg length discrepancy. | Heel lift |
| Foot orthosis recommendation: Limited DF. | Heel lift. |
| Foot orthosis recommendation: Pes planus. | Scaphoid pad or longitudinal arch supports. |
| Foot orthosis recommendation: Metatarsalgia. | 1. metatarsal pad 2. rocker bar |
| Foot orthosis recommendation: pronation and flexible pes valgus | varus post (medial heel wedge) |
| Foot orthosis recommendation: genu varum or flexible pes varus. | Valgus post (lateral heel wedge) |
| Foot orthosis recommendation: Forefoot varus | medial sole wedge |
| Foot orthosis recommendation: Forefoot valgus | Lateral sole wedge |
| Foot orthosis recommendation: weak or inflexible foot that lacks forward propulsion. | Rocker bar |
| What feature helps to limit knee recurvatum in stance and toe drag during swing phase? | Common problem: excessive plantarflexion. Feature: PF stop (posterior stop) |
| What pathological gait pattern can be prevented by a DF stop (anterior stop)? | 1. knee buckling. 2. excessive knee flexion during early stance. |
| Which feature in the KAFO helps extend the knee and stabilize the knee during early stance? | Offset joint. |
| Contraindication for an offset joint. | Knee flexion contracture. |
| A specialized orthoses for children with T9-12 SCI. | THKAFO |
| Who should avoid heel lifts and rocker bars? | Patient with insensitive foot. |
| Possible reason for the following orthotic gait deviation: Lateral trunk bending. (leaning towards the orthotic side). | 1. KAFO medial upright too high 2. insufficient shoe lift 3. hip pain 4. weak/tight abductors on the orthotic side 5. short leg 6. poor balance |
| Possible reasons for the following orthotic gait deviation: Circumduction or vaulting. | 1. locked knee 2. excessive PF 3. weak hip flexors 4. weak dorsiflexors |
| Possible reasons for the following orthotic gait deviation: Anterior trunk bending. | 1. inadequate knee lock 2. weak quads 3. hip/knee flexion contracture |
| Possible reasons for the following orthotic gait deviation: Posterior trunk lean | 1. inadequate hip lock 2. weak glute max 3. knee ankylosis |
| Possible reasons for the following orthotic gait deviation: Hyperextension of knee. | 1. inadequate PF stop 2. inadequate knee lock 3. calf band too deep 4. weak quads 5. loose knee ligaments or extensor spasticity 6. pes equinus |
| Possible reasons for the following orthotic gait deviation: Excessive knee flexion/buckling. | 1. inadequate DF stop 2. inadequate knee lock 3. knee/hip flexion contracture 4. weak quads 5. knee pain |
| Possible reasons for the following orthotic gait deviation: Foot slap | 1. inadequate DF assist or dorsiflexors 2. inadequate PF stop |
| Possible reasons for the following orthotic gait deviation: Toe-first contact | 1. inadequate DF assist 2. inadequate PF stop 3. inadequate heel lift 4. heel pain 5. extensor spasticity 6. pes equinus 7. short leg |
| Possible reasons for the following orthotic gait deviation: Flat foot contact | 1. inadequate longitudinal arch support 2. pes planus |
| Possible reasons for the following orthotic gait deviation: Excessive pronation | 1. transverse plane malalignment 2. weak invertors 3. pes valgus 4. spasticity 5. genu valgum |
| Possible reasons for the following orthotic gait deviation: Excessive supination | 1. transverse plane malalignment 2. weak evertors 3. pes varus 4. genu varum |
| Possible reasons for the following orthotic gait deviation: Wide BoS | 1. KAFO or medial upright too high 2. HKAFO hip joint aligned in excessive abduction 3. poor balance 4. sound limb too short |
| Ideal reserved length for amputation: 1. tibia 2. femur | 1. 20 - 50% 2. 35- 60% |
| The socks should not exceed ____ ply thickness for proper fitting and weight bearing of the socket. | 15 ply |
| Pressure sensitive areas when fitting a patellar-tendon-bearing knee socket. | 1. anterior tibia 2. anterior tibial crest 3. fibular head 4. peroneal nerve |
| Pressure-tolerant areas when fitting a patellar-tendon-bearing knee socket. | 1. patellar tendon 2. medial tibial plateau 3. tibial and fibular shafts 4. distal end of tibia |
| What might be the prosthetic or anatomic causes of the following gait deviation? Excessive knee flexion upon initial contact. | 1. high shoe heel 2. insufficient PF 3. stiff heel cushion 4. socket too far anterior or excessively flexed 5. cuff tabs too posterior |
| What might be the prosthetic or anatomic causes of the following gait deviation? Insufficient knee flexion upon initial contact. | 1. low shoe heel 2. excessive PF 3. soft heel cushion 4. socket too far posterior or insufficiently flexed 5. extensor hyperreflexia 6. weak quads 7. anterodistal pain 8. arthritis |
| What might be the prosthetic or anatomic causes of the following gait deviation? excessive lateral thrust | excessive foot inset |
| What might be the prosthetic or anatomic causes of the following gait deviation? excessive medial thrust | excessive foot outset |
| What might be the prosthetic or anatomic causes of the following gait deviation? Early knee flexion (drop off) | 1. high shoe heel 2. insufficient PF 3. keel too short 4. DF stop too soft 5. socket too anterior or excessively flexed 6. cuff tabs too posterior 7. flexion contracture |
| What might be the prosthetic or anatomic causes of the following gait deviation? Delayed knee flexion when walking uphill | 1. low shoe heel 2. excessive PF 3. keel too long 4. DF stop too stiff 5. socket too posterior 6. socket not flexed enough 7. extensor hyperreflexia |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Abduction during stance | 1. long prosthesis 2. abducted hip joint 3. inadequate lateral wall adduction 4. sharp or high medial wall 5. abduction contracture 6. weak abductors 7. laterodistal pain |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Circumduction | 1. long prosthesis 2. locked knee unit 3. loose friction 4. inadequate suspension 5. small socket 6. loose socket 7. foot in PF 8. abduction contracture 9. poor knee control |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Lateral bend during stance. | 1. short prosthesis 2. inadequate lateral wall adduction 3. sharp/high medial wall 4. abduction contracture 5. weak abductors 6. hip pain or instability |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? forward flexion in stance | 1. unstable knee unit 2. short walker or crutch |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? lordosis in stance | 1. inadequate socket flexion 2. hip flexion contracture 3. weak extensors |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Medial whip during heel off | 1. faulty socket contour 2. knee bolt externally or internally rotated 3. foot malrotation 4. prosthesis donned in malrotation |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Foot rotation during heel contact. | 1. stiff heel cushion 2. malrotation of foot |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? High heel rise during early swing | 1. inadequate friction 2. slack extension aid |
| What might be the prosthetic or anatomic causes of the following gait deviation for a patient with a transfemoral amputation? Terminal impact during late swing. | 1. inadequate friction 2. taut extension aid 3. forceful hip flexion |
| Wheel chair measurement: 1. seat width 2. seat depth 3. seat height 4. arm rest height 5. back height | 1. seat width: hip width + 2" 2. seat depth: femur length - 2-3" 3. seat height: insure minimal clearance of 2" if have foot plate 4. arm rest height: seat platform to just below elbow at 90 deg flexion with neutral shoulder 5. back height: seat platform to desired height |
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