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ORTHOTIC CPM EXAM
ACTUAL EXAM WITH CORRECT SOLUTIONS.
Which muscle group is most likely affected if you observe a patient with a shortened step on the sound side (assuming the patient is unilaterally involved)? - correct answer- plantarflexors
What type of AFO would you use for a patient with a tibial nerve lesion? - correct answer- Plantarflexion free, dorsiflexion stop
A patient exhibits hallux rigidus, at which part of stance phase will the patient have the most discomfort? - correct answer- Late stance phase
What does the term foot progression angle refer to? - correct answer- Relationship between line of progression and long axis of foot
At which joint and in which plane does the motion of inversion and eversion occur? - correct answer- Subtalar (or talocalcaneonavicular) joint, coronal plane
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What motion and at what phase of gait does a cushioned heel simulate? - correct answer- plantarflexion at heel strike, initial contact
Injury to which nerve presents as paralytic equinus during swing phase? - correct answer- common peroneal nerve
If the ankle is 90 degrees at initial contact, what type of moment do you have at the knee? - correct answer- Knee flexion moment
If the ankle is in 3 degrees of plantarflexion at midstance, what type of moment do you have at the knee? - correct answer- knee extension moment
During which phase of gait does the ankle achieve the greatest amount of dorsiflexion in a healthy individual which normal ROM and muscle functionality? - correct answer- terminal stance
Which ligament maintains the medial arch? - correct answer- spring ligament (plantarcalcanealnavicular ligament) 2 / 4
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What percentage of the gait cycle is spent in double limb support? - correct answer- 20%
The dorsiflexion stop performs the function of which muscle? - correct answer- gastricnemius/soleus
The functions of the tibialis anterior muscles are? - correct answer- dorsiflexion and inversion
What moment at the knee is created in stance phase of gait in a solid thermoplastic AFO set to neutral with a rigid full length footplate? Additionally, where in stance would be this most noticed by the patient? - correct answer- increase the knee extension moment, terminal stance
Crouch gait pattern presentation - correct answer- flexed hips, flexed knees, dorsiflexed ankles
A single gait cycle defined as? - correct answer- Heel strike on one side to heel strike on the ipsilateral side 3 / 4
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How can you prevent a knee orthosis from migrating down? - correct answer- Supracondylar wedge, suprapatellar strap, attach a footplate, lightweight belt
What adjustment to a metal AFO would best accommodate excessive tibial torsion? - correct answer- deflection of sidebars
Patient reports pain and redness at the medial malleolus upon weight bearing which worsens with ambulation - what adjustments would you make? - correct answer- -does patient have adequate clearance at medial joint space?-addition of pad in medial longitudinal arch/proximal to the medial malleolus -dynamic slotted medial instep strap to provide valgus correction intrinsic medial heel post
If you have a total contact UCBL intrinsically, but you still have calcaneal valgus, what modifications do you need to make? - correct answer- add extrinsic medial wedge
Patient was fit one week ago with a solid ankle AFO and reports that they feel like their knee flexes rapidly at heel strike.
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