Deck 31: Orthotics

Question 1

All of the following are true regarding orthotic shoe inserts EXCEPT

A)they reduce shoe volume.
B)they have considerable effect on metatarsophalangeal function.
C)some evidence shows orthoses altering erector spinae and gluteus medius activity onset.
D)some evidence shows decreased patellofemoral pain.

Answer 1

B

Question 2

A difference of more than 1/2 in.(1 cm)in leg length discrepancy

A)can be measured,with the person recumbent,from anterior superior iliac spine to lateral malleolus.
B)should be compensated for by a shoe elevation.
C)for the patient with weakness in one limb,a 1/2-in.(1-cm)lift on the contralateral shoe will aid balance of the paralyzed leg during stance phase.
D)all of the above.

Answer 2

B

Question 3

A higher heel on the orthotic shoe

A)places the ankle in its extreme dorsiflexion range.
B)forces the tibia backward.
C)transmits more stress to the metatarsals.
D)increases tension on the Achilles tendon and other posterior structures.

Answer 3

C

Question 4

With a KAFO,if the medial and lateral stops do not contact their respective stops at the same time

A)the stop that contacts last will erode rapidly.
B)may contribute to twisting of the orthosis.
C)may result in the person inadvertently flexing the knee in weightbearing.
D)A and B only.

Question 5

If the AFO is to reduce the amount of weight transmitted through the foot,it may have a ______________________.

Question 6

Referring to an offset joint,which of the following is/are true?

A)A hinge is placed just anterior to the midline of the leg.
B)A patient weight line is posterior to the offset joint,stabilizing knee extension.
C)It is contraindicated in the presence of hip or knee flexion contractures.
D)All of the above.

Question 7

Energy measurement is a valuable guide to functional capacity,with its cost

A)calculated from the amount of oxygen consumed as the subject performs.
B)determined per unit of distance traversed over time (one method).
C)determined per unit of time over distance traversed (one method).
D)all of the above.

Question 8

A reciprocating gait orthosis is

A)a THKAFO.
B)an orthosis in which the knees are stabilized with knee locks,midline knee joints,or pretibial bands,and the feet are encased in solid ankle orthoses.
C)an orthosis in which steel cables or rods prevent inadvertent knee flexion on the supporting leg.
D)none of the above.

Question 9

The person who wears bilateral KAFOs will

A)require the ability to shift weight to the heels to take pressure off the hands,so the hands can be moved forward.
B)requires training in the parallel bars and then with crutches until the person can shift all weight to the feet and lift one hand at a time.
C)if advanced,may utilize a rapid swingthrough gait.
D)A and C only.

Question 10

Tone-reducing orthoses are

A)plastic AFOs designed for children with spastic cerebral palsy
B)plastic AFOs designed for adults with spastic hemiplegia.
C)the foot plate and broad upright designed to modify reflex hypertonicity by applying constant pressure to the plantarflexors and evertors.
D)all of the above.

Question 11

Which of the following orthoses is designed for nighttime use?

A)Milwaukee
B)Boston
C)Providence
D)Wilmington

Question 12

AFO uprights

A)if made of aluminum,are lighter than steel.
B)if made of carbon graphite and titanium,weigh appreciably less than aluminum and rival the strength of steel.
C)if made of the newer materials,are more expensive.
D)all of the above.

Question 13

The disadvantage of a corset is that it

A)increases intraabdominal pressure.
B)can promote muscular atrophy and contracture over time.
C)increases stress on posterior spinal musculature.
D)only temporarily reduces abdominal and erector spinae muscular activity.

Question 14

Of the several appliances available for children with spina bifida,which is specifically designed to enable sitting?

A)The parapodium
B)The standing frame
C)Custommade AFOs/KAFOs/THKAFOs
D)None of the above enables sitting.

Question 15

The ideal orthopedic shoe should

A)distribute weightbearing forces to provide optimum comfort and function.
B)transfer pressure from sensitive malaligned structures toward painfree areas.
C)serve as the foundation for ankle-foot orthoses or more extensive bracing.
D)all of the above.

Question 16

A rocker bar

A)is a flat strip of leather or firm material posterior to the metatarsal heads.
B)at late stance,transfers stress at metatarsophalangeal joints to metatarsal shafts.
C)shifts load from the metatarsophalangeal joints to the metatarsal shafts.
D)all of the above.

Question 17

The near universal abandonment of orthoses by individuals with thoracic spinal cord injury on discharge from the rehabilitation center is typically the result of

A)the difficulty of donning the orthoses.
B)the energy needed to ambulate
C)the desire to spend more time accomplishing vocational and recreational tasks.
D)all of the above.

Question 18

A Blucher lace stay

A)is distinguished by separation between the anterior stay margin and the vamp.
B)is distinguished by the lace stay that is continuous with the vamp.
C)has an opening that permits little or no adjustability.
D)has a small inlet into the shoe.

Question 19

Which of the following describes a heel wedge?

A)It alters alignment of the talus.
B)A medial heel wedge can help realign flexible pes varus or accommodate rigid pes valgus.
C)It alters medial-lateral metatarsal alignment.
D)A lateral wedge shifts weightbearing to the lateral side of the front of the foot.