L2 Orthotic Exam

Question 1

Pre-Orthotic Exam

Answer 1

Interview
Chart Review
Outcome Measures
Assessment of function/task analysis
impairment test

Question 2

What subjective might lead you to consider the need for an orthotic device?

Answer 2

instability at ankle or knee
history of falls
injury
reports of decreased gait endurance or gait speed

Question 3

Orthotics Prosthetics Users Survey

Answer 3

self reported questionnaire
5 modules
maintain awareness of improvement in activity
evaluate changes in functional status and QOL

Question 4

Task analysis

Answer 4

when functional activity is limited, this can be used to ascertain the impairments that might restrict the individual’s ability to perform the functional task

Question 5

Outcome measures that can be used

Answer 5

10 meter walk test
6 minute walk test
functional gait assessment
TUG
box and blocks test
action research arm test

Question 6

Assessment of function with trial device

Answer 6

use of trial orthotic device to immediately compare function with and without orthotic device

Question 7

Immediate effect

Answer 7

testing without an orthosis followed by retesting immediately after donning an orthosis

Question 8

Training Effect

Answer 8

testing with the orthosis, followed by a period of use with the orthosis, then re-testing with the orthosis

Question 9

Therapeutic Effect

Answer 9

testing without the orthosis, followed by a period of use with the orthosis, the retesting without the orhtosis

Question 10

Combined effect

Answer 10

cumulative effects of both the immediate and training effects. initial test without the device followed by a period of training and then retesting with the device

Question 11

Evaluation of Impairments

Answer 11

confirm whether or not the client has the impairments suspected based upon the functional analysis

gather info related to the specific region of the body that may require an orthosis

exam to include relevant aspects of the body

Question 12

Fixed or structural deformities

Answer 12

should be accommodated or supported by an orthosis

Question 13

Flexible or non-fixed deformity

Answer 13

an orthosis should be designed to apply corrective forces

Question 14

Impaired proprioception

Answer 14

pts with impaired proprioception may require bracing even in motor function is adequate

Question 15

Increased muscle tone

Answer 15

may require a more rigid or restrictive orthosis

Question 16

Cardio/Pulmonary Implications for orthotics

Answer 16

1. fluctuating edema = challenging fit
2. PVD affects the quality of skin, more skin breakdown. slower healing time
3. energy expenditure

Question 17

What goal categories should you use for an orthotic?

Answer 17

functional goals
specific goals for orthosis

Question 18

Patient or Function Based Goals

Answer 18

improving independence with functional mobility
independence with donning/doffing device
independence with wear schedule
independence with skin inspection

Question 19

Orthotic Goals

Answer 19

1. to assist joint movement when it is insufficient
2. to stabilize a joint by stopping or limiting motion when it is excessive, abnormal, or unwanted
3. to protect a joint from excessive, unwanted or deleterious loading or forces that may cause pain or injury
4. to assist in the management of joint or skeletal deformities

Question 20

Key components of orthotic prescription

Answer 20

medical and treatment diagnosis
impairments that affect function
functional goal for orthosis
specific orthotic goals
location of orthosis
any specific device recommendations
precautions
justification of need

Question 21

Orthotic Justification

Answer 21

1. Describe need
2. Include an explanation of how orthosis will enhance or maitain functional mobility
3. Length of need of orthosis
4. Patient’s condition (must have neuro, circulatory, or ortho diagnosis)

Question 22

AFO Specific Justification

Answer 22

Must include statements of the following:
1. Patient is ambulatory
2. Pt has weakness or deformity of ankle/foot
3. Patient requires stabilization for medical reasons
4. Patient has ability to benefit functionally from orthotic device

Question 23

KAFO Specific Justification

Answer 23

must include following statements
1. patient is ambulatory
2. patient has weakness or deformity of ankle or foot AND requires knee stability
3. Requires stabilization of foot, ankle, knee for medical reasons

Question 24

Orthotic Checkout Exam

Answer 24

done after the patient receives orthosis and returns to therapy

exam of orthotic device
re-exam of client’s physical status
exam of orthosis on client, static
exam of orthosis on client, dynamic
exam of the skin after 30 min

Question 25

Initial Wear Schedule

Answer 25

Day 1 = wear time 1 hour, split between AM/PM
Continues as so up through day 4 (increase the hour to match the numerical day)

Day 5 = can increase wear time at your discretion

Question 26

Patient Ed on skin checks

Answer 26

after every wear, patient should remove shoes, device, and socks, then check skin

any redness should go away with 15-20 min

if redness continues, stop wearing the orthosis and contact orthotist

Question 27

Observation of client’s physical status

Answer 27

observe changes in body weight, girth, ROM, functional status

Question 28

Exam of orthosis on client, static

Answer 28

joints are aligned properly, no areas of excessive pressure, static balance is fine

Question 29

Exam of orthosis, dynamic

Answer 29

orthosis is stable, functions as prescribed, no excess skin pressure or irritation, does the pt need extra training, is the patient satisfied