, Orthotics and Prosthetics Boards Written Exam Test Bank 3
with Latest Correctly Answered Questions Review / Orthotics
and Prosthetics Boards Written Latest Questions and Answers
Review - 150 Questions
Section 1: Lower Extremity Orthotics (Questions 1-15)
1 A patient presents with excessive genu recurvatum during the stance phase of gait, with passive knee
hyperextension exceeding 15 degrees. Which orthotic design is most appropriate to control this deviation while
allowing functional knee flexion during swing?
A) KAFO with drop locks and a solid ankle AFO
B) AFO with a dorsiflexion assist and a posterior offset knee joint
C) KAFO with a stance-phase control knee joint and a plantarflexion stop at neutral
D) Floor-reaction AFO with a pre-tibial shell extending to the patellar tendon
Answer: C
Rationale: A KAFO with a stance-phase control knee joint prevents hyperextension during stance while allowing
free swing. The plantarflexion stop at neutral prevents excessive plantarflexion that could exacerbate recurvatum.
Option A locks the knee, hindering swing; option B is an AFO, which cannot control the knee; option D focuses on
ground reaction forces but does not directly control the knee.
2 In designing a custom-molded AFO for a patient with hemiplegia and a plantarflexion contracture of 10 degrees,
which of the following trimline modifications would best reduce excessive knee extension moment during late
stance?
A) Extending the medial trimline proximally to the medial femoral condyle
B) Adding a dorsiflexion stop at 10 degrees of dorsiflexion
C) Setting the ankle in 5 degrees of dorsiflexion with a solid ankle
D) Incorporating a plantarflexion stop at 5 degrees of plantarflexion
Answer: C
Rationale: Setting the ankle in slight dorsiflexion shifts the ground reaction force anterior to the knee, creating an
external knee flexion moment that counters the hyperextension tendency. Option A would provide mediolateral
stability but does not affect knee moment. Option B would allow excessive dorsiflexion, increasing knee flexion
moment. Option D would maintain a plantarflexed position, worsening recurvatum.
3 A patient with post-polio syndrome and severe quadriceps weakness walks with a hyperextended knee and a
contralateral Trendelenburg gait. Which orthosis would most effectively reduce hip abductor demand while
stabilizing the knee?
A) KAFO with a free knee and a solid ankle AFO
B) Floor-reaction AFO with a rigid ankle and a patellar tendon-bearing (PTB) cuff
C) HKAFO with a pelvic band and bilateral KAFOs
D) AFO with a dorsiflexion assist and a medial T-strap
Answer: B
Rationale: A floor-reaction AFO (also called a ground-reaction AFO) uses a rigid ankle and a PTB cuff to create an
extension moment at the knee, stabilizing it. The rigid ankle also shifts the ground reaction force medially,
reducing hip abductor demand by decreasing the lever arm of the body weight. Option A would not provide knee
,stability without a locked knee. Option C is excessive for unilateral weakness. Option D does not address knee
stability.
4 A patient with a unilateral transfemoral amputation and a well-fitting prosthesis exhibits excessive lateral trunk
lean toward the prosthetic side during stance. Which of the following prosthetic alignments is most likely
contributing to this deviation?
A) Foot excessively inset relative to the socket
B) Socket in excessive adduction
C) Foot excessively outset relative to the socket
D) Socket in excessive flexion
Answer: A
Rationale: A foot that is too inset (medially placed) shifts the ground reaction force lateral to the hip joint,
increasing the hip abductor moment arm and requiring lateral trunk lean to maintain balance. Option B (socket
adduction) would bring the socket closer to the midline, also increasing abductor demand. Option C (foot outset)
would reduce abductor demand. Option D (socket flexion) primarily affects knee stability, not lateral lean.
5 Which of the following best describes the biomechanical effect of a solid ankle AFO with a 5-degree
plantarflexion stop on the gait of a patient with dorsiflexor weakness?
A) It prevents foot drop during swing and allows controlled plantarflexion at initial contact
B) It prevents foot drop during swing and blocks all plantarflexion, causing early heel rise
C) It allows free plantarflexion during stance and limits dorsiflexion during swing
D) It permits full ankle motion except at terminal stance where plantarflexion is limited
Answer: A
Rationale: A solid ankle AFO with a plantarflexion stop at 5 degrees prevents excessive plantarflexion (foot drop)
during swing, and at initial contact allows a small amount of plantarflexion for shock absorption. Option B is
incorrect because the stop does not block all plantarflexion; it allows up to 5 degrees. Option C reverses the
function. Option D describes a dorsiflexion stop, not a plantarflexion stop.
6 A patient with Charcot-Marie-Tooth disease presents with bilateral foot drop and a steppage gait. Which orthotic
design would best address both swing phase clearance and stance phase stability without impeding ankle motion
for non-level walking?
A) Posterior leaf spring AFO with a plantarflexion stop at neutral
B) Solid ankle AFO set in 5 degrees of dorsiflexion
C) Articulated AFO with a dorsiflexion assist and a plantarflexion stop at neutral
D) Carbon fiber dynamic AFO with a flexible ankle
Answer: C
Rationale: An articulated AFO with a dorsiflexion assist provides toe clearance during swing, and a plantarflexion
stop at neutral prevents foot drop. The articulation allows some dorsiflexion during stance for knee flexion and
accommodates uneven terrain. Option A (posterior leaf spring) provides only swing phase control. Option B (solid
ankle) blocks all motion, hindering non-level walking. Option D (flexible ankle) may not provide adequate stance
phase stability.
7 A patient with a T10 spinal cord injury uses a reciprocating gait orthosis (RGO) for ambulation. Which of the
following gait parameters is most critical for achieving a smooth reciprocal pattern with this device?
A) Adequate hip flexion range of motion to 90 degrees
B) Sufficient shoulder depression strength to advance the swing leg
C) Bilateral ankle dorsiflexion strength to initiate swing
, D) Intact proprioception at the knee joints
Answer: B
Rationale: In an RGO, the user relies on upper body strength, particularly shoulder depressors and trunk extensors,
to shift weight and advance the swing leg via the reciprocal cable. Option A is less critical because the orthosis
controls hip motion. Option C is irrelevant as ankle motion is limited by AFOs. Option D is not essential because
the orthosis provides knee stability.
8 When fitting a patient with a unilateral transtibial amputation and a patellar tendon-bearing (PTB) socket, which
of the following is the primary biomechanical advantage of incorporating a supracondylar suspension (SC) cuff?
A) It prevents pistoning by compressing the patellar tendon
B) It provides mediolateral stability at the knee
C) It reduces pressure on the patellar tendon by distributing load to the femoral condyles
D) It allows for a more anatomic alignment of the knee joint
Answer: B
Rationale: The SC cuff wraps around the femoral condyles, providing mediolateral knee stability and suspension.
Option A is incorrect; pistoning is reduced by the PTB socket itself. Option C is incorrect; the SC cuff does not
offload the patellar tendon-it adds suspension. Option D is not a primary advantage; alignment is determined by
socket and foot placement.
9 A patient with bilateral genu varum and medial compartment knee osteoarthritis is considering an unloader knee
brace. Which of the following design features is most essential for effective load redistribution?
A) A rigid frame with a lateral hinge and a medial condyle pad
B) A dynamic strap system that pulls the tibia into valgus
C) A custom-molded shell with a three-point pressure system
D) A hinged brace with a valgus moment applied via a lateral upright and a medial thigh cuff
Answer: D
Rationale: An unloader brace for genu varum applies a valgus moment to the knee by using a lateral upright and a
medial thigh cuff, creating a three-point bending force that unloads the medial compartment. Option A describes a
stabilizing brace, not an unloader. Option B is a strap system but lacks the rigid frame for effective moment. Option
C is too generic; the three-point system must be specifically oriented for valgus.
10 A patient with a history of a CVA presents with a plantarflexed and inverted foot during swing phase, and a
varus thrust during stance. Which orthotic intervention would most directly address both swing phase
positioning and stance phase control?
A) A solid ankle AFO with a lateral T-strap
B) An articulated AFO with a dorsiflexion assist and a medial T-strap
C) A floor-reaction AFO with a supramalleolar orthosis (SMO)
D) A posterior leaf spring AFO with a lateral heel wedge
Answer: B
Rationale: An articulated AFO with dorsiflexion assist lifts the foot during swing, and a medial T-strap applies a
corrective eversion force to counteract varus during stance and swing. Option A (solid ankle) would block motion
and the lateral T-strap would worsen varus. Option C (SMO) provides limited control. Option D (posterior leaf
spring) provides swing control but the lateral wedge may not correct varus thrust effectively.
11 A patient with chronic ankle instability and peroneal nerve weakness presents for orthotic management. Which
orthotic design most effectively combines subtalar joint control with accommodation for peroneal muscle
weakness while permitting some ankle plantarflexion during gait?
with Latest Correctly Answered Questions Review / Orthotics
and Prosthetics Boards Written Latest Questions and Answers
Review - 150 Questions
Section 1: Lower Extremity Orthotics (Questions 1-15)
1 A patient presents with excessive genu recurvatum during the stance phase of gait, with passive knee
hyperextension exceeding 15 degrees. Which orthotic design is most appropriate to control this deviation while
allowing functional knee flexion during swing?
A) KAFO with drop locks and a solid ankle AFO
B) AFO with a dorsiflexion assist and a posterior offset knee joint
C) KAFO with a stance-phase control knee joint and a plantarflexion stop at neutral
D) Floor-reaction AFO with a pre-tibial shell extending to the patellar tendon
Answer: C
Rationale: A KAFO with a stance-phase control knee joint prevents hyperextension during stance while allowing
free swing. The plantarflexion stop at neutral prevents excessive plantarflexion that could exacerbate recurvatum.
Option A locks the knee, hindering swing; option B is an AFO, which cannot control the knee; option D focuses on
ground reaction forces but does not directly control the knee.
2 In designing a custom-molded AFO for a patient with hemiplegia and a plantarflexion contracture of 10 degrees,
which of the following trimline modifications would best reduce excessive knee extension moment during late
stance?
A) Extending the medial trimline proximally to the medial femoral condyle
B) Adding a dorsiflexion stop at 10 degrees of dorsiflexion
C) Setting the ankle in 5 degrees of dorsiflexion with a solid ankle
D) Incorporating a plantarflexion stop at 5 degrees of plantarflexion
Answer: C
Rationale: Setting the ankle in slight dorsiflexion shifts the ground reaction force anterior to the knee, creating an
external knee flexion moment that counters the hyperextension tendency. Option A would provide mediolateral
stability but does not affect knee moment. Option B would allow excessive dorsiflexion, increasing knee flexion
moment. Option D would maintain a plantarflexed position, worsening recurvatum.
3 A patient with post-polio syndrome and severe quadriceps weakness walks with a hyperextended knee and a
contralateral Trendelenburg gait. Which orthosis would most effectively reduce hip abductor demand while
stabilizing the knee?
A) KAFO with a free knee and a solid ankle AFO
B) Floor-reaction AFO with a rigid ankle and a patellar tendon-bearing (PTB) cuff
C) HKAFO with a pelvic band and bilateral KAFOs
D) AFO with a dorsiflexion assist and a medial T-strap
Answer: B
Rationale: A floor-reaction AFO (also called a ground-reaction AFO) uses a rigid ankle and a PTB cuff to create an
extension moment at the knee, stabilizing it. The rigid ankle also shifts the ground reaction force medially,
reducing hip abductor demand by decreasing the lever arm of the body weight. Option A would not provide knee
,stability without a locked knee. Option C is excessive for unilateral weakness. Option D does not address knee
stability.
4 A patient with a unilateral transfemoral amputation and a well-fitting prosthesis exhibits excessive lateral trunk
lean toward the prosthetic side during stance. Which of the following prosthetic alignments is most likely
contributing to this deviation?
A) Foot excessively inset relative to the socket
B) Socket in excessive adduction
C) Foot excessively outset relative to the socket
D) Socket in excessive flexion
Answer: A
Rationale: A foot that is too inset (medially placed) shifts the ground reaction force lateral to the hip joint,
increasing the hip abductor moment arm and requiring lateral trunk lean to maintain balance. Option B (socket
adduction) would bring the socket closer to the midline, also increasing abductor demand. Option C (foot outset)
would reduce abductor demand. Option D (socket flexion) primarily affects knee stability, not lateral lean.
5 Which of the following best describes the biomechanical effect of a solid ankle AFO with a 5-degree
plantarflexion stop on the gait of a patient with dorsiflexor weakness?
A) It prevents foot drop during swing and allows controlled plantarflexion at initial contact
B) It prevents foot drop during swing and blocks all plantarflexion, causing early heel rise
C) It allows free plantarflexion during stance and limits dorsiflexion during swing
D) It permits full ankle motion except at terminal stance where plantarflexion is limited
Answer: A
Rationale: A solid ankle AFO with a plantarflexion stop at 5 degrees prevents excessive plantarflexion (foot drop)
during swing, and at initial contact allows a small amount of plantarflexion for shock absorption. Option B is
incorrect because the stop does not block all plantarflexion; it allows up to 5 degrees. Option C reverses the
function. Option D describes a dorsiflexion stop, not a plantarflexion stop.
6 A patient with Charcot-Marie-Tooth disease presents with bilateral foot drop and a steppage gait. Which orthotic
design would best address both swing phase clearance and stance phase stability without impeding ankle motion
for non-level walking?
A) Posterior leaf spring AFO with a plantarflexion stop at neutral
B) Solid ankle AFO set in 5 degrees of dorsiflexion
C) Articulated AFO with a dorsiflexion assist and a plantarflexion stop at neutral
D) Carbon fiber dynamic AFO with a flexible ankle
Answer: C
Rationale: An articulated AFO with a dorsiflexion assist provides toe clearance during swing, and a plantarflexion
stop at neutral prevents foot drop. The articulation allows some dorsiflexion during stance for knee flexion and
accommodates uneven terrain. Option A (posterior leaf spring) provides only swing phase control. Option B (solid
ankle) blocks all motion, hindering non-level walking. Option D (flexible ankle) may not provide adequate stance
phase stability.
7 A patient with a T10 spinal cord injury uses a reciprocating gait orthosis (RGO) for ambulation. Which of the
following gait parameters is most critical for achieving a smooth reciprocal pattern with this device?
A) Adequate hip flexion range of motion to 90 degrees
B) Sufficient shoulder depression strength to advance the swing leg
C) Bilateral ankle dorsiflexion strength to initiate swing
, D) Intact proprioception at the knee joints
Answer: B
Rationale: In an RGO, the user relies on upper body strength, particularly shoulder depressors and trunk extensors,
to shift weight and advance the swing leg via the reciprocal cable. Option A is less critical because the orthosis
controls hip motion. Option C is irrelevant as ankle motion is limited by AFOs. Option D is not essential because
the orthosis provides knee stability.
8 When fitting a patient with a unilateral transtibial amputation and a patellar tendon-bearing (PTB) socket, which
of the following is the primary biomechanical advantage of incorporating a supracondylar suspension (SC) cuff?
A) It prevents pistoning by compressing the patellar tendon
B) It provides mediolateral stability at the knee
C) It reduces pressure on the patellar tendon by distributing load to the femoral condyles
D) It allows for a more anatomic alignment of the knee joint
Answer: B
Rationale: The SC cuff wraps around the femoral condyles, providing mediolateral knee stability and suspension.
Option A is incorrect; pistoning is reduced by the PTB socket itself. Option C is incorrect; the SC cuff does not
offload the patellar tendon-it adds suspension. Option D is not a primary advantage; alignment is determined by
socket and foot placement.
9 A patient with bilateral genu varum and medial compartment knee osteoarthritis is considering an unloader knee
brace. Which of the following design features is most essential for effective load redistribution?
A) A rigid frame with a lateral hinge and a medial condyle pad
B) A dynamic strap system that pulls the tibia into valgus
C) A custom-molded shell with a three-point pressure system
D) A hinged brace with a valgus moment applied via a lateral upright and a medial thigh cuff
Answer: D
Rationale: An unloader brace for genu varum applies a valgus moment to the knee by using a lateral upright and a
medial thigh cuff, creating a three-point bending force that unloads the medial compartment. Option A describes a
stabilizing brace, not an unloader. Option B is a strap system but lacks the rigid frame for effective moment. Option
C is too generic; the three-point system must be specifically oriented for valgus.
10 A patient with a history of a CVA presents with a plantarflexed and inverted foot during swing phase, and a
varus thrust during stance. Which orthotic intervention would most directly address both swing phase
positioning and stance phase control?
A) A solid ankle AFO with a lateral T-strap
B) An articulated AFO with a dorsiflexion assist and a medial T-strap
C) A floor-reaction AFO with a supramalleolar orthosis (SMO)
D) A posterior leaf spring AFO with a lateral heel wedge
Answer: B
Rationale: An articulated AFO with dorsiflexion assist lifts the foot during swing, and a medial T-strap applies a
corrective eversion force to counteract varus during stance and swing. Option A (solid ankle) would block motion
and the lateral T-strap would worsen varus. Option C (SMO) provides limited control. Option D (posterior leaf
spring) provides swing control but the lateral wedge may not correct varus thrust effectively.
11 A patient with chronic ankle instability and peroneal nerve weakness presents for orthotic management. Which
orthotic design most effectively combines subtalar joint control with accommodation for peroneal muscle
weakness while permitting some ankle plantarflexion during gait?
