ORTHOTIC DEVICES FINAL EXAM 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔Shoe style for neuro patients - ✔✔Higher counter = more control; higher tops often
recommended with AFOs but can be harder to don.
✔✔Shoe upper considerations - ✔✔Extended opening easier to don; velcro vs laces;
padded collars/tongues improve comfort.
✔✔Shoe weight goal - ✔✔Lightest shoe that still provides required stability/mobility.
✔✔Outsole pitch - ✔✔Typical ~¾ inch pitch from heel to ball.
✔✔Rocker sole - ✔✔Sole modification to enhance or create forefoot rocker.
✔✔Toe spring - ✔✔Increased toe spring can assist toe clearance.
✔✔Flares/wedges - ✔✔Outsole modifications for increased stability and/or alignment.
✔✔Heel lift - ✔✔Shoe modification that can alter ankle/knee mechanics via pitch.
✔✔Footwear fitting tips - ✔✔Fit end of day; fit to larger foot; fit to brace; match shoe
shape to foot/orthosis shape.
✔✔Functional foot orthosis - ✔✔FO designed to control abnormal motion, enhance
normal motion, and optimize tissue stress.
✔✔Accommodative foot orthosis - ✔✔FO designed to redistribute pressures, support
fixed deformity, reduce skin breakdown risk, and relieve pain.
✔✔Mechanical goals of functional FOs - ✔✔Control pronation/supination, control loads,
redistribute plantar pressures, support abnormal postures, facilitate sagittal progression,
control shock absorption.
✔✔Triplanar foot function - ✔✔Foot function occurs in 3 planes; FO prescription uses a
triplanar approach.
✔✔STJ neutral - ✔✔Subtalar joint neutral used as reference frame for forefoot-to-
rearfoot alignment assessment.
✔✔Rearfoot varus - ✔✔Calcaneal inversion alignment (in NWB/WB assessment).
✔✔Rearfoot valgus - ✔✔Calcaneal eversion alignment (in NWB/WB assessment).
, ✔✔Forefoot varus - ✔✔Forefoot inverted relative to rearfoot in STJ neutral.
✔✔Forefoot valgus - ✔✔Forefoot everted relative to rearfoot in STJ neutral.
✔✔Plantarflexed first ray - ✔✔First ray plantarflexed relative to other metatarsals;
influences compensation patterns.
✔✔Compensated forefoot varus - ✔✔Forefoot varus with compensatory pronation to
achieve plantigrade contact.
✔✔Uncompensated forefoot varus - ✔✔Forefoot varus without adequate compensation;
may remain non-plantigrade.
✔✔Intrinsic posting - ✔✔Posting built into the orthotic shell (within the device).
✔✔Extrinsic posting - ✔✔Posting added to underside of shell (external add-on).
✔✔Medial wedging - ✔✔Posting to bias foot toward supination control (rearfoot or
forefoot).
✔✔Lateral wedging - ✔✔Posting to bias foot toward pronation control (rearfoot or
forefoot).
✔✔Spinal orthosis nomenclature - ✔✔Cervical, cervicothoracic, thoracolumbosacral,
lumbosacral, sacral.
✔✔Objectives of spinal orthoses - ✔✔Control position, apply corrective forces to
abnormal curvatures, stabilize when soft tissues inadequate, restrict movement after
trauma.
✔✔Spinal orthosis mechanism - ✔✔Uses three-point pressure system for trunk/head
support, motion control, realignment, and partial weight transfer of head to trunk in
upright.
✔✔Factors affecting spinal orthosis effectiveness - ✔✔Force points,
direction/magnitude, tightness, injury/instability type, body habitus.
✔✔Negative effects of spinal orthoses - ✔✔Axial muscle atrophy, contractures, skin
breakdown (pressure/moisture), psychological dependency.
✔✔3-column spine concept - ✔✔Spine described as anterior, middle, and posterior
columns.
✔✔C0-C1 motion - ✔✔Significant flex/extension; minor lateral bending; little rotation.
QUESTIONS AND SOLUTIONS RATED A+
✔✔Shoe style for neuro patients - ✔✔Higher counter = more control; higher tops often
recommended with AFOs but can be harder to don.
✔✔Shoe upper considerations - ✔✔Extended opening easier to don; velcro vs laces;
padded collars/tongues improve comfort.
✔✔Shoe weight goal - ✔✔Lightest shoe that still provides required stability/mobility.
✔✔Outsole pitch - ✔✔Typical ~¾ inch pitch from heel to ball.
✔✔Rocker sole - ✔✔Sole modification to enhance or create forefoot rocker.
✔✔Toe spring - ✔✔Increased toe spring can assist toe clearance.
✔✔Flares/wedges - ✔✔Outsole modifications for increased stability and/or alignment.
✔✔Heel lift - ✔✔Shoe modification that can alter ankle/knee mechanics via pitch.
✔✔Footwear fitting tips - ✔✔Fit end of day; fit to larger foot; fit to brace; match shoe
shape to foot/orthosis shape.
✔✔Functional foot orthosis - ✔✔FO designed to control abnormal motion, enhance
normal motion, and optimize tissue stress.
✔✔Accommodative foot orthosis - ✔✔FO designed to redistribute pressures, support
fixed deformity, reduce skin breakdown risk, and relieve pain.
✔✔Mechanical goals of functional FOs - ✔✔Control pronation/supination, control loads,
redistribute plantar pressures, support abnormal postures, facilitate sagittal progression,
control shock absorption.
✔✔Triplanar foot function - ✔✔Foot function occurs in 3 planes; FO prescription uses a
triplanar approach.
✔✔STJ neutral - ✔✔Subtalar joint neutral used as reference frame for forefoot-to-
rearfoot alignment assessment.
✔✔Rearfoot varus - ✔✔Calcaneal inversion alignment (in NWB/WB assessment).
✔✔Rearfoot valgus - ✔✔Calcaneal eversion alignment (in NWB/WB assessment).
, ✔✔Forefoot varus - ✔✔Forefoot inverted relative to rearfoot in STJ neutral.
✔✔Forefoot valgus - ✔✔Forefoot everted relative to rearfoot in STJ neutral.
✔✔Plantarflexed first ray - ✔✔First ray plantarflexed relative to other metatarsals;
influences compensation patterns.
✔✔Compensated forefoot varus - ✔✔Forefoot varus with compensatory pronation to
achieve plantigrade contact.
✔✔Uncompensated forefoot varus - ✔✔Forefoot varus without adequate compensation;
may remain non-plantigrade.
✔✔Intrinsic posting - ✔✔Posting built into the orthotic shell (within the device).
✔✔Extrinsic posting - ✔✔Posting added to underside of shell (external add-on).
✔✔Medial wedging - ✔✔Posting to bias foot toward supination control (rearfoot or
forefoot).
✔✔Lateral wedging - ✔✔Posting to bias foot toward pronation control (rearfoot or
forefoot).
✔✔Spinal orthosis nomenclature - ✔✔Cervical, cervicothoracic, thoracolumbosacral,
lumbosacral, sacral.
✔✔Objectives of spinal orthoses - ✔✔Control position, apply corrective forces to
abnormal curvatures, stabilize when soft tissues inadequate, restrict movement after
trauma.
✔✔Spinal orthosis mechanism - ✔✔Uses three-point pressure system for trunk/head
support, motion control, realignment, and partial weight transfer of head to trunk in
upright.
✔✔Factors affecting spinal orthosis effectiveness - ✔✔Force points,
direction/magnitude, tightness, injury/instability type, body habitus.
✔✔Negative effects of spinal orthoses - ✔✔Axial muscle atrophy, contractures, skin
breakdown (pressure/moisture), psychological dependency.
✔✔3-column spine concept - ✔✔Spine described as anterior, middle, and posterior
columns.
✔✔C0-C1 motion - ✔✔Significant flex/extension; minor lateral bending; little rotation.
