POAT EXAM 1 USA
1) If a patient has absent ankle PF muscle activation, what degree should the AFO
ankle joint be placed in?
a. O deg ankle PF/DF
b. 5 deg ankle PF
c. 5 deg ankle DF - answer1) A
Reasoning: If does not mention a gait deviation yet, so start at neutral 0 deg and go
from there. Only start with it set in 5 deg of PF or DF if you already know they are
experiencing knee hyperextension or buckling.
1) A person has 4/5 quad and 2/5 ankle PF strength on the affected side, and intact
proprioception. Will they likely require a KAFO?
a. Yes
b. No - answerB
1) If a patient has absent ankle DF muscle activation resulting in poor foot clearance,
which orthotic componentry do they need?
a. DF assist
b. PF stop
c. PF assist - answerB
Reasoning: They need some level of activation in the dorsiflexors in order to benefit
from a DF assist. A PF stop would be for absent activation. There is no such component
as a PF assist.
1) A patient presents only with DF strength 3+/5 and foot drag in swing phase. What
kind of AFO is recommended?
a. Polyarticulating AFO with PF stop
b. Static AFO
c. Posterior leaf spring AFO - answerC
Reasoning: Answer choice A does not provide any assistance to clear the foot, and thus
is not correct.
1) What grade of MMT for BLE quad must a patient demonstrate to indicate the use of
bilateral AFOs (versus bilateral KAFOs)?
a. >2/5 MMT in quads bilaterally
b. >3/5 MMT in quads bilaterally
c. >4/5 MMT in quads bilaterally
d. 5/5 MMT in quads bilaterally - answerB
,1) What orthotic device componentry is most appropriate for a patient experiencing
knee buckling in stance phase?
a. DF stop
b. Drop lock
c. DF assist
d. PF stop - answerA
1) What does DAFO stand for?
a. Double adjustable foot orthosis
b. Dynamic arm foot orthosis
c. Dynamic ankle foot orthosis
d. Durometer and foot orthosis - answerC
1) A patient demonstrates knee hyperextension during initial contact and stance phase.
What joint ROM must be limited to limit knee hyperextension?
a. Limit ankle PF
b. Limit ankle DF - answerA
1) How will the patient's gait pattern change if you add a heel lift to a SAFO set at 0 deg
neutral DF/PF?
a. Eliminate all rockers of gait
b. Increased knee flexion during stance phase
c. Increased knee extension during stance phase
d. No change in gait - answerB
Reasoning: Answer choice C would be the correct answer if a heel lift was added
without an orthosis being worn and sufficient ankle PF ROM was available to adjust for
it; that would promote a knee extension moment.
1) Which rockers are lost, or non-functional, when a patient uses a SAFO?
a. Heel rocker
b. Ankle rocker
c. Toe rocker
d. All rockers - answerD
1) A patient using a KAFO has knee hyperextension during stance phase. Which
direction should the knee axis of a KAFO be moved to limit knee hyperextension?
a. Move the KAFO knee joint posteriorly
b. Move the KAFO knee joint anteriorly - answerB
Reasoning: Moving the knee axis of the KAFO anteriorly will bring the axis of movement
closer to or in front of the weight line, resulting in a knee flexion moment to decrease the
hyperextension the patient is experiencing.
1) How can a LE orthotic device limit ankle PF spasticity? - answerIt prevents the
velocity dependent stretch of the plantarflexors by restricting the ankle ROM.
, 1) What are 2 muscle groups that should be strengthened for a patient demonstrating
knee buckling during stance phase?
a. Quads and DFs
b. Hamstrings and PFs
c. Quads and PFs
d. Hamstrings and DFs - answerC
1) What are 2 purposes of a rocker bottom shoe? - answerTo improve heel strike, to
promote heel-toe gait pattern, or reduce amount of hallux extension ROM required, to
restore rockers that are lost with use of a SAFO.
What should contribute to orthoses prescription during the evaluation? - answerPerform
assessment to determine impairments
Orthopedic, sensation, strength, tone/muscle extensibility
Tone or muscle extensibility impairments could lead to... - answerpoor fit or
malalignment of orthosis à skin breakdown, limited use of device, reduced effectiveness
What is a static orthotic device? - answeran orthotic device with no movable joints
incorporated in the design
What is a dynamic orthotic device? - answerorthotic devices with moveable joints
Why should a patient use a static orthotic device? - answerHighest degree of stability
and foot clearance
Lower risk of pistoning or chaffing due to movement of orthosis
Why should a patient use a dynamic orthotic device? - answerHigher degree of
adjustability to stabilize or maximize joint mobility
To provide dynamic response and substitute for muscle activation
What is and what is the function of the toebox of a shoe? - answerThe stiffener in the
toe of the shoe
Retains the shape of the shoe
Provides protection for the toes
Some patients benefit from a wide toe box to prevent injury or skin breakdown
What is an inlay? - answerThe inlay goes on top of the insole and is removable.
1) If a patient has absent ankle PF muscle activation, what degree should the AFO
ankle joint be placed in?
a. O deg ankle PF/DF
b. 5 deg ankle PF
c. 5 deg ankle DF - answer1) A
Reasoning: If does not mention a gait deviation yet, so start at neutral 0 deg and go
from there. Only start with it set in 5 deg of PF or DF if you already know they are
experiencing knee hyperextension or buckling.
1) A person has 4/5 quad and 2/5 ankle PF strength on the affected side, and intact
proprioception. Will they likely require a KAFO?
a. Yes
b. No - answerB
1) If a patient has absent ankle DF muscle activation resulting in poor foot clearance,
which orthotic componentry do they need?
a. DF assist
b. PF stop
c. PF assist - answerB
Reasoning: They need some level of activation in the dorsiflexors in order to benefit
from a DF assist. A PF stop would be for absent activation. There is no such component
as a PF assist.
1) A patient presents only with DF strength 3+/5 and foot drag in swing phase. What
kind of AFO is recommended?
a. Polyarticulating AFO with PF stop
b. Static AFO
c. Posterior leaf spring AFO - answerC
Reasoning: Answer choice A does not provide any assistance to clear the foot, and thus
is not correct.
1) What grade of MMT for BLE quad must a patient demonstrate to indicate the use of
bilateral AFOs (versus bilateral KAFOs)?
a. >2/5 MMT in quads bilaterally
b. >3/5 MMT in quads bilaterally
c. >4/5 MMT in quads bilaterally
d. 5/5 MMT in quads bilaterally - answerB
,1) What orthotic device componentry is most appropriate for a patient experiencing
knee buckling in stance phase?
a. DF stop
b. Drop lock
c. DF assist
d. PF stop - answerA
1) What does DAFO stand for?
a. Double adjustable foot orthosis
b. Dynamic arm foot orthosis
c. Dynamic ankle foot orthosis
d. Durometer and foot orthosis - answerC
1) A patient demonstrates knee hyperextension during initial contact and stance phase.
What joint ROM must be limited to limit knee hyperextension?
a. Limit ankle PF
b. Limit ankle DF - answerA
1) How will the patient's gait pattern change if you add a heel lift to a SAFO set at 0 deg
neutral DF/PF?
a. Eliminate all rockers of gait
b. Increased knee flexion during stance phase
c. Increased knee extension during stance phase
d. No change in gait - answerB
Reasoning: Answer choice C would be the correct answer if a heel lift was added
without an orthosis being worn and sufficient ankle PF ROM was available to adjust for
it; that would promote a knee extension moment.
1) Which rockers are lost, or non-functional, when a patient uses a SAFO?
a. Heel rocker
b. Ankle rocker
c. Toe rocker
d. All rockers - answerD
1) A patient using a KAFO has knee hyperextension during stance phase. Which
direction should the knee axis of a KAFO be moved to limit knee hyperextension?
a. Move the KAFO knee joint posteriorly
b. Move the KAFO knee joint anteriorly - answerB
Reasoning: Moving the knee axis of the KAFO anteriorly will bring the axis of movement
closer to or in front of the weight line, resulting in a knee flexion moment to decrease the
hyperextension the patient is experiencing.
1) How can a LE orthotic device limit ankle PF spasticity? - answerIt prevents the
velocity dependent stretch of the plantarflexors by restricting the ankle ROM.
, 1) What are 2 muscle groups that should be strengthened for a patient demonstrating
knee buckling during stance phase?
a. Quads and DFs
b. Hamstrings and PFs
c. Quads and PFs
d. Hamstrings and DFs - answerC
1) What are 2 purposes of a rocker bottom shoe? - answerTo improve heel strike, to
promote heel-toe gait pattern, or reduce amount of hallux extension ROM required, to
restore rockers that are lost with use of a SAFO.
What should contribute to orthoses prescription during the evaluation? - answerPerform
assessment to determine impairments
Orthopedic, sensation, strength, tone/muscle extensibility
Tone or muscle extensibility impairments could lead to... - answerpoor fit or
malalignment of orthosis à skin breakdown, limited use of device, reduced effectiveness
What is a static orthotic device? - answeran orthotic device with no movable joints
incorporated in the design
What is a dynamic orthotic device? - answerorthotic devices with moveable joints
Why should a patient use a static orthotic device? - answerHighest degree of stability
and foot clearance
Lower risk of pistoning or chaffing due to movement of orthosis
Why should a patient use a dynamic orthotic device? - answerHigher degree of
adjustability to stabilize or maximize joint mobility
To provide dynamic response and substitute for muscle activation
What is and what is the function of the toebox of a shoe? - answerThe stiffener in the
toe of the shoe
Retains the shape of the shoe
Provides protection for the toes
Some patients benefit from a wide toe box to prevent injury or skin breakdown
What is an inlay? - answerThe inlay goes on top of the insole and is removable.
