2
CPM orthotics Exam with precise detailed solutions
|| || || || || ||
UCBL- university of california berkley laboratory trimlines - ✔✔distal to
|| || || || || || || || || ||
metheads, encompass navicular || ||
*If have a full footplate= would piston out of device
|| || || || || || || || ||
UCBL- university of california berkley laboratory correction - ✔✔hindfoot-
|| || || || || || || || ||
inversion of calcaneus to neutral; midfoot- abduct talus by externally rotating
|| || || || || || || || || || ||
tibia and fibula; forefoot- adduct
|| || || ||
UCBL- university of california berkley laboratory indicated - ✔✔child,
|| || || || || || || || ||
pronation/ pes planus || ||
UCBL- university of california berkley laboratory conta-indicated - ✔✔rigid,
|| || || || || || || || ||
pes cavus/ supinated
|| ||
Carlson Modifications - ✔✔Intrinsic medial heel wedge
|| || || || || ||
Extrinsic medial heel post || || ||
Stabilization proximal to base of 5th metatarsal || || || || || ||
Support inferior to sustentaculum tali
|| || || ||
SMO- supramalleolar orthosis trimlines - ✔✔Trimlines : superior to the
|| || || || || || || || || ||
superior border of the malleoli, sulcus or met trimline
|| || || || || || || ||
***If have a full footplate would piston out of device
|| || || || || || || || ||
,2
SMO- supramalleolar orthosis biomechanics - ✔✔increased control in coronal
|| || || || || || || || ||
plane compared to the UCBL, longer lever arm
|| || || || || || ||
Coronal plane control aid in m/l control
|| || || || || ||
SMO- supramalleolar orthosis indications - ✔✔pes planus, control of ankle in
|| || || || || || || || || || ||
coronal plane ||
SMO- supramalleolar orthosis contra-indications - ✔✔ankle sagittal plane
|| || || || || || || ||
weakness (weak dorsiflexors or knee extensors)
|| || || || ||
Control excessive pronation forces - ✔✔1. control calcaneal eversion- medial
|| || || || || || || || || ||
upward force applied to STJ and medial force on the lateral surface of
|| || || || || || || || || || || || ||
calcaneous ||
2. support medial arch
|| || ||
3. control forefoot abduction- medial forces on the lateral portion of the 5th
|| || || || || || || || || || || || ||
methead and calcaneous; lateral force on the medial portion of the arch
|| || || || || || || || || || || ||
4. control valgus- medial force on the lateral proximal shank and calcaneous;
|| || || || || || || || || || || ||
lateral force above medial malleolus
|| || || || ||
5. control dorsiflexion- posterior force on the anterior proximal shank; anterior
|| || || || || || || || || || ||
force on the posterior leg above malleolli; downward force on the forefoot
|| || || || || || || || || || ||
Control excessive supination forces - ✔✔1. control calcaneal inversion- lateral
|| || || || || || || || || ||
force on the medial proximal surface of the calcaneous and medial force on the
|| || || || || || || || || || || || || ||
lateral distal surface of calcaneous
|| || || || ||
2. support transverse arch
|| || ||
,2
3. control forefoot adduction- lateral forces on the medial portion of the 1st
|| || || || || || || || || || || || ||
methead and calcaneous; medial force on the lateral surface of the base of the
|| || || || || || || || || || || || || ||
5th met || ||
4. control varus- lateral force on the medial proximal shank and calcaneous;
|| || || || || || || || || || || ||
medial force above lateral malleolus
|| || || || ||
5. control plantarflexion- anterior force on the posterior proximal shank;
|| || || || || || || || || ||
posterior force on the anterior instep; upward force on the forefoot
|| || || || || || || || || ||
Solid AFO Trimlines - ✔✔20 mm distal to distal edge of fibular head
|| || || || || || || || || || || ||
Solid AFO indicated - ✔✔high tone, need maximum m/l control, tri-planar
|| || || || || || || || || || ||
problems
High tone: CP || ||
Max m/l control: pronation, inversion/eversion, severe PTTD
|| || || || || ||
Tri-planar problems at ankle: fractures? || || || ||
Solid AFO contra-indicated - ✔✔weak quadriceps (need strong quadriceps to
|| || || || || || || || || ||
resist knee flexion moment at loading response)
|| || || || || ||
why would you use a lateral sabolich trimline - ✔✔change to standard
|| || || || || || || || || || || ||
trimlines you would use for a flexible hindfoot varus within a solid AFO
|| || || || || || || || || || || ||
3 point pressure system for flexible hindfoot varus - ✔✔proximal tibia/ medial
|| || || || || || || || || || || ||
calf, lateral sabolich, medial 1st MTP
|| || || || ||
***Varus and supination have the same 3 point pressure systems
|| || || || || || || || ||
, 2
why would you extend a solid AFO posterior trimline more proximal: -
|| || || || || || || || || || || ||
✔✔longer lever arm to promote knee flexion and decrease hyperextension
|| || || || || || || || ||
***This compromises knee flexion || || ||
GRAFO trimlines - ✔✔anterior proximal encompasses tibial tubercle
|| || || || || || || ||
anteriorly; anterior distal under proximal third of leg; posterior proximal on top
|| || || || || || || || || || || ||
of distal third
|| ||
Footplate is rigid || ||
Solid ankle, full footplate
|| || ||
GRAFO indications - ✔✔crouch gait- mild knee instability (minimum 4/ 5
|| || || || || || || || || || ||
MMT at knee extensors); weak plantar flexors and/or dorsiflexors
|| || || || || || || ||
CP, spina bifida
|| ||
GRAFO contra-indications - ✔✔knee hyperextension ; coronal plane instability
|| || || || || || || ||
, hip or knee contractures
|| || || || ||
what is most likely affected if you observe a patient with a shortened step on
|| || || || || || || || || || || || || || ||
sound side (assuming patient is unilaterally involved) - ✔✔plantarflexors
|| || || || || || || || ||
weak/ absent plantarflexors allows dorsiflexors to pull into dorsiflexion= early
|| || || || || || || || || ||
knee flexion and patient will need to catch themselves on contralateral side
|| || || || || || || || || || ||
what type of AFO is used for patient with a tibial nerve lesion - ✔✔AFO with
|| || || || || || || || || || || || || || || ||
plantar flexion free and dorsiflexion stop
|| || || || ||
CPM orthotics Exam with precise detailed solutions
|| || || || || ||
UCBL- university of california berkley laboratory trimlines - ✔✔distal to
|| || || || || || || || || ||
metheads, encompass navicular || ||
*If have a full footplate= would piston out of device
|| || || || || || || || ||
UCBL- university of california berkley laboratory correction - ✔✔hindfoot-
|| || || || || || || || ||
inversion of calcaneus to neutral; midfoot- abduct talus by externally rotating
|| || || || || || || || || || ||
tibia and fibula; forefoot- adduct
|| || || ||
UCBL- university of california berkley laboratory indicated - ✔✔child,
|| || || || || || || || ||
pronation/ pes planus || ||
UCBL- university of california berkley laboratory conta-indicated - ✔✔rigid,
|| || || || || || || || ||
pes cavus/ supinated
|| ||
Carlson Modifications - ✔✔Intrinsic medial heel wedge
|| || || || || ||
Extrinsic medial heel post || || ||
Stabilization proximal to base of 5th metatarsal || || || || || ||
Support inferior to sustentaculum tali
|| || || ||
SMO- supramalleolar orthosis trimlines - ✔✔Trimlines : superior to the
|| || || || || || || || || ||
superior border of the malleoli, sulcus or met trimline
|| || || || || || || ||
***If have a full footplate would piston out of device
|| || || || || || || || ||
,2
SMO- supramalleolar orthosis biomechanics - ✔✔increased control in coronal
|| || || || || || || || ||
plane compared to the UCBL, longer lever arm
|| || || || || || ||
Coronal plane control aid in m/l control
|| || || || || ||
SMO- supramalleolar orthosis indications - ✔✔pes planus, control of ankle in
|| || || || || || || || || || ||
coronal plane ||
SMO- supramalleolar orthosis contra-indications - ✔✔ankle sagittal plane
|| || || || || || || ||
weakness (weak dorsiflexors or knee extensors)
|| || || || ||
Control excessive pronation forces - ✔✔1. control calcaneal eversion- medial
|| || || || || || || || || ||
upward force applied to STJ and medial force on the lateral surface of
|| || || || || || || || || || || || ||
calcaneous ||
2. support medial arch
|| || ||
3. control forefoot abduction- medial forces on the lateral portion of the 5th
|| || || || || || || || || || || || ||
methead and calcaneous; lateral force on the medial portion of the arch
|| || || || || || || || || || || ||
4. control valgus- medial force on the lateral proximal shank and calcaneous;
|| || || || || || || || || || || ||
lateral force above medial malleolus
|| || || || ||
5. control dorsiflexion- posterior force on the anterior proximal shank; anterior
|| || || || || || || || || || ||
force on the posterior leg above malleolli; downward force on the forefoot
|| || || || || || || || || || ||
Control excessive supination forces - ✔✔1. control calcaneal inversion- lateral
|| || || || || || || || || ||
force on the medial proximal surface of the calcaneous and medial force on the
|| || || || || || || || || || || || || ||
lateral distal surface of calcaneous
|| || || || ||
2. support transverse arch
|| || ||
,2
3. control forefoot adduction- lateral forces on the medial portion of the 1st
|| || || || || || || || || || || || ||
methead and calcaneous; medial force on the lateral surface of the base of the
|| || || || || || || || || || || || || ||
5th met || ||
4. control varus- lateral force on the medial proximal shank and calcaneous;
|| || || || || || || || || || || ||
medial force above lateral malleolus
|| || || || ||
5. control plantarflexion- anterior force on the posterior proximal shank;
|| || || || || || || || || ||
posterior force on the anterior instep; upward force on the forefoot
|| || || || || || || || || ||
Solid AFO Trimlines - ✔✔20 mm distal to distal edge of fibular head
|| || || || || || || || || || || ||
Solid AFO indicated - ✔✔high tone, need maximum m/l control, tri-planar
|| || || || || || || || || || ||
problems
High tone: CP || ||
Max m/l control: pronation, inversion/eversion, severe PTTD
|| || || || || ||
Tri-planar problems at ankle: fractures? || || || ||
Solid AFO contra-indicated - ✔✔weak quadriceps (need strong quadriceps to
|| || || || || || || || || ||
resist knee flexion moment at loading response)
|| || || || || ||
why would you use a lateral sabolich trimline - ✔✔change to standard
|| || || || || || || || || || || ||
trimlines you would use for a flexible hindfoot varus within a solid AFO
|| || || || || || || || || || || ||
3 point pressure system for flexible hindfoot varus - ✔✔proximal tibia/ medial
|| || || || || || || || || || || ||
calf, lateral sabolich, medial 1st MTP
|| || || || ||
***Varus and supination have the same 3 point pressure systems
|| || || || || || || || ||
, 2
why would you extend a solid AFO posterior trimline more proximal: -
|| || || || || || || || || || || ||
✔✔longer lever arm to promote knee flexion and decrease hyperextension
|| || || || || || || || ||
***This compromises knee flexion || || ||
GRAFO trimlines - ✔✔anterior proximal encompasses tibial tubercle
|| || || || || || || ||
anteriorly; anterior distal under proximal third of leg; posterior proximal on top
|| || || || || || || || || || || ||
of distal third
|| ||
Footplate is rigid || ||
Solid ankle, full footplate
|| || ||
GRAFO indications - ✔✔crouch gait- mild knee instability (minimum 4/ 5
|| || || || || || || || || || ||
MMT at knee extensors); weak plantar flexors and/or dorsiflexors
|| || || || || || || ||
CP, spina bifida
|| ||
GRAFO contra-indications - ✔✔knee hyperextension ; coronal plane instability
|| || || || || || || ||
, hip or knee contractures
|| || || || ||
what is most likely affected if you observe a patient with a shortened step on
|| || || || || || || || || || || || || || ||
sound side (assuming patient is unilaterally involved) - ✔✔plantarflexors
|| || || || || || || || ||
weak/ absent plantarflexors allows dorsiflexors to pull into dorsiflexion= early
|| || || || || || || || || ||
knee flexion and patient will need to catch themselves on contralateral side
|| || || || || || || || || || ||
what type of AFO is used for patient with a tibial nerve lesion - ✔✔AFO with
|| || || || || || || || || || || || || || || ||
plantar flexion free and dorsiflexion stop
|| || || || ||
