Exam 1) Orthotics Exam 1: Questions & Answers:
Updated Solution
/What are the 5 key elements at preventing foot ulcers? - Answer-Identifying the at risk
foot
Regular examination of the foot
Educating the patient, family, and healthcare system
Ensuring routine wearing of appropriate footwear
Treating risk factors
/.What are some examples of conditions that place a foot at risk for an ulcer? - Answer-
Obesity
Smoking
Alcohol
Prior ulcer/amputation
Gender
Age
Trauma
Physical inactivity
Concurrent medical conditions: peripheral neuropathy, poor glycemic control, HTN,
retinopathy, kidney problems, Charcot foot, foot deformity, poor footwear, calluses
Diabetes
/.What are the 3 major things the autonomic system contributes to the diabetic foot? -
Answer-Regulation in maintaining moisture and blood flow
Controlling hair/nail growth
Facilitation of good skin integrity
/.How can we as PT's educate our patient to assist the autonomic system in preventing
injuries to the foot? - Answer-Application of creams or non-alcoholic based lotion to
prevent cracks and appropriate nail care
/.What can dysfunction of the autonomic system cause? - Answer-Diabetic neuropathic
osteoarthropathy—Charcot foot
/.What are the main characteristics of Charcot foot? - Answer-Decreased sensitivity
interfering muscular foot balance
Joint collapse due to bone weakening
Progressive damage to other tissues—ligaments, cartilage
May not be painful
Other:
- redness
- swelling
, -pain/soreness
- strong pedal pulse
- discoloration of joint
- foot deformity
/.How can a person prevent foot ulcers? - Answer-Appropriate footwear
No barefoot walking
Inspect feet regularly
Trim toenails and calluses regularly
Glucose control/weight control
Physical activity
Decrease smoking and alcohol use
/.What should be the two major components of an objective exam when determining a
LE orthotic? - Answer-MMT: to make sure they have adequate hip strength or the ability
to advance the LE
ROM: to identify restrictions in ROM in all positions
/.Hypermobile feet are associated with__________ - Answer-Pronated feet
/.Hypomobile feet are associated with ________________ - Answer-Supinated feet
/.What is overpronation of the foot associated with? - Answer-Knee genu valgus—
patellafemoral lateral shift—chondromalacia or patellar instability
Achilles tendonitis
/.T or F: you can put posting wedges on with insensate feet? - Answer-FALSE
/.What is the goal of corrective foot orthotics? - Answer-A well balanced foot with some
flexibility
/.What are contraindicated for corrective foot orthotics? - Answer-Insensate feet or feet
with a fixed deformity
/.What is the purpose of accomodative foot orthotics? - Answer-To protect insensate
feet
/.Does Medicare cover accomodative foot orthotics? - Answer-Yes—80% covered for
diabetes; 1 pair of shoes/year OR 3 pairs of inserts/year
/.What is the purpose of the UCBL? - Answer-Protection and stabilize the hind foot
/.What is the purpose of the supramalleolar orthosis (SMO)? - Answer-Hind foot control
past the malleoli
/.What are the purposes of the solid AFO? - Answer-Prevent foot drop
Updated Solution
/What are the 5 key elements at preventing foot ulcers? - Answer-Identifying the at risk
foot
Regular examination of the foot
Educating the patient, family, and healthcare system
Ensuring routine wearing of appropriate footwear
Treating risk factors
/.What are some examples of conditions that place a foot at risk for an ulcer? - Answer-
Obesity
Smoking
Alcohol
Prior ulcer/amputation
Gender
Age
Trauma
Physical inactivity
Concurrent medical conditions: peripheral neuropathy, poor glycemic control, HTN,
retinopathy, kidney problems, Charcot foot, foot deformity, poor footwear, calluses
Diabetes
/.What are the 3 major things the autonomic system contributes to the diabetic foot? -
Answer-Regulation in maintaining moisture and blood flow
Controlling hair/nail growth
Facilitation of good skin integrity
/.How can we as PT's educate our patient to assist the autonomic system in preventing
injuries to the foot? - Answer-Application of creams or non-alcoholic based lotion to
prevent cracks and appropriate nail care
/.What can dysfunction of the autonomic system cause? - Answer-Diabetic neuropathic
osteoarthropathy—Charcot foot
/.What are the main characteristics of Charcot foot? - Answer-Decreased sensitivity
interfering muscular foot balance
Joint collapse due to bone weakening
Progressive damage to other tissues—ligaments, cartilage
May not be painful
Other:
- redness
- swelling
, -pain/soreness
- strong pedal pulse
- discoloration of joint
- foot deformity
/.How can a person prevent foot ulcers? - Answer-Appropriate footwear
No barefoot walking
Inspect feet regularly
Trim toenails and calluses regularly
Glucose control/weight control
Physical activity
Decrease smoking and alcohol use
/.What should be the two major components of an objective exam when determining a
LE orthotic? - Answer-MMT: to make sure they have adequate hip strength or the ability
to advance the LE
ROM: to identify restrictions in ROM in all positions
/.Hypermobile feet are associated with__________ - Answer-Pronated feet
/.Hypomobile feet are associated with ________________ - Answer-Supinated feet
/.What is overpronation of the foot associated with? - Answer-Knee genu valgus—
patellafemoral lateral shift—chondromalacia or patellar instability
Achilles tendonitis
/.T or F: you can put posting wedges on with insensate feet? - Answer-FALSE
/.What is the goal of corrective foot orthotics? - Answer-A well balanced foot with some
flexibility
/.What are contraindicated for corrective foot orthotics? - Answer-Insensate feet or feet
with a fixed deformity
/.What is the purpose of accomodative foot orthotics? - Answer-To protect insensate
feet
/.Does Medicare cover accomodative foot orthotics? - Answer-Yes—80% covered for
diabetes; 1 pair of shoes/year OR 3 pairs of inserts/year
/.What is the purpose of the UCBL? - Answer-Protection and stabilize the hind foot
/.What is the purpose of the supramalleolar orthosis (SMO)? - Answer-Hind foot control
past the malleoli
/.What are the purposes of the solid AFO? - Answer-Prevent foot drop
