POD4OFL ASSESSMENT EXAM QUESTIONS & DETAILED
ANSWERS GRADED A+ WELL ACED
w1
1)AFOs - CORRECT ANSWER >>>An Ankle Foot Orthosis (AFO) is a device commonly used in the
management of foot drop.
What is foot drop? - CORRECT ANSWER >>>Foot drop is a gait abnormality in which the foot
'drops' at the ankle due to weakness of the anterior portion of the lower leg (ankle dorsiflexors).
Foot drop is usually a symptom of a greater problem and it can be temporary or permanent.
depending on the extent of muscle weakness or paralysis and it can occur in one or both feet.
Foot drop can be caused by nerve damage alone (sciatic or common fibular nerve) or by muscle
or spinal cord trauma, abnormal anatomy, toxins or disease. Diseases that can cause foot drop
include direct trauma to the posterolateral neck of fibula, CVA, post-polio syndrome, MS,
Charcot Marie Tooth disease, etc.
To accommodate the foot drop, people with the condition may: - CORRECT ANSWER
>>>.Drag their toes along the ground
.Flex their hips and knees to aid in ground clearance (known as 'steppage gait').
.Tiptoe walk on the opposite leg
.Use a wide outward leg swing (known as circumduction) to assist in ground clearance.
How does an AFO assist in the management of foot drop? - CORRECT ANSWER >>>AFOs are a
device worn on the lower part of the leg to assist in controlling foot/ankle alignment and
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,motion and alignment of the ankle and the foot and. In brief, an AFO assists in maintaining the
ankle and foot at 90 degrees (instead of 'dropping' into a plantarflexed position). This can assist
with achieving heel strike during walking (instead of initiating contact with toes) and minimise
the need to use a 'steppage gait' to achieve toe-clearance during the swing phase of gait.
Video/ most commonly AFO seen in clinics - CORRECT ANSWER >>>prefabricated polypropylene
AFO it's made out of plastic
custom-made AFOs - CORRECT ANSWER >>>made from a plastic cast or a 3D scan you see both
of them have had joints included at the ankle ( made out of polypropylene plastic or carbon
fibre).
make by prosthetists orthotists (P&O), it starts with the molding either plaster or 3d-scan,
design, prefabrication and fitting
Common clinical applications of AFOs - CORRECT ANSWER >>>carbon fiber which is used more
these days due to strength and light weight, uses for people with stroke, cerebral palsy that
often need some sort of management at the foot knee ankle but essentially any neurological or
muscular impairment at the foot in the ankle)
AFOs effects on ankle and foot functions - CORRECT ANSWER >>>how the tibia moves over the
foot during stance.
sometime it can be about knee hyperextension or hip function and we're trying to manipulate
the biomechanics from the ground up.
correction with AFOs (video lecture) - CORRECT ANSWER >>>.making initial contact with heel
.during stances knee hyperextension angle is improved
.during swing ankles much closer to 90 degrees
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,. standing more upright
.walking faster .longer
step length
.
Things to look for: - CORRECT ANSWER >>>.Redness, blister, rubbing and callus (refer back to
the provider)
.shouldn't be any obvious gapping, cutting and gapping
.can be rocker-sole or with shoe-raisers
.velcro straps wear out, plastic can occasionally crack (refer back to the provider)
2) Ankle braces - CORRECT ANSWER >>>One of the most common musculoskeletal injuries are
ankle sprains, which most frequently occur when the foot is forced into excessive plantar flexion
and inversion.
Individuals who experience an ankle sprain are much more likely to reinjure the same ankle in
the future which can result in chronic ankle pain and instability.
What can we do? - CORRECT ANSWER >>>Taping, bracing and neuromuscular training
(restoring ankle proprioception) have all been shown to be equally effective for the prevention
of ankle sprains (Bay et al., 2010).
Although taping of the ankle is the most commonly used intervention, prophylactic bracing is
arguably the cheaper option in the longer term. Ankle braces and ankle taping is designed to
reduce excessive ankle plantar flexion and inversion.
Potential issues with bracing: - CORRECT ANSWER >>>.Braces involve upfront costs, although
braces have been shown to be cheaper than taping over a sports season.
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, .Negative effects on athletic performance. It found that bracing reduced sprint speed and
vertical leap by 1%, while agility speed was reduced by 0.5%. The clinician and athlete need to
weight up whether these performance costs outweigh injury risk?
Perceived issues with bracing: - CORRECT ANSWER >>>.Possible weakening of the ankle
musculature, and Reduced proprioception, although this has not been demonstrated in
research.
Which brace is best? And is taping better than bracing (or vice versa)? - CORRECT ANSWER
>>>No ankle brace or ankle taping technique has been shown to be superior for the prevention
of ankle injuries. However, some braces are better at restricting movement in different planes
(inversion v plantarflexion).
As such, you should select a brace in the context of your patient. Consider their ankle injury,
brace comfort, shoe fit and the effect of the brace on their functional performance (agility,
jumping, kicking a ball, etc.).
3.A Controlled Ankle Movement (CAM) walkers - CORRECT ANSWER >>>A CAM Walker is an
adjustable orthopaedic device designed to immobilise the ankle and foot. It is often referred to
as a 'CAM boot' or 'moon-boot' due to its appearance.
CAM walkers are commonly used in the management of orthopaedic conditions which require
immobilisation, including serious sprains, soft-tissue injuries (acute or chronic) and fractures
(acute and stress) of the foot, ankle and leg. They are also often used following surgery or after
a cast is removed.
Are all CAM walkers the same? - CORRECT ANSWER >>>CAM walkers come in several styles to
suit a range of needs.
The height of the walker can vary, depending on how much of the leg needs to be supported.
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ANSWERS GRADED A+ WELL ACED
w1
1)AFOs - CORRECT ANSWER >>>An Ankle Foot Orthosis (AFO) is a device commonly used in the
management of foot drop.
What is foot drop? - CORRECT ANSWER >>>Foot drop is a gait abnormality in which the foot
'drops' at the ankle due to weakness of the anterior portion of the lower leg (ankle dorsiflexors).
Foot drop is usually a symptom of a greater problem and it can be temporary or permanent.
depending on the extent of muscle weakness or paralysis and it can occur in one or both feet.
Foot drop can be caused by nerve damage alone (sciatic or common fibular nerve) or by muscle
or spinal cord trauma, abnormal anatomy, toxins or disease. Diseases that can cause foot drop
include direct trauma to the posterolateral neck of fibula, CVA, post-polio syndrome, MS,
Charcot Marie Tooth disease, etc.
To accommodate the foot drop, people with the condition may: - CORRECT ANSWER
>>>.Drag their toes along the ground
.Flex their hips and knees to aid in ground clearance (known as 'steppage gait').
.Tiptoe walk on the opposite leg
.Use a wide outward leg swing (known as circumduction) to assist in ground clearance.
How does an AFO assist in the management of foot drop? - CORRECT ANSWER >>>AFOs are a
device worn on the lower part of the leg to assist in controlling foot/ankle alignment and
1|Page
,motion and alignment of the ankle and the foot and. In brief, an AFO assists in maintaining the
ankle and foot at 90 degrees (instead of 'dropping' into a plantarflexed position). This can assist
with achieving heel strike during walking (instead of initiating contact with toes) and minimise
the need to use a 'steppage gait' to achieve toe-clearance during the swing phase of gait.
Video/ most commonly AFO seen in clinics - CORRECT ANSWER >>>prefabricated polypropylene
AFO it's made out of plastic
custom-made AFOs - CORRECT ANSWER >>>made from a plastic cast or a 3D scan you see both
of them have had joints included at the ankle ( made out of polypropylene plastic or carbon
fibre).
make by prosthetists orthotists (P&O), it starts with the molding either plaster or 3d-scan,
design, prefabrication and fitting
Common clinical applications of AFOs - CORRECT ANSWER >>>carbon fiber which is used more
these days due to strength and light weight, uses for people with stroke, cerebral palsy that
often need some sort of management at the foot knee ankle but essentially any neurological or
muscular impairment at the foot in the ankle)
AFOs effects on ankle and foot functions - CORRECT ANSWER >>>how the tibia moves over the
foot during stance.
sometime it can be about knee hyperextension or hip function and we're trying to manipulate
the biomechanics from the ground up.
correction with AFOs (video lecture) - CORRECT ANSWER >>>.making initial contact with heel
.during stances knee hyperextension angle is improved
.during swing ankles much closer to 90 degrees
2|Page
,. standing more upright
.walking faster .longer
step length
.
Things to look for: - CORRECT ANSWER >>>.Redness, blister, rubbing and callus (refer back to
the provider)
.shouldn't be any obvious gapping, cutting and gapping
.can be rocker-sole or with shoe-raisers
.velcro straps wear out, plastic can occasionally crack (refer back to the provider)
2) Ankle braces - CORRECT ANSWER >>>One of the most common musculoskeletal injuries are
ankle sprains, which most frequently occur when the foot is forced into excessive plantar flexion
and inversion.
Individuals who experience an ankle sprain are much more likely to reinjure the same ankle in
the future which can result in chronic ankle pain and instability.
What can we do? - CORRECT ANSWER >>>Taping, bracing and neuromuscular training
(restoring ankle proprioception) have all been shown to be equally effective for the prevention
of ankle sprains (Bay et al., 2010).
Although taping of the ankle is the most commonly used intervention, prophylactic bracing is
arguably the cheaper option in the longer term. Ankle braces and ankle taping is designed to
reduce excessive ankle plantar flexion and inversion.
Potential issues with bracing: - CORRECT ANSWER >>>.Braces involve upfront costs, although
braces have been shown to be cheaper than taping over a sports season.
3|Page
, .Negative effects on athletic performance. It found that bracing reduced sprint speed and
vertical leap by 1%, while agility speed was reduced by 0.5%. The clinician and athlete need to
weight up whether these performance costs outweigh injury risk?
Perceived issues with bracing: - CORRECT ANSWER >>>.Possible weakening of the ankle
musculature, and Reduced proprioception, although this has not been demonstrated in
research.
Which brace is best? And is taping better than bracing (or vice versa)? - CORRECT ANSWER
>>>No ankle brace or ankle taping technique has been shown to be superior for the prevention
of ankle injuries. However, some braces are better at restricting movement in different planes
(inversion v plantarflexion).
As such, you should select a brace in the context of your patient. Consider their ankle injury,
brace comfort, shoe fit and the effect of the brace on their functional performance (agility,
jumping, kicking a ball, etc.).
3.A Controlled Ankle Movement (CAM) walkers - CORRECT ANSWER >>>A CAM Walker is an
adjustable orthopaedic device designed to immobilise the ankle and foot. It is often referred to
as a 'CAM boot' or 'moon-boot' due to its appearance.
CAM walkers are commonly used in the management of orthopaedic conditions which require
immobilisation, including serious sprains, soft-tissue injuries (acute or chronic) and fractures
(acute and stress) of the foot, ankle and leg. They are also often used following surgery or after
a cast is removed.
Are all CAM walkers the same? - CORRECT ANSWER >>>CAM walkers come in several styles to
suit a range of needs.
The height of the walker can vary, depending on how much of the leg needs to be supported.
4|Page
