Orthotics CPM Exam Study Guide 2024 with

Orthotics CPM Exam Study Guide 2024 with Complete Solutions AFO casting - Correct Answer 1. Don gloves and gather materials

• Take measurements either on form or calf circumference, ankle circumference, fib head height, foot

length

• apply 2 layers of stockinette
• mark landmarks: fib head/neck, tibial crest, malleoli, calcaneal tuberosity if prominent, base of 5th

met head, navicular, cuboid, met heads 1 and 5, to sulcus, any other prominent/painful areas

• apply cut tube anteriorly and insert into cut slits of stockinette
• wrap with fiberglass, ensure fib head is captured
• Use foot board to align foot as neutrally as possible
• As fiberglass sets draw vertical cut line and horizontal match lines
• Use cast saw to cut the cast off. Warn patient of vibration and loud noise. Use 2 hands and thumb as a

guide

• cut top layer of stockinette and remove cast
• clean patients leg and remove 2nd layer stockinette. don shocks and shoes
• Clean area and answer questions about patient considerations

KAFO: Knee joint too distal - Correct Answer 1. pressure at anterior distal and posterior proximal thigh

• thigh band shifts proximal
• cant rotate as much as anatomical knee

KAFO: knee joint too proximal - Correct Answer 1. pressure at posterior distal and anterior proximal of thigh

• thigh band shifts distal
• bends too much

KAFO: knee joint too posterior - Correct Answer 1. pressure at anterior proximal and posterior distal thigh

• orthosis shifts proximally 1 / 4

KAFO: knee joint too anterior - Correct Answer 1. pressure at anterior distal and proximal posterior thigh

• orthosis shifts distally

KAFO: proper knee joint location - Correct Answer 1. bisection of adductor tubercle and medial tibial plateau

• 60:40 anterior: posterior

KAFO Trimlines: - Correct Answer 1. medial proximal 30 mm distal to perinneum

• proximal lateral distal to greater trochanter
• proximal posterior thigh set at 15 deg slant connecting lateral to medial
• popliteal region allows 105 deg knee flexion

KAFO knee joint clearances - Correct Answer 6mm medial 3 mm lateral KAFO ankle clearances - Correct Answer 6 mm medial and 5 mm lateral KAFO analysis - Correct Answer 1. Correct side and foot plate

• proper strapping materials
• plastic thickness
• rivets-- speedy rivets not durable for attaching metal uprights
• plastazote /p-cell packs down quickly
• check measurements
• Check proper ankle and knee joints
• If KAFO doesn't meet patient's needs do not deliver

KAFO : varus moment control - Correct Answer AFO section: 3 pt pressure 1) prox medial (medial chafe at tibial strap) 2) proximal lateral malleoli (lateral flange) 3) 1st met head (encompass) 2 / 4

KAFO hyperextension control after delivery - Correct Answer 1) add padding to calf section 2) increase dorsiassist power (stiffer joints, adjust double action) 3) increase plantarflexion resistance (pf stop, adjust double action) 4) add heel wedge to AFO KAFO joints that prevent hyperextension (without limiting ADLs) - Correct Answer 1. posterior offset KAFO correct genuvarum/genuvalgum after delivery - Correct Answer 1. add pull strap proximal and distal to the knee joint so line of pull corrects deformity

• add padding proximal and distal to KC (if valgus add padding medially, and if varus add padding

laterally) to increase corrective force KAFO: pain at at posterior distal thigh indicates what? - Correct Answer knee joint is too proximal KAFO: pain at anterior distal thigh and posterior proximal thigh indicates what? - Correct Answer knee joint is too distal KAFO: what may be the issue if knee joints will not fully lock? - Correct Answer 1. drop locks may be upside down

• mechanical KC not aligned with anatomical KC
• The joints are not squared properly
• excursion length are uneven

Scenario: pt with metal and leather KAFO with drop locks and double action ankle joints feels unsteady and trips easily going down ramps. what adjustments? - Correct Answer 1. allow more plantarflexion at the ankle

• provide dorsiassist with a spring in the posterior channel (will resist pf and smooth the foot flat

transition)

• add cushioned heel to shoe

AFO 3 point force system for dorsiflexion weakness (resist PF in swing): - Correct Answer 1. anteriorly directed force at posterior calf 3 / 4

• posterior and distal force at dorsum of ankle (shoe, instep strap)
• superiorly directed force at met heads (foot plate)

AFO 3 point force system for plantarflexion weakness (resist DF in stance): - Correct Answer 1. posterior directed force at tibia

• anterior and proximal force at heel
• distal directed force at met heads

AFO Full length footplate considerations - Correct Answer 1. claw toes, hammer toes, toe grasping

• mid foot fracture
• tone/spasticity

AFO hyperextension adjustments - Correct Answer 1. heel wedge

• taller proximal trimline
• sent 3-4 deg dorsiflexion
• footplate too rigid-- shorten to sulcus or metheads

AFO 3 point force system for valgus correction/ reduce pronation - Correct Answer 1. medially directed force at lateral proximal calf band (lateral chafe for tibial strap)

• lateral directed force at medial supramalleolus (medial flange)
• medially directed force at 5th methead (encapsulate)

AFO 3 point force for varus correction/ reduce supination - Correct Answer 1. lateral directed force at medial proximal calf band (medial chafe for tibial strap)

• medial directed force at lateral supramalleolus (lateral flange)
• laterally directed force at 1st methead (encompass)

AFO patient: valgus presentation - Correct Answer 1. forefoot abduction

• calcaneal valgus
• 1st methead pain and callus
• / 4