ORTHOTICS/PROSTHETICS/GAIT
EXAM 2025 QUESTIONS AND ANSWERS
20. Which of the following orthoses or shoe modifications is used in the conservative
management of plantar fasciitis? (a) Heel lift (b) Posterior night splint (c) Lateral heel wedge (d)
Metatarsal bar - ANS 20 (b) A heel lift plantarflexes the foot and is used for Achilles
tendinitis. A metatarsal bar is used for metatarsalgia. A lateral heel wedge can be used for the
conservative management of osteoarthritis of the knee. A posterior night splint dorsiflexed to
5/ is the correct answer.
30. During normal human locomotion, the center of gravity travels through a sinusoidal
pathway that is modified by 6 determinants of gait. Which of the following is not considered 1
of the 6 determinants? (a) Pelvic extension (b) Foot and ankle synchronization (c) Knee flexion
(d) Lateral pelvic displacement - ANS 30 (a) The 6 determinants are as follows: lateral
displacement that reduces horizontal excursion from 6" down to 1.7"; knee flexion that reduces
vertical excursion 7/16"; pelvic rotation that reduces vertical excursion 3/8"; pelvic tilt that
reduces vertical excursion 3/16"; and foot and ankle synchronization as well as ankle and knee
synchronization that both serve to smooth out the sinusoidal curve but do not decrease
excursion.
39. The most common complication after amputation in the immature child is (a) phantom limb
pain. (b) diffuse edema. (c) terminal overgrowth. (d) painful neuroma. - ANS 39 (c) Terminal
overgrowth at the transected end of a long bone is the most common complication after
amputation in the skeletally immature child. It occurs most frequently in the humerus, fibula,
tibia, and femur, in that order. The oppositional growth may be so vigorous that the bone
pierces the skin. The treatment of choice is surgical revision.
40. A 79-year-old cachectic woman with coronary artery disease and unstable angina sustains a
right hip fracture after a fall. After an open-reduction internal fixation of the hip joint with the
use of a dynamic hip screw, the orthopedic surgeon determines that the patient is 25% partial
1 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
,weight bearing to the right side. She has weak upper body strength and good balance. Which of
the following assistive devices is most appropriate? (a) Standard walker (b) Rolling walker (c)
Axillary crutches (d) Quad cane - ANS 40 (b) Standard walkers require good standing balance
and good upper body strength. Crutches require good upper body strength and have an
increased energy expenditure of 40%-60%, which would be contraindicated in unstable angina.
Quad canes are not appropriate when significant weight-bearing relief is required. Rolling
walkers are most appropriate for patients who lack upper body strength and provide safer gait
than crutches or canes.
59. In considering selection of a lower limb prosthesis for a child with a congenital transfemoral
amputation, a knee joint should be included (a) at initial fitting. (b) between 3 to 5 years of age.
(c) when sports activities are anticipated. (d) when the child pulls to stand. - ANS 59 (b) The
lower limb deficient child should be fitted with a prosthesis when he or she is ready to pull up
to a standing position, usually between 9 and 12 months. A knee joint is added between 3 and 5
years.
70. What level of amputation has the highest acceptance rate for an upper extremity
prosthesis? (a) Wrist disarticulation (b) Transradial (c) Elbow disarticulation (d) Transhumeral -
ANS 70 (b) Overall rejection of prosthetic usage occurs in 33%-38% of unilateral upper
extremity amputees. The highest acceptance rate is transradial at about 93%, and the lowest is
wrist disarticulation at about 6%.
80. When considering realistic functional goals for the majority of transhumeral amputees, the
maximal weight (in pounds) that can be carried with the body-powered prosthesis is (a) 7. (b)
15. (c) 30. (D) 50. - ANS 80 (b) Handling of heavy objects is limited in upper extremity
amputees. A transhumeral amputee is expected to lift 10lb to 15lb, unless the residual limb is
very short or sensitive. A transradial amputee is expected to lift 20lb to 30lb unless the residual
limb is very short or sensitive.
82. In the orthotic and prosthetic clinic, a patient with Parkinson's disease presents for gait
analysis. The primary gait disturbance found is an alternation in stride length and altered
cadence. A gaittraining program for a person with Parkinson's disease should include (a) visual
cueing techniques. (b) bilateral ankle-foot orthoses. (c) patterning techniques. (d) vestibular
stimulation exercises. - ANS 82 (a) Treatment options for gait disturbance in patients with
Parkinson's disease include visual and auditory cueing, in addition to traditional endurance and
strengthening exercises.
2 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
, 100. When comparing quadrilateral sockets with ischial containment sockets, a successful
fitting ismore likely in a quadrilateral socket when (a) the adductor musculature is intact. (b) the
residual limb is fleshy. (c) trunk stability demands are high at mid stance. (d) the residual limb is
shorter. - ANS 100 (a) Chances of a successful fitting of a quadrilateral socket are best when
the residual limb is longer with a firm residuum and intact adductor musculature. Ischial
containment sockets are more successful than quadrilateral sockets for persons with shorter,
fleshy, unstable residual limbs.
104. In a patient with bilateral hip flexion contractures, which of the following gait deviations
would bemost likely? (a) Bilateral Trendelenburg gait (b) Early heel rise during stance (c) Swing-
phase circumduction (d) Increased knee flexion in stance - ANS 104 (d) In normal gait, hip
extension to neutral occurs during stance phase. When mild hip flexion contractures are
present, a compensatory increase in lumbar lordosis occurs to maintain upright trunk posture.
As the extent of the hip flexion contractures worsens, there is usually an additional
compensatory increase in knee flexion during stance phase.
110. Which of the following knee types provides good stability in early stance phase and ease of
flexionwhile weight bearing during the pre-swing phase (terminal stance) of the gait cycle? (a)
Single axis (b) Stance phase control (c) Polycentric (d) Manual locking - ANS 110 (c) Many
polycentric knees are designed so that the center of rotation moves anteriorly very rapidly
during the first few degrees of knee flexion, quickly passing in front of the floor reaction line
and facilitating the swing phase. Because the polycentric knee can be flexed under weight
bearing during the terminal stance, when properly dynamically aligned it can offer both
excellent stance stability and ease of swing-phase flexion. Furthermore, all polycentric knees
shorten mechanically to a slight degree during flexion, adding additional toe clearance during
midswing.
120. An amputee presents for evaluation of distal blistering and evidence of vascular
congestion. Youdiagnose choke syndrome. Which of the following would NOT be an acceptable
treatment for choke syndrome? (a) Expanding the proximal socket (b) Increasing the auxiliary
suspension to decrease vertical pull (c) Relieving the distal socket where it interfaces with the
choked surface (d) Padding the distal socket where it corresponds to the choked surface -
ANS 120 (c) The choke syndrome (proximal soft tissue constriction leading to vascular
congestion) may occur with suction sockets or self-suspending systems. Relieving the proximal
socket to allow vascular return, providing auxiliary suspension to decrease the vertical pull on
the residual limb, and improving the intimacy of the socket-limb interface correct this problem.
3 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
EXAM 2025 QUESTIONS AND ANSWERS
20. Which of the following orthoses or shoe modifications is used in the conservative
management of plantar fasciitis? (a) Heel lift (b) Posterior night splint (c) Lateral heel wedge (d)
Metatarsal bar - ANS 20 (b) A heel lift plantarflexes the foot and is used for Achilles
tendinitis. A metatarsal bar is used for metatarsalgia. A lateral heel wedge can be used for the
conservative management of osteoarthritis of the knee. A posterior night splint dorsiflexed to
5/ is the correct answer.
30. During normal human locomotion, the center of gravity travels through a sinusoidal
pathway that is modified by 6 determinants of gait. Which of the following is not considered 1
of the 6 determinants? (a) Pelvic extension (b) Foot and ankle synchronization (c) Knee flexion
(d) Lateral pelvic displacement - ANS 30 (a) The 6 determinants are as follows: lateral
displacement that reduces horizontal excursion from 6" down to 1.7"; knee flexion that reduces
vertical excursion 7/16"; pelvic rotation that reduces vertical excursion 3/8"; pelvic tilt that
reduces vertical excursion 3/16"; and foot and ankle synchronization as well as ankle and knee
synchronization that both serve to smooth out the sinusoidal curve but do not decrease
excursion.
39. The most common complication after amputation in the immature child is (a) phantom limb
pain. (b) diffuse edema. (c) terminal overgrowth. (d) painful neuroma. - ANS 39 (c) Terminal
overgrowth at the transected end of a long bone is the most common complication after
amputation in the skeletally immature child. It occurs most frequently in the humerus, fibula,
tibia, and femur, in that order. The oppositional growth may be so vigorous that the bone
pierces the skin. The treatment of choice is surgical revision.
40. A 79-year-old cachectic woman with coronary artery disease and unstable angina sustains a
right hip fracture after a fall. After an open-reduction internal fixation of the hip joint with the
use of a dynamic hip screw, the orthopedic surgeon determines that the patient is 25% partial
1 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
,weight bearing to the right side. She has weak upper body strength and good balance. Which of
the following assistive devices is most appropriate? (a) Standard walker (b) Rolling walker (c)
Axillary crutches (d) Quad cane - ANS 40 (b) Standard walkers require good standing balance
and good upper body strength. Crutches require good upper body strength and have an
increased energy expenditure of 40%-60%, which would be contraindicated in unstable angina.
Quad canes are not appropriate when significant weight-bearing relief is required. Rolling
walkers are most appropriate for patients who lack upper body strength and provide safer gait
than crutches or canes.
59. In considering selection of a lower limb prosthesis for a child with a congenital transfemoral
amputation, a knee joint should be included (a) at initial fitting. (b) between 3 to 5 years of age.
(c) when sports activities are anticipated. (d) when the child pulls to stand. - ANS 59 (b) The
lower limb deficient child should be fitted with a prosthesis when he or she is ready to pull up
to a standing position, usually between 9 and 12 months. A knee joint is added between 3 and 5
years.
70. What level of amputation has the highest acceptance rate for an upper extremity
prosthesis? (a) Wrist disarticulation (b) Transradial (c) Elbow disarticulation (d) Transhumeral -
ANS 70 (b) Overall rejection of prosthetic usage occurs in 33%-38% of unilateral upper
extremity amputees. The highest acceptance rate is transradial at about 93%, and the lowest is
wrist disarticulation at about 6%.
80. When considering realistic functional goals for the majority of transhumeral amputees, the
maximal weight (in pounds) that can be carried with the body-powered prosthesis is (a) 7. (b)
15. (c) 30. (D) 50. - ANS 80 (b) Handling of heavy objects is limited in upper extremity
amputees. A transhumeral amputee is expected to lift 10lb to 15lb, unless the residual limb is
very short or sensitive. A transradial amputee is expected to lift 20lb to 30lb unless the residual
limb is very short or sensitive.
82. In the orthotic and prosthetic clinic, a patient with Parkinson's disease presents for gait
analysis. The primary gait disturbance found is an alternation in stride length and altered
cadence. A gaittraining program for a person with Parkinson's disease should include (a) visual
cueing techniques. (b) bilateral ankle-foot orthoses. (c) patterning techniques. (d) vestibular
stimulation exercises. - ANS 82 (a) Treatment options for gait disturbance in patients with
Parkinson's disease include visual and auditory cueing, in addition to traditional endurance and
strengthening exercises.
2 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
, 100. When comparing quadrilateral sockets with ischial containment sockets, a successful
fitting ismore likely in a quadrilateral socket when (a) the adductor musculature is intact. (b) the
residual limb is fleshy. (c) trunk stability demands are high at mid stance. (d) the residual limb is
shorter. - ANS 100 (a) Chances of a successful fitting of a quadrilateral socket are best when
the residual limb is longer with a firm residuum and intact adductor musculature. Ischial
containment sockets are more successful than quadrilateral sockets for persons with shorter,
fleshy, unstable residual limbs.
104. In a patient with bilateral hip flexion contractures, which of the following gait deviations
would bemost likely? (a) Bilateral Trendelenburg gait (b) Early heel rise during stance (c) Swing-
phase circumduction (d) Increased knee flexion in stance - ANS 104 (d) In normal gait, hip
extension to neutral occurs during stance phase. When mild hip flexion contractures are
present, a compensatory increase in lumbar lordosis occurs to maintain upright trunk posture.
As the extent of the hip flexion contractures worsens, there is usually an additional
compensatory increase in knee flexion during stance phase.
110. Which of the following knee types provides good stability in early stance phase and ease of
flexionwhile weight bearing during the pre-swing phase (terminal stance) of the gait cycle? (a)
Single axis (b) Stance phase control (c) Polycentric (d) Manual locking - ANS 110 (c) Many
polycentric knees are designed so that the center of rotation moves anteriorly very rapidly
during the first few degrees of knee flexion, quickly passing in front of the floor reaction line
and facilitating the swing phase. Because the polycentric knee can be flexed under weight
bearing during the terminal stance, when properly dynamically aligned it can offer both
excellent stance stability and ease of swing-phase flexion. Furthermore, all polycentric knees
shorten mechanically to a slight degree during flexion, adding additional toe clearance during
midswing.
120. An amputee presents for evaluation of distal blistering and evidence of vascular
congestion. Youdiagnose choke syndrome. Which of the following would NOT be an acceptable
treatment for choke syndrome? (a) Expanding the proximal socket (b) Increasing the auxiliary
suspension to decrease vertical pull (c) Relieving the distal socket where it interfaces with the
choked surface (d) Padding the distal socket where it corresponds to the choked surface -
ANS 120 (c) The choke syndrome (proximal soft tissue constriction leading to vascular
congestion) may occur with suction sockets or self-suspending systems. Relieving the proximal
socket to allow vascular return, providing auxiliary suspension to decrease the vertical pull on
the residual limb, and improving the intimacy of the socket-limb interface correct this problem.
3 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
