NPTE-PT Gait, Balance, and Orthotics 2 — Questions and Answers
Question 1: A patient with a right transtibial amputation demonstrates lateral trunk bending toward the prosthetic side during stance. What is the MOST likely cause?
- Prosthetic foot set too far lateral
- Prosthetic socket too loose proximally
- Prosthetic shank too long (Correct answer)
- Prosthesis aligned in excessive varus
Correct answer: Prosthetic shank too long
Lateral trunk lean toward the prosthetic side during stance is most commonly caused by a prosthetic shank that is too long, causing the patient to lean over it.
Question 2: During the swing phase of gait, a patient with a below-knee brace (AFO) exhibits toe drag. Which AFO adjustment would BEST correct this?
- Increase plantarflexion stop resistance
- Add a dorsiflexion assist spring (Correct answer)
- Reduce the height of the AFO trim lines
- Widen the AFO footplate
Correct answer: Add a dorsiflexion assist spring
A dorsiflexion assist spring in the AFO helps lift the foot during swing phase, preventing toe drag caused by inadequate dorsiflexion.
Question 3: Which Berg Balance Scale score BEST indicates a high fall risk in a community-dwelling older adult?
- Above 45
- 41–45
- Below 41 (Correct answer)
- Exactly 56
Correct answer: Below 41
A Berg Balance Scale score below 41 is associated with a significantly high fall risk in older adults.
Question 4: A patient with L4 nerve root dysfunction will MOST likely require which orthotic device?
- Knee-ankle-foot orthosis (KAFO)
- Solid ankle AFO
- AFO with dorsiflexion assist (Correct answer)
- Swedish knee cage
Correct answer: AFO with dorsiflexion assist
L4 innervates the tibialis anterior (dorsiflexors); weakness causes foot drop, best managed with a dorsiflexion-assist AFO.
Question 5: During quiet standing, which system provides the PRIMARY sensory input for balance in a well-lit environment on a firm surface?
- Vestibular
- Proprioceptive/somatosensory (Correct answer)
- Visual
- Cerebellar
Correct answer: Proprioceptive/somatosensory
On a firm, stable surface, the proprioceptive/somatosensory system provides the dominant input for balance control.
Question 6: A patient demonstrates a steppage gait pattern. Which muscle group is MOST likely weak?
- Hip extensors
- Ankle plantarflexors
- Ankle dorsiflexors (Correct answer)
- Hip abductors
Correct answer: Ankle dorsiflexors
Steppage gait (exaggerated hip and knee flexion during swing) compensates for weak ankle dorsiflexors causing foot drop.
Question 7: Which outcome measure uses a 6-item test including single-leg stance and tandem walking to assess fall risk?
- Tinetti POMA (Correct answer)
- Dynamic Gait Index (DGI)
- Timed Up and Go (TUG)
- Functional Reach Test
Correct answer: Tinetti POMA
The Tinetti Performance-Oriented Mobility Assessment (POMA) includes balance and gait subscales, and is widely used to assess fall risk in older adults.
