National Physical Therapy Examination (NPTE) Practice Exam

What is the most appropriate orthosis for a patient with foot drop and pronation during weight-bearing?

1. Molded ankle-foot orthosis (AFO)

2. AFO with a split stirrup

3. Custom insole with lateral arch supports

4. Metal AFO with the ankle set in 5° of dorsiflexion

The correct answer is: Molded ankle-foot orthosis (AFO)

The molded ankle-foot orthosis (AFO) is the most appropriate choice for a patient experiencing foot drop and pronation during weight-bearing activities. Foot drop is characterized by an inability to dorsiflex the foot, which can lead to tripping or difficulty with walking. A molded AFO provides significant support and stabilization of the ankle and foot, effectively addressing both the lack of dorsiflexion and the tendency to pronate. The design of a molded AFO can be tailored to the patient's specific anatomical features and functional needs, ensuring optimal alignment and support. This orthosis helps maintain the foot in a neutral or slightly dorsiflexed position, which not only prevents foot drop but also reduces the risk of other complications, such as instability and further deformities during ambulation. In contrast, the other options do not adequately address both components of the patient's condition. An AFO with a split stirrup, while providing some support, may not offer the level of control needed to manage both foot drop and pronation effectively. A custom insole with lateral arch supports primarily targets issues related to alignment and comfort, but lacks the rigid support necessary to control the ankle joint in cases of foot drop. Lastly, a metal AFO with the ankle set