Equipment, Devices and Therapeutic Modalities

Why it matters on this exam

Rule-based and quickly learned — the best points-per-hour on the exam, and commonly missed because candidates leave them to the last week.

Key concepts

• Assistive devices: stability hierarchy from parallel bars to a cane; cane height at the greater trochanter with 20–30 degrees of elbow flexion; cane in the hand opposite the affected limb; the gait patterns each weight-bearing status allows.
• Orthotics and prosthetics: AFO types and what each controls, prosthetic gait deviations and their causes (too-long prosthesis, insufficient socket flexion, weak abductors), suspension systems.
• Wheelchair measurement: seat width, depth, height and back height taken from the patient, with the consequences of getting each wrong.
• Electrotherapy: NMES versus TENS parameters and purposes, iontophoresis polarity, contraindications including pacemakers, over the carotid sinus, and pregnancy.
• Thermal and mechanical: superficial versus deep heating (ultrasound depth by frequency), cryotherapy stages, traction parameters, compression contraindications.

Common mistakes

• Placing the cane on the affected side.
• Applying ultrasound at 3 MHz for deep tissue when 1 MHz penetrates deeper.

Worked example

A patient with left hemiparesis and moderate balance impairment needs the most stable device they can manage with one functional hand: a hemi-walker or quad cane in the right hand, not a standard walker that requires two hands.