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OVER 98% PASS RATE FOR THE NCS, PCS, OCS, AND GCS EXAMS › forums › NCS Advantage › Rancho R.O.A.D.M.A.P Question

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    • February 16, 2026 at 6:17 pm #490952
      Cally Chang
      Participant

      Would someone be able to explain, or provide videos/resources, why a DF stop would be indicated for ankle plantar flexion (knee extension) in stance? According to the ROADMAP for AFO, if you were to choose an orthosis with articulated ankle joint it was the ‘b’ option.

      Also wanted to know if there was a better/more efficient way to be more familiar with lower extremity orthoses, other than just memorizing the ROADMAP. Thanks!

    • February 19, 2026 at 2:10 pm #490975
      Masato Kobayashi
      Participant

      Hi Cally. I wanted to chime in on this topic so we can problem-solve it together since this is a topic I’m refining as well. I would say clinically, even if a patient demonstrates knee extension in stance there is still a chance for them to buckle anteriorly particularly due to PF weakness – eccentric control from the gastroc-soleus complex is needed in stance. So if a patient demonstrates the criteria of PF weakness (4 or less) and/or excessive DF/PF in stance, this could warrant a DF stop to prevent buckling through stance.

      Wondering if this makes sense to you or others reading? Happy to hear from others!

    • February 19, 2026 at 5:44 pm #490976
      Christina Arrechavala
      Participant

      Knee hyperextension could be occurring to help with stability from knee/PF weakness. If you have quad or PF weakness, you have uncontrolled tibial advancement, so a DF stop can help control excessive tibial advancement, thus making the patient not have to go into hyperextension to regain control.

    • February 19, 2026 at 6:28 pm #490977
      Kasey Calwell
      Participant

      I want to build on this forum with a question from Exam #4, Question #3…

      The question states that the patient has no sensation reported behind the knee or ankle, 3+/5 quad, 5/5 hip flexor. According to RANCHO, that would put this person in a KAFO, not an AFO. Am I misunderstanding the question? (Also especially on discharge from hospital, if it was 50/50 between the two, I would probably lean towards KAFO.

    • February 20, 2026 at 4:22 pm #490983
      Masato Kobayashi
      Participant

      Kasey, I agree with you. At first I thought the patient would be appropriate for a KAFO but if we were to get really granular, KAFOs are recommended for individuals with less than (not less than or equal to) 3+/5. Since the patient has 3+/5 strength in the quads, an AFO would be warranted.

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