Test Gait, Balance, and Orthotics 1 Flashcards

During the loading response phase of gait (0–12% of the gait cycle), the quadriceps act eccentrically primarily to:

Answer: Control knee flexion and absorb impact forces

During loading response, the knee flexes approximately 15–20° to absorb shock. The quadriceps contract eccentrically to control this flexion and prevent the knee from collapsing. Failure results in a knee-flexion gait deviation or 'buckling knee' pattern.

A patient post-CVA demonstrates circumduction of the lower extremity during the swing phase. This compensatory movement most directly substitutes for inadequate:

Answer: Knee flexion and ankle dorsiflexion during swing

Circumduction is a compensatory arc of the limb to achieve foot clearance when the patient cannot adequately flex the knee or dorsiflex the ankle during swing. Both motions are needed to shorten the functional limb length for clearance.

On the Berg Balance Scale (BBS), a score below which threshold is most strongly associated with high fall risk and likely dependence on an assistive device for safe ambulation?

Answer: 45 out of 56

A BBS score below 45/56 is the widely cited threshold for significantly elevated fall risk. Scores of 0–20 suggest wheelchair dependence, 21–40 suggest ambulatory with assistance, and 41–56 suggest independent, with the 45-point cut-off being the clinically actionable fall-risk marker.

Which muscle is the primary restraint controlling forward tibial progression during midstance, preventing excessive ankle dorsiflexion and maintaining upright posture?

Answer: Soleus

The soleus, with its origin on the tibia and fibula, acts as a posterior restraint on the tibia during midstance. It works eccentrically to control how quickly the tibia advances over the fixed foot. The gastrocnemius assists but is less active at this phase because the knee remains relatively extended.

A patient with a complete T12 spinal cord injury requires orthotic prescription for ambulation. Which orthotic is MOST appropriate to support ambulation in this patient?

Answer: Hip–knee–ankle–foot orthosis (HKAFO)

A complete T12 injury results in loss of all lower-extremity motor function below the lesion, including the hip flexors (L2–L3) and all distal musculature. An HKAFO controls the hip, knee, and ankle, allowing reciprocal gait with forearm crutches. A KAFO alone would not address the absent hip control.

During the Functional Reach Test (FRT), what is being measured that makes it a valid clinical indicator of dynamic balance and fall risk?

Answer: The maximum forward distance a patient can reach while maintaining a fixed base of support standing

The FRT measures the maximum distance (in inches or centimeters) a patient can reach forward with an outstretched arm beyond arm's length while maintaining a standing fixed base of support. A reach of less than 6 inches (15 cm) is associated with a significantly elevated fall risk. It quantifies the limits of the anterior stability boundary.