NPTE-PT Gait, Balance, and Orthotics 3 — Questions and Answers
Question 1: A patient post-CVA walks with the pelvis dropping on the unaffected side during stance on the affected leg. This is MOST consistent with weakness of which muscle?
- Affected hip adductors
- Affected hip abductors (Correct answer)
- Unaffected hip extensors
- Affected knee extensors
Correct answer: Affected hip abductors
Contralateral pelvic drop (Trendelenburg sign) during single-limb stance on the affected side indicates weakness of the ipsilateral hip abductors.
Question 2: Which component of a KAFO is MOST important for a patient with severe quadriceps weakness who needs to lock the knee during stance?
- Posterior offset knee joint
- Drop-lock knee joint (Correct answer)
- Polycentric knee joint
- Free-motion knee joint
Correct answer: Drop-lock knee joint
A drop-lock (ring-lock) knee joint mechanically locks the knee in full extension, providing stability for patients with severe quadriceps weakness.
Question 3: During the Romberg test with eyes closed, a patient sways excessively and nearly falls. This finding MOST suggests dysfunction in which system?
- Visual system only
- Proprioceptive/vestibular system (Correct answer)
- Cerebellar motor coordination
- Cognitive processing
Correct answer: Proprioceptive/vestibular system
The Romberg test isolates vestibular and proprioceptive contributions by removing vision; a positive result implicates somatosensory or vestibular dysfunction.
Question 4: A patient with Parkinson's disease demonstrates festinating gait. Which description BEST characterizes this deviation?
- Wide-based, ataxic stepping pattern
- Shuffling, accelerating steps with forward trunk lean (Correct answer)
- Circumduction of the lower extremity during swing
- Exaggerated knee and hip flexion during swing
Correct answer: Shuffling, accelerating steps with forward trunk lean
Festinating gait in Parkinson's disease is characterized by short, shuffling steps that accelerate involuntarily with a forward-flexed trunk posture.
Question 5: The normal cadence for an adult walking at comfortable speed is approximately:
- 60–70 steps/minute
- 90–120 steps/minute (Correct answer)
- 130–150 steps/minute
- 40–55 steps/minute
Correct answer: 90–120 steps/minute
Normal comfortable walking cadence in adults is approximately 90–120 steps per minute (steps, not strides).
Question 6: Which type of AFO is MOST appropriate for a patient who needs mediolateral ankle stability but requires some sagittal plane motion for functional activities?
- Solid ankle AFO
- Posterior leaf spring AFO
- Articulated AFO with motion stops (Correct answer)
- Supramalleolar orthosis (SMO)
Correct answer: Articulated AFO with motion stops
An articulated AFO with adjustable motion stops allows some controlled sagittal plane movement while providing mediolateral stability.
Question 7: During gait analysis, loading response (initial double support) is characterized by which combination of joint events?
- Hip extension, knee flexion, ankle plantarflexion
- Hip flexion, knee extension, ankle dorsiflexion
- Hip flexion, knee flexion, ankle plantarflexion (Correct answer)
- Hip extension, knee extension, ankle dorsiflexion
Correct answer: Hip flexion, knee flexion, ankle plantarflexion
During loading response, the hip flexes slightly, the knee flexes 15–20° for shock absorption, and the ankle plantarflexes to lower the foot to the floor.
NPTE-PT Gait, Balance, and Orthotics 3
A patient post-CVA walks with the pelvis dropping on the unaffected side during stance on the affected leg.
This is MOST consistent with weakness of which muscle?