NPTE-PT Gait, Balance, and Orthotics 4 — Questions and Answers
Question 1: A patient with a T6 complete spinal cord injury uses a KAFO with forearm crutches. Which gait pattern is MOST energy-efficient for this patient over short distances?
- Swing-to gait
- Swing-through gait (Correct answer)
- Four-point gait
- Reciprocal gait
Correct answer: Swing-through gait
Swing-through gait is the fastest and most energy-efficient pattern for patients with thoracic SCI using bilateral KAFOs and crutches, despite its high-energy demands.
Question 2: Which balance assessment tool specifically examines anticipatory postural adjustments and reactive balance strategies under six sensory conditions?
- Berg Balance Scale
- Sensory Organization Test (Computerized Dynamic Posturography) (Correct answer)
- Functional Reach Test
- Clinical Test of Sensory Integration in Balance (CTSIB)
Correct answer: Sensory Organization Test (Computerized Dynamic Posturography)
The Sensory Organization Test (SOT), part of computerized dynamic posturography, systematically assesses balance under six conditions that isolate and manipulate visual, vestibular, and somatosensory inputs.
Question 3: A patient with a painful right knee uses a cane. On which side should the cane be held and why?
- Right side to offload the knee directly
- Left side to reduce hip abductor demand on the right (Correct answer)
- Either side — it makes no functional difference
- Right side to improve proprioceptive feedback
Correct answer: Left side to reduce hip abductor demand on the right
The cane is held on the contralateral (left) side so that it contacts the ground simultaneously with the affected leg, reducing the load through the right knee joint.
Question 4: Which gait deviation is MOST commonly associated with excessive foot pronation in the stance phase?
- Lateral trunk lean
- Medial collapse of the knee (dynamic valgus) (Correct answer)
- Hip hiking
- Scissor gait
Correct answer: Medial collapse of the knee (dynamic valgus)
Excessive foot pronation during stance causes internal tibial rotation, which is transmitted proximally, resulting in dynamic knee valgus.
Question 5: A reciprocal gait orthosis (RGO) is MOST appropriate for which patient population?
- Transfemoral amputees requiring prosthetic alignment
- Patients with bilateral lower extremity spasticity post-stroke
- Patients with thoracic-level paraplegia for household ambulation (Correct answer)
- Patients with hemiplegia and severe foot drop
Correct answer: Patients with thoracic-level paraplegia for household ambulation
The RGO enables reciprocal walking in patients with thoracic paraplegia by linking the hip joints with cables so hip extension on one side drives flexion on the other.
Question 6: The Timed Up and Go (TUG) test uses what threshold score to identify community-dwelling older adults at increased fall risk?
- Greater than 10 seconds
- Greater than 12 seconds (Correct answer)
- Greater than 20 seconds
- Greater than 30 seconds
Correct answer: Greater than 12 seconds
A TUG score greater than 12 seconds is commonly used to identify older community-dwelling adults at increased fall risk.
Question 7: During terminal stance, the center of mass moves anterior to the base of support. Which muscle group is MOST critical for controlling forward progression at this point?
- Hip extensors
- Quadriceps
- Ankle plantarflexors (Correct answer)
- Hip flexors
Correct answer: Ankle plantarflexors
The ankle plantarflexors (gastrocnemius and soleus) undergo lengthening contraction during terminal stance to control forward progression and generate propulsive force.
NPTE-PT Gait, Balance, and Orthotics 4
A patient with a T6 complete spinal cord injury uses a KAFO with forearm crutches.
Which gait pattern is MOST energy-efficient for this patient over short distances?