NPTE-PTA Functional Training and Gait 1 — Questions and Answers
Question 1: During normal gait, when does the center of mass reach its lowest point?
- At initial contact (heel strike)
- During midstance
- At terminal stance (heel rise)
- During loading response (foot flat) (Correct answer)
Correct answer: During loading response (foot flat)
The center of mass reaches its lowest point during double support (loading response) and its highest point during midstance, producing an inverted pendulum pattern.
Question 2: Which assistive device provides the most stability for a patient who is non-weight-bearing on the right lower extremity?
- Single-point cane
- Forearm (Lofstrand) crutches
- Axillary crutches
- Standard walker (Correct answer)
Correct answer: Standard walker
A standard walker provides the greatest base of support and stability for a non-weight-bearing patient, particularly for those with balance and strength limitations.
Question 3: A patient with a right hip replacement is using a cane. In which hand should the cane be held?
- Right hand (ipsilateral to the affected hip)
- Left hand (contralateral to the affected hip) (Correct answer)
- Either hand — it makes no difference
- No cane is needed after hip replacement
Correct answer: Left hand (contralateral to the affected hip)
The cane is held in the contralateral (left) hand so it advances with the affected right leg, reducing the load on the hip abductors and the involved joint.
Question 4: Which gait pattern is safest for a patient who is touch-down weight-bearing (TDWB) using axillary crutches on a staircase going up?
- Lead with the unaffected leg up, then bring crutches and affected leg (Correct answer)
- Lead with the affected leg up, then bring the unaffected leg
- Go up with both legs simultaneously
- Use a swing-through pattern on stairs
Correct answer: Lead with the unaffected leg up, then bring crutches and affected leg
The mnemonic 'good goes up, bad goes down' applies: the unaffected leg leads going up stairs, and the affected leg leads going down stairs.
Question 5: What is the primary purpose of the push-off phase (terminal stance to pre-swing) in the gait cycle?
- Shock absorption and weight acceptance
- Forward propulsion of the body (Correct answer)
- Lateral weight transfer
- Hip extension and trunk stabilization
Correct answer: Forward propulsion of the body
The push-off phase generates forward propulsion via ankle plantarflexion, providing the energy needed to advance the limb into swing and propel the body forward.
Question 6: Which adaptive equipment modification helps a patient with severe bilateral grip weakness to perform self-feeding?
- Rocker knife
- Built-up handle utensils
- Universal cuff (utensil holder) (Correct answer)
- Long-handled spoon
Correct answer: Universal cuff (utensil holder)
A universal cuff attaches a utensil to the hand without requiring grip, enabling self-feeding for patients with severe grip weakness or paralysis.
NPTE-PTA Functional Training and Gait 1
During normal gait, when does the center of mass reach its lowest point?