Hi Lauren,
Thanks for this question! The pathway to lead to the correct answer is:
1. Patient has decreased ankle strength OR impaired/absent proprioception at the knee/ankle OR ankle PF spasticity –> YES
2. Spasticity, PF contracture, or absent proprioception affects foot placement during standing or gait –> NO
3. Determine if DF stop is indicated –> YES (PF strength <=4, excessive DF in stance), DF stop indicated
4. Determine if DF assist is required --> YES (DF strength <=4)
The patient's spasticity is mild (MAS grade of 1) and there is no indication that it is affecting foot placement in stance or gait. Standing posture is marked by excess ankle DF. Decreased foot clearance could be due to spasticity, but it is more likely explained by weakness given the mild nature of his spasticity - especially given his knee flexes during stance phase of gait.
Hope this helps!
Chrissy
