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1) This question was written when the falls risk cut-off for the BBS was 45/56. It has been updated to have one correct answer.

2) You’re correct that both decreased foot clearance and increased force at initial contact can result from impaired sensation. This patient has an acute/sub-acute CVA as he has just been admitted to inpatient rehab. At this point, it is more likely that we will see decreased foot clearance during swing phase due to the inability to feel where his feet are in space and to increase sensory input through the floor. As the patient progresses and can consistently clear his feet and achieve heel strike at initial contact, we might see foot slap during loading response.

3) Figure 1 in the Fritz and Lusardi paper shows how walking speed is linked to discharge location. Walking speeds <0.1 m/s indicate increased likelihood of being discharged to a SNF while walking speeds >0.1 m/s indicate a discharge to home is more likely.

4) This patient was referred for back pain but presents with concerning signs of neurologic dysfunction. Given that a source of these signs has not been identified, the therapist’s best recommendation is for the patient to receive immediate medical attention. Because the patient’s symptoms have been gradually worsening, spinal neoplasm is more likely than Guillain-Barre syndrome. This patient has a number of red flags warranting immediate medical attention (age >50, symptoms radiating below the knee, atypical pain that is not affected by position changes, incontinence).

Here is the abstract from an article about red flags in acute low back pain (https://www.consultant360.com/peer-reviewed/acute-low-back-pain-recognizing-red-flags-workup#:~:text=%E2%80%9CRed%20flags%E2%80%9D%20include%20pain%20that,of%20a%20severe%20or%20rapidly):
A focused history and physical examination directed towards uncovering signs that suggest a serious underlying cause of low back pain are crucial. “Red flags” include pain that lasts more than 6 weeks; pain in persons younger than 18 years or older than 50 years; pain that radiates below the knee; a history of major trauma; constitutional symptoms; atypical pain (eg, that which occurs at night or that is unrelenting); the presence of a severe or rapidly progressive neurologic deficit; urinary and/or fecal incontinence; poor rectal tone; and a history of malignancy. These markers provide a cost-effective means of guiding your selection of laboratory and diagnostic imaging studies.