Exam #2 Question

[Valerie Wacker]

Hi! I am wondering why the answer to this question wouldn’t be ‘D’ rather than ‘A’. If the patient has 3+/5 (at worst) ankle strength, that would indicate she has full AROM, and therefore she couldn’t have a plantarflexion contracture. What am I missing on this question?

32. A patient with multiple sclerosis presents to clinic for her evaluation.  Upon walking into the clinic, the therapist notes abnormal gait pattern with bilateral foot drop during swing phase (right > left), decreased step length on the left, and right knee hyperextension during mid-stance.  Manual muscle testing reveals left lower extremity strength is grossly 4/5.  Right lower extremity scores were grossly 3+ to 4-/5.  What should the therapist examine next to determine the cause of the patient’s right knee hyperextension during gait?
* a. Ankle dorsiflexion range of motion to rule out plantarflexion contracture
* b. Knee extension range of motion to check for hypermobility
* c. Single-leg balance to determine pelvic stability
* d. Five times sit to stand to determine functional strength

[Chrissy Durrough Lugge]

Good catch, Valerie! I clarified the question to indicate strength scores are within the available range of motion.

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