OVER 98% PASS RATE FOR THE NCS, OCS, AND PCS EXAMS › forums › NCS Advantage (CURRENT) › Exam 3 question
For the exam 3 question about causes of knee hyperextension in mid stance, could you explain how hamstring weakness could contribute to this gait deviation? Thank you!
Individuals with profound hamstring weakness may have knee hyperextension in mid-stance due to a lack of eccentric control of knee extension (i.e., normally functioning hamstrings could prevent the knee from snapping into hyperextension).
Okay that makes sense! Thank you!
I also have a question regarding exam 3. One question asks what type of AFO would you consider for someone who has the following: decreased foot clearance during swing phase, knee hyperextension during stance phase, 4/5 knee extensor strength, 2/5 ankle DF strength, 3/5 ankle PF strength, ankle DF PROM 0 deg, impaired proprioception and grade 2 ankle PF spasticity.
Due to the spasticity, impaired proprioception and generalized weakness in ankles; I choose rigid AFO.
But the answer is articulating AFO with PF stop
For the criteria to have rigid AFO based on Ranchos ROADMAP – is a rigid only reasonable for this patient if the patient had ABSENT proprioception? and what is the threshold on spasticity that makes you think rigid AFO (i.e. MAS >2) vs artitculated?
Thank you for your help!
Thanks for this question! Yes, because the patient’s plantarflexor spasticity is graded as 2 on the MAS (“affected part easily moved”) and proprioception is impaired (not absent), he falls into the Group D category (articulating AFO with PF stop) on the ROADMAP. Spasticity grades of 3 or greater tend to fall into the severe category because passive movement becomes difficult at that level.
Hope this helps, and happy New Year!
Is there a link to the Ranchos ROADMAP?
Hi Dean! There is a copy of the ROADMAP on the course homepage under Module 12 (Gait and Movement Analysis).