During evaluation, a patient has normal passive ROM but cannot complete active dorsiflexion and inversion, and shows no tolerance for external resistance. Which gait pattern would you most likely observe?

During evaluation, a patient has normal passive ROM but cannot complete active dorsiflexion and inversion, and shows no tolerance for external resistance. Which gait pattern would you most likely observe?

• A. Normal gait with no deviations
• B. Throwing the trunk backward on the right side shortly after heel strike (initial contact)
• C. Increased right hip flexion during the midswing phase
• D. Lateral bending toward the right side during midstance

Answer: (C)

Weakness of ankle dorsiflexors (and invertors) means the foot cannot be safely lifted during the swing phase, leading to foot drop. With normal passive range, the limitation is in active strength, and the patient won’t tolerate resistance because the muscles aren’t strong enough to perform the movement. To get the leg through swing without tripping, the body compensates by increasing hip flexion during midswing to lift the thigh higher and provide clearance. That means you’d expect to see a more pronounced right hip flexion as the leg advances in the midswing portion of the gait. Other patterns don’t align with the underlying issue: a normal gait would not show a compensatory hip motion; trunk rotation or backward trunk movement at initial contact points to other control issues; lateral bending in midstance suggests hip abductor weakness rather than distal ankle weakness.

Weakness of ankle dorsiflexors (and invertors) means the foot cannot be safely lifted during the swing phase, leading to foot drop. With normal passive range, the limitation is in active strength, and the patient won’t tolerate resistance because the muscles aren’t strong enough to perform the movement.

To get the leg through swing without tripping, the body compensates by increasing hip flexion during midswing to lift the thigh higher and provide clearance. That means you’d expect to see a more pronounced right hip flexion as the leg advances in the midswing portion of the gait.

Other patterns don’t align with the underlying issue: a normal gait would not show a compensatory hip motion; trunk rotation or backward trunk movement at initial contact points to other control issues; lateral bending in midstance suggests hip abductor weakness rather than distal ankle weakness.