The presence of adverse impact means that a test is always biased.

Neal (he/him) is 52 years old and works as a mail carrier for UPS. He is coming to PT because he has noticed increased unsteadiness while walking or climbing stairs with packages in his arms. He also says his whole left leg gets more tired and “falls asleep” sometimes during a long work day, but denies any specific injuries or pain. His PMH includes Stage 1 hypertension but otherwise he is healthy and fit. He is scheduled to a see a neurologist next week. What would be the best place to start the sensory evaluation?

Micah (he/him) had a brain tumor excised 4 months ago, and now has significant spasticity in his right quadriceps. As a result, he walks with a stiff-leg gait and has difficulty descending stairs. His neurologist is monitoring his medication levels to help manage spasticity. Which intervention would reflect current best PT practice for addressing spasticity?

Movement Analysis:   Posture: Betsaida is sitting in a bedside chair with armrests when you enter her room.  She has mildly kyphotic posture with forward head and shoulders, and posterior pelvic tilt.  Her weight is shifted towards her right side and she is leaning on her right elbow on the armrest of the chair.  Her left arm is flexed at the elbow and wrist, and resting on her stomach. Movement: Betsaida has been using a LBQC for walking. After putting a gait belt on Betsaida, you ask her to stand up and walk a few steps with you.  She immediately scoots forward in the chair a few inches, then rocks back and forth several times as she attempts to stand.  You notice that she is putting the majority of her weight through her right arm and leg, and is shifted away from her left side.  She ultimately requires Mod A from you to stand up.  Once she is standing, she grasps the LBQC with her right hand and walks 50 feet with you on the tile floor.  You notice that she has foot flat contact on the left at initial contact, excess knee and hip flexion on the left as she moves through stance phase, decreased trailing limb posture on the left, a short quick step on the right, then L toe drag through swing phase until she comes back to foot flat contact.  The entire time she is walking, she exhibits excess forward flexion at the trunk, with her left shoulder and pelvis retracted and her LUE more flexed and abducted than it was when she was sitting. She does not attempt to use her LUE at all during this task. When she turns to walk back to her room, she staggers a little and moves more slowly.  She requires Min A from you while she is walking and turning.  She walks back to the bed, turns with Min A, and sits down with good control but with the weight through her right arm and leg again. Considering the phases of the Hedman model of task analysis, describe two specific movement problems that Betsaida is facing, and name the phase in which each problem is occurring. (2 points)

Stress with work can affect family interactions; stress with family can affect work interactions.

Nomie (they/them) is 14 y/o and recently sustained a severe traumatic brain injury in a motor vehicle accident.  They are able to ambulate 150 feet with verbal cues only from the PT or their mom, before fatiguing and needing to rest.  What FIM score would Nomie receive for locomotion?

You are treating a patient with a head injury on a Saturday who was evaluated on Friday afternoon by another therapist. You note in the evaluation that the patient has MAS 3 in her left ankle plantarflexors. ROM is within normal limits. What would you expect to see in your patient’s walking as a result of this? Choose all that apply. 

Assume that the body structure/functions you assessed in the previous question showed impairment in those areas.  Given what you know to this point, choose a type of ankle-foot orthosis that you think might benefit Betsaida and provide rationale/justification. 

You are treating Juan (he/him) in outpatient PT about 3 months after he experienced a left hemisphere stroke impacting his right arm motor control. You do the quick Fugl-Meyer screen and find that he is able to flex his right shoulder forward with his elbow straight. When you ask him to abduct his shoulder out to the side, his elbow flexes and his forearm supinates. You ask him to repeat the shoulder abduction movement two more times with cues to keep his arm straight, but you continue to note elbow flexion and forearm supination. What do these screening results tell you? 

Which patient would be most appropriate for a ground reaction AFO?