Which gait feature indicates dorsiflexor weakness in hemiparetic gait?

Which gait feature indicates dorsiflexor weakness in hemiparetic gait?

• A. High knee flexion during swing
• B. Toe walking
• C. Foot drop during swing phase
• D. Symmetric gait with fast pace

Answer: (C)

Dorsiflexors lift the front of the foot during the swing phase to clear the toes from the ground. When these muscles are weak in hemiparetic gait, the foot cannot dorsiflex adequately, so the forefoot drops and the toes drag during swing—this is foot drop. That direct loss of dorsiflexion during swing is the clearest sign of dorsiflexor weakness, making it the best choice. Toe walking usually points to plantarflexor overactivity or contracture rather than dorsiflexor weakness. High knee flexion during swing can be a compensatory strategy to clear the foot when there is drop, but it’s not the defining feature of dorsiflexor weakness. Symmetric gait with a fast pace doesn’t reflect dorsiflexor weakness and doesn’t indicate the problem.

Dorsiflexors lift the front of the foot during the swing phase to clear the toes from the ground. When these muscles are weak in hemiparetic gait, the foot cannot dorsiflex adequately, so the forefoot drops and the toes drag during swing—this is foot drop. That direct loss of dorsiflexion during swing is the clearest sign of dorsiflexor weakness, making it the best choice.

Toe walking usually points to plantarflexor overactivity or contracture rather than dorsiflexor weakness. High knee flexion during swing can be a compensatory strategy to clear the foot when there is drop, but it’s not the defining feature of dorsiflexor weakness. Symmetric gait with a fast pace doesn’t reflect dorsiflexor weakness and doesn’t indicate the problem.