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The DST as a diagnostic tool

3.9 Years old child, premature birth (week 33) with delayed motor development.

The DST can be use as a diagnostic tool to assess rehabilitation progress. In addition to patients' performance, much can be learn from their spontaneous choices, such as the leading leg, position of hands, climbing techniques, etc.


1

Instruction: climb without using the handrails.

Performance: patient uses his right leg in a 'step to' technique.

Observation: hands are fixated and tense, and patient is using a left side band in the back (shoulders are shifting to the left), probably to compensate weak muscles around the pelvic and hip.

2

Instruction: go down.

Performance: patient uses a ‘step to’ technique, leading with his left leg and using both handrails.

Observation: right leg works harder, and is externally rotated, probably due to weakness around hip and knee, or ankle ROM (less likely).

3

Instruction: go down without using the handrails.

Performance: patient uses the same technique as before.

Observation: the entire body is rotated right, trying to compensate on muscle weakness (leaning on the knee).

4

Instruction: climb backwards.

Performance: patient uses the handrails with both hands, and a 'step to' with his right leg leading.

Observation: right leg works harder, and the entire pelvic is rotated right, probably to compensate on weakness.

5

Instruction: climb backwards on a lower height (to try to achieve better form).

Performance: patient chooses not to use the handrails at all, but at the last stair he uses one hand.

Observation: patient compensates with rotating right, and at the last stair he rotates almost completely.

6

Instruction: go down sideways.

Performance: patient uses the left handrail, which makes him lead the step with his left leg.

Observation: right leg works harder.