3.9 Years old child, premature birth (week 33) with delayed motor development.
The DST can be used as a diagnostic tool, to assess rehabilitation progress. In addition to patients' performance, much can be learned from their spontaneous choices, such as leading leg, position of hands, climbing technique, 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 the patient bends the left side of his back. His shoulders shift to the left, probably to compensate on weak muscles around the pelvis and hip.
2
Instruction: go down the stairs.
Performance: patient uses a ‘step to’ technique with his left leg leading while using both handrails.
Observation: right leg works harder, and is externally rotated, probably because of weakness around his hip and knee, or ankle ROM (less likely).
3
Instruction: go down the stairs without using the handrails.
Performance: patient uses the same technique as when he used the handrails.
Observation: patient’s entire body is rotated right, trying to compensate on his muscle weakness (leaning on the knee).
4
Instruction: climb backwards.
Performance: patient uses the handrails with both hands, and a 'step to' technique with his right leg leading.
Observation: right leg works harder, and the entire pelvis is rotated right, probably to compensate on weakness.
5
Instruction: climb backwards on a lower height (to try and 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 step he rotates right almost completely.
6
Instruction: go down the stairs sideways.
Performance: patient uses the left handrail, which puts his left leg in the lead.
Observation: right leg works harder.
Video Guide 4