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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.


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.


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).


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).


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.


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.


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.