A patient has right hemiparesis after traumatic brain injury. While standing, the patient cannot extend the hip when the knee is flexed, or flex the hip when the knee is extended. In which functional activity will this deficit be MOST evident?

A patient has right hemiparesis after traumatic brain injury. While standing, the patient cannot extend the hip when the knee is flexed, or flex the hip when the knee is extended. In which functional activity will this deficit be MOST evident?

• A. Shifting weight while standing
• B. Walking sideways
• C. Walking backward
• D. Moving from sitting to standing

Answer: (C)

This pattern tests how hip muscles function across different knee positions, because different muscles contribute to hip motions depending on whether the knee is flexed or extended. When the knee is flexed, extending the hip relies mainly on the gluteus maximus; when the knee is extended, flexing the hip relies more on the iliopsoas. If a patient cannot extend the hip with the knee flexed, that suggests weakness of the gluteus maximus on the involved side; if they cannot flex the hip with the knee extended, that points to weakness of the iliopsoas. Clinically, walking backward most clearly stresses both of these hip actions across changing knee positions. It demands hip flexion with the knee extended during swing and hip extension with the knee flexed during stance, making the deficit most evident in this task. The other activities—shifting weight in place, walking sideways, or standing to sitting—do not challenge this specific pattern of hip motion as directly.

This pattern tests how hip muscles function across different knee positions, because different muscles contribute to hip motions depending on whether the knee is flexed or extended. When the knee is flexed, extending the hip relies mainly on the gluteus maximus; when the knee is extended, flexing the hip relies more on the iliopsoas. If a patient cannot extend the hip with the knee flexed, that suggests weakness of the gluteus maximus on the involved side; if they cannot flex the hip with the knee extended, that points to weakness of the iliopsoas.

Clinically, walking backward most clearly stresses both of these hip actions across changing knee positions. It demands hip flexion with the knee extended during swing and hip extension with the knee flexed during stance, making the deficit most evident in this task. The other activities—shifting weight in place, walking sideways, or standing to sitting—do not challenge this specific pattern of hip motion as directly.