A four-point (reciprocal) gait pattern is used when the person with SCI has which of the following?

A four-point (reciprocal) gait pattern is used when the person with SCI has which of the following?

• A. Complete absence of all lower extremity motor function
• B. Intact hip flexors allowing reciprocal limb advancement, or when using RGOs
• C. Only intact ankle dorsiflexors bilaterally
• D. Intact quadriceps but absent hip flexors and hamstrings

Answer: (B)

Four-point gait is a reciprocal pattern where each limb moves in turn with its own assistive device, providing the highest stability among the reciprocal gaits. Achieving that sequence relies on having a controlled hip flexion to advance the leg forward, or a mechanism that substitutes for it. If hip flexors are intact, you can actively flex the hip to swing the leg forward while the opposite device advances in a coordinated, opposite sequence. If a reciprocating gait orthosis is used, its linkage automatically produces reciprocal hip movement, enabling four-point gait even when hip flexors aren’t strong enough on their own. That’s why this pattern is used when hip flexors allow reciprocal limb advancement, or when RGOs are in place to enable that reciprocal timing. Without either condition—no hip flexion control and no mechanical aid—the four-point pattern isn’t feasible.

Four-point gait is a reciprocal pattern where each limb moves in turn with its own assistive device, providing the highest stability among the reciprocal gaits. Achieving that sequence relies on having a controlled hip flexion to advance the leg forward, or a mechanism that substitutes for it. If hip flexors are intact, you can actively flex the hip to swing the leg forward while the opposite device advances in a coordinated, opposite sequence. If a reciprocating gait orthosis is used, its linkage automatically produces reciprocal hip movement, enabling four-point gait even when hip flexors aren’t strong enough on their own. That’s why this pattern is used when hip flexors allow reciprocal limb advancement, or when RGOs are in place to enable that reciprocal timing. Without either condition—no hip flexion control and no mechanical aid—the four-point pattern isn’t feasible.