Documenting Duck Walk on Physical Exam
To properly document a duck walk on physical examination, describe the patient performing a deep squat and waddling forward while maintaining the squatting position, noting any pain, instability, or limitations in movement.
Proper Documentation Technique
Document the duck walk as part of a structured physical examination, particularly when evaluating for meniscal tears, lower extremity strength, or joint stability 1
Include specific instructions given to the patient: "Patient was asked to perform a deep squat and 'waddle' forward while maintaining the squatting position" 1
Record the duration or distance of the duck walk (e.g., "Patient performed duck walk for approximately 3 meters" or "Patient completed duck walk for 20 seconds") 2
Key Elements to Document
Patient's ability to complete the maneuver:
- Full completion
- Partial completion with limitations
- Unable to perform 1
Presence of specific symptoms during the maneuver:
- Joint line pain (medial or lateral)
- Painful "clicking" or mechanical symptoms
- General discomfort 1
Observed biomechanical abnormalities:
- Asymmetry in weight distribution between legs
- Compensatory movements
- Inability to maintain proper squat depth 3
Clinical Context and Interpretation
When evaluating for meniscal tears, document whether the test is positive (presence of joint line pain or painful clicking) or negative (absence of symptoms) 1
Note that the duck walk test has a sensitivity of approximately 71% and specificity of 39% for meniscal tears, making it more useful as part of a comprehensive knee examination rather than as a standalone diagnostic test 1
Document any modifications needed for the patient to complete the test (e.g., "Patient required hand support to maintain balance during duck walk") 2, 3
Common Pitfalls to Avoid
Avoid using vague terminology like "waddling gait" without specific descriptions, as this term lacks precision and clinical utility 4
Do not confuse the duck walk test with a Trendelenburg gait assessment, which specifically evaluates for pelvic drop on the side of the swinging leg 4
Remember that the duck walk is a provocative test designed to elicit symptoms, not an assessment of a pathological gait pattern 1
Document specific limitations if the patient cannot complete the test, rather than simply noting "unable to perform duck walk" 3
By following these documentation guidelines, you will provide clear and clinically useful information about the patient's performance on the duck walk test, which can aid in diagnosis and treatment planning for lower extremity conditions.