Dexterity-load leg (standing up) (L7)

An important component of standing up is the ability to load (push weight down through) the affected leg. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary.

Equipment:

• Adjustable height plinth
• Scales
• Block
• Arm sling (if necessary)

Key Points:

• Patient is positioned in sitting with < 100% thigh support, feet shoulder-width apart, knees directly over feet, ie, no hip external rotation and ankles dorsiflexed
• Patient pushes down through the affected heel
• Therapist is positioned to the side or in front of the patient and provides manual guidance at the knee if necessary
• Scales may be used for feedback

Common Errors:

• Patient loads leg by flexing at the hips rather than pushing through the heel

Progression and Variety:

• Decrease/remove manual guidance
• Reduce thigh support
• Increase target weight (to maximum of approx 30% body weight)
• Sustain muscle contraction