AIM:
To train hip extension (in supine) in preparation for mid to end stance phase of walking.
Rationale:
An important component of the stance phase of walking is hip extension. Patients must be able to contract the hip extensors from neutral to approximately 20° of hip extension. Task-related training is set up so the patient can practice with support from a plinth and/or manual guidance from the therapist if necessary.
Equipment:
- Adjustable height plinth
- Block (if necessary)
Key Points:
- Patient is in supine with the trunk positioned diagonally across the bed and the affected leg placed over the side. The affected hip is in neutral or slightly flexed and is not abducted, the knee is flexed and the ankle is plantargrade
- Patient pushes down through the affected heel and contracts the hip extensors
- Therapist provides manual guidance at the hip and/or knee if necessary
- Ensure movement is in an appropriate range for the activity, ie, 0-20° of hip extension
Common Errors:
- Patient uses excessive activity in back extensors (lumbar lordosis increases), quadriceps (knee extends), and/or plantarflexors (ankle plantarflexes)
- Patient pushes down through intact leg
Progression and Variety:
- Decrease/remove manual guidance
- Sustain muscle contraction
- Change starting position to slightly more hip extension
- Increase speed of movement