AIM:
To train hip abduction (in standing) in preparation for mid to end stance phase of walking.
Rationale:
An important component of the stance phase of walking is lateral horizontal pelvic shift. Patients must be able to contract the hip abductors especially when the hip is in extension, while weightbearing through the leg. Task-related training is set up so the patient can practice with manual guidance from the therapist, if necessary.
Equipment:
- Chair
- Arm sling (if necessary)
- Stool
Key Points:
- Patient is positioned in standing against the wall, with feet shoulder-width apart, toes pointing forward, trunk, hips and knees extended
- Patient shifts weight onto the intact leg and abducts affected leg approximately 20°. To progress this practice, patient shifts weight onto the affected leg and abducts intact leg
- Therapist is positioned to the side of the patient and provides manual guidance at the hip and knee if necessary
- A chair may be placed on the patient’s intact side, for support (if necessary)
- Ensure patient’s heel remains in contact with the wall during hip abduction
Common Errors:
- Patient flexes the hip
- Patient externally rotates hip
- Patient sides flexes contralateral to the abducting leg
Progression and Variety:
- Decrease/remove manual guidance
- Sustain muscle contraction
- Increase amplitude of movement
- Increase speed of movement