AIM:
To train knee flexion/extension 0-10° (in sitting) in preparation for mid stance phase of walking
Rationale:
An important component of the stance phase of walking is knee flexion and extension, especially in the 0-10 degree range, while weightbearing through the leg. Task-related training is set-up so the patient practises in sitting with manual guidance from the therapist.
Equipment:
- Chair against wall or solid structure (to prevent slipping)
- Stool
Key Points:
- Patient is positioned in sitting with hips slightly extended (to reduce stretch on hamstrings)
- Ensure patient’s back is supported and the chair is placed against an immovable object, eg, wall, plinth
- Therapists sits on a stool beside the patient and provides a force through the patients heel, flexing the hip and knee
- Patient uses knee extensors eccentrically and concentrically to move the knee into flexion and extension
- Therapist provides cues for range of movement using the hands
- Ensure movement is in an appropriate range for the activity, ie, 0-10° knee extension
Common Errors:
- Therapist applies force in an inappropriate direction, eg, dorsiflexes the foot
- Therapist fails to apply force throughout the whole movement, ie, flexion and extension
- Patient hyperextends the knee
- Patient flexes the knee excessively
Progression and Variety:
- Remove cues
- Increase speed of movement
- Decrease amplitude of movement