Dexterity-knee F/E in standing (L14)

AIM:

To train knee flexion/extension 0-10° (in standing) in preparation for mid stance phase of walking.

Rationale:

An important component of the stance phase of walking is controlled knee flexion and extension, especially in the 0-10° range, 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
  • Stool
  • Arm sling (if necessary)

Key Points:

  • Patient is positioned in standing, feet shoulder-width apart, toes pointing forward, trunk, hips and knees extended
  • Patient flexes and extends the affected knee
  • Therapist is positioned to the side of the patient and provides manual guidance at the knee if necessary
  • A chair may be placed on the patient’s intact side, for support (if necessary)
  • Therapist may provide cues for range of movement using the hands
  • Ensure there is at least 50% of the patient’s bodyweight on the affected side
  • Ensure movement is in an appropriate range for the activity, ie, 0-10° knee extension

Common Errors:

  • Patient fails to place sufficient weight through the affected leg
  • Patient hyperextends the knee
  • Patient flexes the knee excessively

Progression and Variety:

  • Decrease/remove manual guidance
  • Increase hip extension of the affected leg by practicing in step stance
  • Decrease amplitude of movement
  • Increase speed of movement