AIM:
To train hip and knee extension in preparation for mid-stance phase of walking
Rationale:
An important characteristic of the mid-stance phase of walking is the ability to maintain hip, knee and ankle 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:
- Small wooden block
- Chair (for patient support)
- Stool (for therapist)
- Targets eg tape
- Arm sling (if necessary)
Key Points:
- Patient is positioned in standing, feet shoulder-width apart, toes pointing forward, trunk, hips and knees extended
- A chair may be placed on the patient’s intact side, for support (if necessary)
- Patient shifts weight onto the affected leg for a few seconds then shifts weight back onto the intact leg. To progress this practice, the patient steps forwards and backwards with the intact leg
- Therapist is positioned to the side of the patient and provides manual guidance at the hip and/or knee if necessary
- Ensure hip and knee remain extended and lateral horizontal pelvic shift is not excessive
Common Errors:
- Patient hyperextends or flexes the knee
- Patient flexes trunk laterally instead of shifting weight onto the affected leg
Progression and Variety:
- Decrease/remove manual guidance
- Increase length of time spent weightbearing through the affected leg
- Increase speed of movement