AIM:
To train ankle plantar flexion in preparation for end of stance phase of walking
Rationale:
An important component of the end of stance phase of walking is ankle plantarflexion. Patients must be able to rapidly contract the plantarflexor muscles, while the hip is in extension, for “push-off”. Task-related training is set-up so the patient can practice with manual guidance from the therapist if necessary.
Equipment:
- Stool
- Chair (for patient support)
- Arm sling (if necessary)
Key Points:
- Patient is positioned in standing with the intact leg on a stool, trunk, hips and knees extended
- Patient plantarflexes and dorsiflexes at the ankle
- Therapist is positioned to the side of the patient and provides manual guidance at the arms
- Ensure trunk, knee and hip and are extended throughout exercise
- Ensure movement is in an appropriate range for the activity, ie, 0 – approx 30° ankle plantar-flexion
Common Errors:
- Patient fails to place sufficient weight through the affected leg
- Patient hyperextends the knee
Progression and Variety:
- Decrease/remove manual guidance
- Increase amplitude of movement
- Increase speed of movement
- Increase amount of hip extension of the affected leg