AIM:
To train hip abduction (in sidling) in preparation for mid to end 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, to control this component. Task-related training is set up so the patient can practice with support from a plinth and/or manual guidance from the therapist if necessary.
Equipment:
- Adjustable height plinth (against wall)
- Pillow
Key Points:
- Patient is positioned in sidelying with affected side uppermost, knee in extension and ankle plantargrade. The intact (lower) hip and knee may be flexed for comfort
- Patient slides the heel up the wall until leg is horizontal to the plinth
- Therapist is positioned at the foot of the plinth and provides manual guidance if necessary
- Ensure patient’s heel remains in contact with the wall
- Ensure movement is in an appropriate range for the activity, ie, abduction to neutral with hip in extension
Common Errors:
- Patient flexes the hip
- Patient externally rotates hip
Progression and Variety:
- Decrease/remove manual guidance
- Sustain muscle contraction
- Increase amplitude of movement
- Increase speed of movement