AIM:
To train hip and knee extension in preparation for the whole of stance phase of walking.
Rationale:
An important characteristic of the stance phase of walking is the ability to extend the hip, knee and ankle 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
- Targets eg tape
- Chair (for patient support)
- Arm sling (if necessary)
- Stool (for therapist)
Key Points:
- Patient is positioned in standing, affected foot placed on a block with toes pointing forward, trunk, hips and knees extended
- A chair may be placed on the patient’s intact side, for support (if necessary)
- Patient steps with the intact leg up onto the block and back down; to progress patient steps over the block and back again
- Therapist is positioned to the side of the patient and provides manual guidance at the knee if necessary
- Ensure hip and knee extend fully and lateral horizontal pelvic shift is not excessive
Common Errors:
- Patient hyperextends the knee
- Patient excessively flexes hip and knee
Progression and Variety:
- Decrease/remove manual guidance
- Increase length of time spent weightbearing through the affected leg, e.g., increase block height
- Increase speed of movement
- Position the block to the affected side and practise stepping up and down sideways