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