AIM:
To train loading the leg in preparation for standing up.
Rationale
An important component of standing up is the ability to load (push weight down through) the affected leg. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary.
Equipment:
- Adjustable height plinth
- Scales
- Block
- Arm sling (if necessary)
Key Points:
- Patient is positioned in sitting with < 100% thigh support, feet shoulder-width apart, knees directly over feet, ie, no hip external rotation and ankles dorsiflexed
- Patient pushes down through the affected heel
- Therapist is positioned to the side or in front of the patient and provides manual guidance at the knee if necessary
- Scales may be used for feedback
Common Errors:
- Patient loads leg by flexing at the hips rather than pushing through the heel
Progression and Variety:
- Decrease/remove manual guidance
- Reduce thigh support
- Increase target weight (to maximum of approx 30% body weight)
- Sustain muscle contraction