Activity-walking (assisted) (L23)

AIM:

To train walking by providing assistance

Rationale:

Whole-task training is set up so the patient can practice walking with manual guidance from the therapist.

Equipment:

  • Stool on wheels
  • Arm sling (if necessary)

Key Points:

  • Patient is positioned in standing, feet shoulder-width apart, toes pointing forward, trunk, hips and knees extended
  • Therapist is positioned to the side of the patient (preferably on a stool on wheels) to assist walking
  • During stance phase, the therapist provides manual guidance to assist hip and knee extension
  • During swing phase, the therapist provides manual guidance to assist knee flexion and ankle dorsiflexion
  • The first step is taken with the intact leg Ensure patient does not externally rotate hips A second therapist may be required to assist

Common Errors:

  • Therapist crosses arms when switching manual guidance between stance and swing phase
  • Therapist’s instructions and manual guidance are not synchronized

Progression and Variety:

  • Decrease/remove manual guidance
  • Increase step length
  • Walking in different directions, eg, backwards, sideways