AIM:
To train ankle plantar flexion in preparation for mid to end stance phase of walking.
Rationale:
An important component of the mid to end stance phase of walking is ankle plantarflexion and dorsiflexion. Patients must be able to rapidly switch from eccentric to concentric contraction of the plantarflexors muscles. Task-related training is set-up so the patient can practice with manual guidance from the therapist.
Equipment:
- Small wooden block or wedge
- Arm sling (if necessary)
Key Points:
- Patient is positioned in standing on a block or wedge, feet shoulder-width apart, toes pointing forward, trunk, hips and knees extended
- Patient plantarflexes and dorsiflexes at the ankle
- Therapist is positioned in front of the patient and provides manual guidance at the arms
- Ensure there is a rapid switch from eccentric to concentric contraction of the plantarflexor muscles
- Ensure trunk, knee and hip and are extended throughout exercise
- Ensure movement is in an appropriate range for the activity ie 0-20° ankle dorsiflexion
Common Errors:
- Patient fails to place sufficient weight through the affected leg
- Patient hyperextends the knee
Progression and Variety:
- Decrease manual guidance
- Increase speed of movement
- Weightbearing through the affected leg only