AIM:
To train hip and knee flexion in preparation for swing phase of walking
Rationale:
An important component of the swing phase of walking is hip and knee flexion. Task- related training is set up so the patient can practice with manual guidance from the therapist if necessary.
Equipment:
- Small wooden block
- Object to constrain movement, eg, plastic container
- Target, eg, tape
- Arm sling (if necessary)
Key Points:
- Patient is positioned in standing in front of a block, feet shoulder-width apart, toes pointing forward, trunk, hips and knees extended
- Ensure feet are positioned close to the block
- Patient flexes hip and knee to place affected foot on the block
- Therapist is positioned in front of the patient and provides manual guidance at the arms
- An object may be used to constrain movement and provide feedback about leg circumduction
- A chair is placed on the patient’s intact side, for support if needed
- Ensure movement is in an appropriate range for the activity, ie, 0-25° hip flexion
Common Errors:
- Patient inclines trunk backwards
- Patient hitches hip
- Patient circumducts leg
Progression and Variety:
- Decrease/remove manual guidance
- Remove targets and/or objects constraining movement
- Increase speed of movement
- Increase amount of initial hip extension of the affected leg, ie, start in step stance