Dexterity-hip/knee E (all stance) (L18)

AIM:

To train hip and knee extension in preparation for the whole of stance phase of walking.

Rationale:

An important characteristic of the stance phase of walking is the ability to extend the hip, knee and ankle 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:

  • Small wooden block
  • Targets eg tape
  • Chair (for patient support)
  • Arm sling (if necessary)
  • Stool (for therapist)

Key Points:

  • Patient is positioned in standing, affected foot placed on a block with toes pointing forward, trunk, hips and knees extended
  • A chair may be placed on the patient’s intact side, for support (if necessary)
  • Patient steps with the intact leg up onto the block and back down; to progress patient steps over the block and back again
  • Therapist is positioned to the side of the patient and provides manual guidance at the knee if necessary
  • Ensure hip and knee extend fully and lateral horizontal pelvic shift is not excessive

Common Errors:

  • Patient hyperextends the knee
  • Patient excessively flexes hip and knee

Progression and Variety:

  • Decrease/remove manual guidance
  • Increase length of time spent weightbearing through the affected leg, e.g., increase block height
  • Increase speed of movement
  • Position the block to the affected side and practise stepping up and down sideways