AIM:
To train moving the foot back in preparation for standing up
Rationale:
An important component of standing up is the ability to move the affected foot into dorsiflexion. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary.
Equipment:
- Adjustable height plinth
- Skateboard
- Block
- Targets, eg, tape
- Arm sling (if necessary)
Key Points:
- Patient is positioned in sitting with < 100% thigh support, feet shoulder-width apart, and knees directly over feet, ie, no hip external rotation
- Patient flexes the knee and slides the affected foot into dorsiflexion
- Therapist is positioned to the side of the patient and provides manual guidance at the knee and/or foot if necessary
- Ensure movement is in an appropriate range for the activity, ie, towards the end of dorsiflexion range
Common Errors:
- Patient does not maintain neutral hip rotation
- Patient lifts heel off support surface
Progression and Variety:
- Reduce thigh support
- Increase frictional characteristics of the support surface
- Increase amplitude of movement
- Increase speed of movement