Exercises to regain walking mobility

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   Our user asked: "After a stroke, on the weak leg, we can get the knee to initiate taking a step and the heel to raise but cannot get the toe off the ground to swing the leg through and complete taking the step. What exercises would help?" 

Ask a PT Response: "Patients that have decrease strength at the dorsiflexors after sustaining a stroke will have difficulty, in most cases, with achieving strength gains for this muscle group. Often times an AFO is utilized to assist with ambulating and achieving a more efficient gait pattern. Meanwhile ROM exercises and strengthening exercises such as isometrics can be initiated. Modalities such as e-stim or a WalkAide could also be utilized."

Our user responded: "Thank you for responding. I should have mentioned that she has an AFO already and wears it when we do the walking. Can you give me examples of isometrics to do? I am not sure what that is, nor have I heard of the walkaide. I have heard about e-stim and will ask her doctor about that when we go at the end of the month. We do several bed exercises but I am just looking for what type of exercises specifically to those muscles should we be doing. One that we just added was have her lay down, slide her ankles towards her buttocks, and with knees up, roll hips from side to side. We are also trying to make progress on the sit to stand exercise to strengthen her thighs. Any advice would be much appreciated!!"

Ask a PT Response: "Examples of isometrics can be found at: http://www.cyberpt.com/cptvid01ias.asp You can modify it as well be using leg of table or providing a surface to push onto by using your hand. WalkAide is a device which assists with ambulating and gives stimulation to facilitate ankle dorsiflexion at initial contact in gait: http://www.walkaide.com/ . Other exercises can also include ankle stabilization/strengthening exercises on a 1/2 foam roller or balance board (BAPS board). Also can work on pulling full foam roller or a ball back towards chair while in sitting or scooting with a chair with wheels if balance is good. Sit to stand exercises will require good upper extremity strength, core strength and hip + knee strength. Break the task up into parts and strengthen within the parts and then put it all together for performing the specific task. I hope this helps."

Edited by Ask a PT - May 05 2009 at 2:34pm

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Ask a PT Members Profile Send Private Message Find Members Posts Add to Buddy List Senior Member Joined: Jul 07 2008 Status: Offline Points: 954	Post Options Post Reply Quote Ask a PT Report Post Thanks(0) Quote Reply Topic: Exercises to regain walking mobility Posted: May 05 2009 at 11:39am
	Our user asked: "After a stroke, on the weak leg, we can get the knee to initiate taking a step and the heel to raise but cannot get the toe off the ground to swing the leg through and complete taking the step. What exercises would help?" Ask a PT Response: "Patients that have decrease strength at the dorsiflexors after sustaining a stroke will have difficulty, in most cases, with achieving strength gains for this muscle group. Often times an AFO is utilized to assist with ambulating and achieving a more efficient gait pattern. Meanwhile ROM exercises and strengthening exercises such as isometrics can be initiated. Modalities such as e-stim or a WalkAide could also be utilized." Our user responded: "Thank you for responding. I should have mentioned that she has an AFO already and wears it when we do the walking. Can you give me examples of isometrics to do? I am not sure what that is, nor have I heard of the walkaide. I have heard about e-stim and will ask her doctor about that when we go at the end of the month. We do several bed exercises but I am just looking for what type of exercises specifically to those muscles should we be doing. One that we just added was have her lay down, slide her ankles towards her buttocks, and with knees up, roll hips from side to side. We are also trying to make progress on the sit to stand exercise to strengthen her thighs. Any advice would be much appreciated!!" Ask a PT Response: "Examples of isometrics can be found at: http://www.cyberpt.com/cptvid01ias.asp You can modify it as well be using leg of table or providing a surface to push onto by using your hand. WalkAide is a device which assists with ambulating and gives stimulation to facilitate ankle dorsiflexion at initial contact in gait: http://www.walkaide.com/ . Other exercises can also include ankle stabilization/strengthening exercises on a 1/2 foam roller or balance board (BAPS board). Also can work on pulling full foam roller or a ball back towards chair while in sitting or scooting with a chair with wheels if balance is good. Sit to stand exercises will require good upper extremity strength, core strength and hip + knee strength. Break the task up into parts and strengthen within the parts and then put it all together for performing the specific task. I hope this helps." Edited by Ask a PT - May 05 2009 at 2:34pm

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