Correcting Center of Mass position using hand position

Updated: Apr 29

73 years old left hemi-plegic post stroke patient exercising climbing up and down the DST.

PT Adjusts stairs' height to allow the patient to practice ‘step to’ technique with the use of both handrails.


1. The PT assists the patient to position his left hand on the handrail. The patient grips the handle without assistance, but needs to be instructed, encouraged, and reminded to move it.


2. The patient first tries to climb with his weak leg. He hesitates because his hands, and thereby his Center of Mass, are located too far behind. After the PT Instructs him to raise his left hand higher on the handrail, the patient is able to continue.


3. Patients' hands are leading the movement, helping him to adjust his body before stepping down.


4. Going down the stairs is more demanding and intimidating for the patient, and you can see the impact on his left knee.


5. The patient’s Center of Mass is too far behind his base of support, which impact his standing balance. The PT Instructs him to move the hands forward in order to shift his weight.


6. Now the patient knows how to correct himself without the PT guidance. Notice his hand movement. (arrow towards his left hand).


7. The patient passes safely to his walker by moving his hands from the handrails to the device without assistance.


Video Guide 3