30 years old patient with severe congenital deformation of the RT leg
Patient was asked to go up and down the slope sideways while holding the handrails. This exercise encourages the patient to put more weight on his right leg, as it needs to support his entire body while he lifts the other leg forward.
1. The patient uses small steps in order to lean more on his left leg and reduce the load from his right leg. He lands hard on his left leg, as he tries to move the weight back to it as soon as he can.
2. The PT instructs the patient to land softer on his left leg. To do so he must reduce the effort from his right leg, by raising his right heel. This small action moves his weight forward over his hands. It provides him more control over the movement and improves his landing.
3. When the patient climbs the slope, he feels comfortable to try and use only one hand. This may seem like a positive progress, but in fact he is now hopping on his left leg side-wise, to avoid putting weight on his right leg. Because this technique puts a massive load on his left leg, it is actually better for him to assist the handrails.
4. The PT instructs the patient to assist the handrails and land softer on his left leg. Again, he does so by raising his right heel, which moves his weight forward over his hands. This provides him more control over his movement.
Video Guide 25