Upper extremities strengthening and coordination – jumping from step to step

Updated: Jun 1, 2020

7 years old patient with right hemiplegia holds both handrails and jump up the stairs. This exercises the patient’s upper extremities, activates his core muscles, and uses his plegic side.

1. The patient needs assistance to position his right plegic hand. He hesitates and tries to avoid putting weight on his right side. Eventually he manages to perform a jump, but puts most of his weight is on his left side. Body mass stays low and his back is bent.

2. The PT holds down patient's right hand, and instructs him to jump with both legs. The right leg lands first, which might indicate he did most of the jump with his left leg. When he lands on his right foot, his plantar flexion muscle tone prevents his heel from touching the ground.

3. Because the patient’s hands are now on the upper handrail, it is harder for him to shift his body weight forward above his hands. This makes the jump much harder and puts more effort on his legs. After he hesitates, the patient manages to jump, using the same leg technique as before.

4. Patient prepares to jump down the stairs, and The PT helps position his right hand on the handrails. While jumping, he puts most of his weight on his left side, and lands loudly mostly on his left leg. Due to the asymmetric weight shift, the patient’s body rotates.

5. PT needs to remind the patient to move his right hand forward. Again, he uses mostly his left side.

6. The PT corrects patient's body position and instructs him to put both of his hands at the same distance from his body. This should force him to use his right side more, but just before he jumps, the patient re-positions his left hand. He moves it forward to compensate the right hand’s weakness, and again lands mainly on his left leg, and his body leans.

7. The PT re-positions patient’s right hand again, and hold it in place.

8. Patient tries to jump without using his hands. Most of the jumps and landings are performed by his left leg.

A Special thanks to the "Ha'gan Ha'shikumi" and their amazing staff, for sharing their knowledge, thoughts and experience.

Video Guide 10

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