72 years old male with left hemiplegia due to CVA
1. The patient was asked to climb the stairs. He uses a ‘step over’ technique, while using both handrails.
2. When climbing down, the patient first uses a ‘step to’ technique, leading with his weak leg. This means his strong leg is doing most of the effort.
3. To further exercise his weak leg, the PT asks him to lead with his strong leg. When he does so, the patient puts more weight on his hands, and has less control over his movement.
4. Because he struggles to control the eccentric contraction required from his weak leg, the patient’s strong leg lands fast and hard. In addition, his limited range of motion due to swelling in his ankle makes it harder for him to control the descent.