PT Stroke Rehab Continuing Education Course — Transcript

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1. 0:05so the other one of the other gate
2. 0:07admirals we talk about is if someone is
3. 0:10hyper extending their knee and remember
4. 0:12we talked about it could be weak quads
5. 0:13it could be weak glutes it could be a
6. 0:15timing issue
7. 0:16so another a nice way to cue that if if
8. 0:19they don't need if they can support
9. 0:20their leg they just need a little help
10. 0:22to stop doing that go ahead and step
11. 0:23forward with your left leg so this
12. 0:26becomes important with the therapist in
13. 0:27that come back wait wait shift keep your
14. 0:30foot there bend your knee so you've just
15. 0:31gone to foot flat
16. 0:33so my goal is to remember the posterior
17. 0:35pelvic tilt is what's bringing them
18. 0:37forward over their leg right and that
19. 0:40posterior pelvic tooth the pelvic tilt
20. 0:43with the glute max activating is going
21. 0:45to get the knee extending okay so but
22. 0:47it's it's a timing issue for the
23. 0:49therapist as well i have to get him
24. 0:51facilitated and his pelvis moving before
25. 0:55the knee moves back if the knee is
26. 0:56moving back the quads are on we want the
27. 1:00femur moving forward okay so my force
28. 1:02this time is going to be
29. 1:04it's going to be a
30. 1:05rotation but i'm trying to get him
31. 1:06forward too so a nice cue would be stick
32. 1:09your belly button forward good yep stick
33. 1:12your belly button forward nice stick
34. 1:14your belly button forward and that helps
35. 1:16get that hip extension and controlling
36. 1:19that knee that knee excess of knee
37. 1:21extension
38. 1:22now
39. 1:23if you have somebody who requires a lot
40. 1:26more assistance they can't they can't
41. 1:28bear weight through that leg we can do
42. 1:30something like
43. 1:32sometimes i'll get a stool come forward
44. 1:34a little bit so we can see you
45. 1:36and
46. 1:37so you're going to step forward with
47. 1:38your right so this leg is
48. 1:41the weaker leg right
49. 1:44and the knee is bent so first of all if
50. 1:47i can do it this way if i don't have to
51. 1:49give a lot of support but if i'm having
52. 1:50to help him his legs support himself
53. 1:53then what i can do is i can bring my
54. 1:54shoulder onto his ischial tuberosity
55. 1:56just superior to it and i can still do
56. 1:59that motion trying to get that posterior
57. 2:00pelvic tilt but now my hands can come
58. 2:02down here to help control the knee all
59. 2:04right so i'm going to come here and then
60. 2:06i'm going to help him come forward yep
61. 2:08and then he's going to step
62. 2:10and then he's going to come forward yep
63. 2:12and then he's going to step and then
64. 2:13he's going to come forward
65. 2:15yep and then he's going to step so you
66. 2:17know some most the time
67. 2:20those people will do well with some
68. 2:21upper extremity support i like the
69. 2:24bilateral platform walkers because i can
70. 2:26externally rotate them which gets their
71. 2:28trunk into extension and um and helps
72. 2:31them keep stay upright they're getting
73. 2:33it's equal bilateral so it helps them
74. 2:35stay in midline and then i can really
75. 2:37help with that hip in the knee in the
76. 2:38knee support