Hyperextension of knee in Hemiplegics

[spandanphysio]

Hi Mgrules for established cases as u mention brace set in dorsiflexion is used.another method for prevetion is positioning from initiation stage.i m using dynamic knee activities like stair climbing and wieght transfer in all direction which helps a lot to control knee joint.

[rose]

hi
MGrules i face knee hyperextension alote with the patients i am using eccentric exercises with the weigt bearing very effective and check up on hip extensor propaply its weak so its another factor try to work on it too.it will helps

[Canuck Physio]

In regards to the problems as listed below:

- Hyper extension of hemiplegic knee?

You are currently utilizing strengthening of Quads + Hams?

You mentioned TA tightness, but this is not present?

How about the Calves? Is there activation in the gastroc? If the gastroc is not activating, and the TA is compensating in some manner or another you may be getting lengthening during stance.

Have you tried strengthening the Gastroc concomitantly? As well what exercises have you completed to strengthen the hamstrings? Isolated curls will not necessarily strengthen the hamstrings sufficiently.

An exercise I would recommend is the following, which is an adaptation of the RDL which has been found to activate the Biceps femoris (via EMG activity) the most:

Position patient with support, slight bend in knee.

Provide 1 Kettle bell to lift:

Perform lift as follows:

Raise weight from the ground while extending the torso in a deadlift fashion while maintaining the slight knee flexion.

* this will train the muscle in an already shortened position, while maximally stimulating the hamstrings over its entire range:
Ref: Medicine and Science in Sports and Exercise 32(5): S55, 2000

The key for this is safety, obviously the non-hemiplegic side must be supported.

Request feedback re: above

[apocalypse]

RDL with a hemiplegic patient - I'm gonna give that a try!!

---------- Post added at 05:38 PM ---------- Previous post was at 05:36 PM ----------

Can you tell me about the PSI? How it works? At work we are doing a case study regarding the prevention/treatment of knee hyperextension, and that may be an idea to bring up. Another treatment I've found that works for someone is a brace set in some dorsiflexion, which helps with knee instability and causes a knee flexion moment.

Did you ever do that case study? Love to hear the results.