When you exercise both legs at the same time there is always more demand on the trunk muscles than when only one leg is exercising. To exercise the trunk specifically you hold both the legs together. The leg patterns for trunk exercise are discussed in 7 Chapter 10.
When you hold the legs separately the emphasis of the exercise is on the legs. Bilateral leg work allows you to use irradiation from the patient's strong leg to facilitate weak motions or muscles in the involved leg. You can use any combination of patterns and techniques in any position. Work with those patterns, techniques and positions that give you and the patient the greatest advantage in strength and control.
The most common positions for doing bilateral leg patterns are supine, prone, and sitting. In sitting we show two possible combinations. The first is a bilateral symmetrical combination, flexion-abduction with knee extension (O Fig. 8.14), and the second is a reciprocal asymmetrical combination, left leg flexion-abduction with knee extension combined with right leg extension-abduction with knee flexion (O Fig. 8.15). In a supine position, the symmetrical straight leg combinations of flexion-abduction (O Fig. 8.16 a, b) and extension-adduction (O Fig. 8.16 c, d), the reciprocal combination of left leg extension-abduction with right leg flexion-abduction (O Fig. 8.17), and the asymmetrical pattern of hip extension with knee flexion (O Fig. 8.18) are shown. In the prone position we show hip extension with knee flexion (O Fig. 8.19).
Teach the patient to combine hip extension with knee flexion in a smooth motion.
Points to Remember
8.7.1 Leg Patterns in a Sitting Position
Bilateral straight leg patterns have treatment goals on the structural level, such as strengthening leg or trunk muscles.
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