How do I teach steps to someone with a stroke? Is it different to orthopaedics?
The good news is that it is the same pattern as you would use with an orthopaedic patient.
Going Up - Good Foot, Bad Foot, Gait Aid
Going Down - Gait Aid, Bad Foot, Good Foot
I have had people ask me whether it would be better to make a stroke patient go up with their bad foot first as this will force them to weight bear and strengthen this leg.
I agree this would be an effective exercise if the patient was up to that level, however I would argue that:
Exercises like this are more safely done with a single step where a patient can be supported more effectively (and where they wouldn’t be falling down multiple steps if something goes wrong).
I would not let any of my students do a strengthening exercise up multiple steps as I would (in most cases) consider it unsafe. There is also no clinical benefit to doing this up multiple steps rather than repeated on a single step.
When you are teaching steps to a patient your focus, your only focus, is safety, safety, safety. The safest pattern to teach a patient is the one above.
