Therapy for Affected Leg

by Alice
(Mississippi, USA)

Question: Should a stoke survivor try to lead with the weak leg when walking? Will this help strengthen the weak leg?

Answer: During a normal walking pattern, a person steps through with each leg so there is not really a leading leg except on the first step. Often with a stroke, a patient will not perform full alternating strides, but instead will step with one leg and then bring the other leg forward and next to the lead leg. If the person is using a hemi-walker, they will be instructed to lead with the walker and weak leg. If the person is not using a walker, then it may vary which leg is used first. I think it is beneficial to learn to lead with both legs.

If a stroke patient has trouble moving the weaker leg, then it may be more beneficial to work on moving the weaker leg forward and back. On the other hand, if the patient has more trouble with the weaker leg's knee buckling, it will be more important to work on stepping forward and back with the strong leg because this makes the weaker leg take the person's full body weight. Taking the full body weight on one leg is usually much more difficult than swinging the leg forward. What this means for the stroke patient is that it is important to work both on stepping through with the weak leg and taking weight while the other leg steps forward.