What Single Leg Stance Assessment can tell you

In this video we’re going to look at the single leg stance and some of the things you can derive from it during your assessment. Hi and welcome back to PhysioTutors. You’re probably used to assess static postural control or balance using the single leg stance and it’s a great indicator for fall risk in the elderly population. But why not use it with any other patient as well? 40% of the gait cycle are spent in single leg stance and it’s also an essential posture during walking stairs for example. Now some might argue that walking, for example, is a dynamic movement and single leg stance is a static posture but the stabilization mechanisms are essentially the same. So here are some of the findings you might see during single leg stance assessment. Asking the patient to take of shoes and socks can already reveal difficulties. For example, does the patient sit down or is it difficult for them to reach their feet? Observe spine and lower extremity mobility. Observe the patient getting up from the seated position. Do they stand with equal weight on both feet? Do they rely more on one side for weightbearing? They will more often use the more stable leg. Now when standing, is weight shifted to one leg? And are they standing that way to escape pain or is it their natural position? Remember, if your patient is complaining about pain, be aware that pain influences movement patterns. Ask the patient to look straight ahead with their arms on their side and then stand on one leg. Don’t specify on which leg and how high the other leg should be lifted. The patient will likely choose the more stable leg and lift the opposite leg to a height that’s comfortable for them. Observe the breathing and movement of the ribcage. Elevation of the ribcage when breathing or holding the breath during the test might indicate poor intrinsic core stabilization. Are the toes of the stance leg gripping or changing to white colour? Is the foot searching for stability, moving in and out of inversion or eversion? This might indicate instability of the foot or poor stability in the stance leg with possible gluteus maximus inhibition. Watch out for Trendelenburg sign, indicating Gluteus medius weakness of the stance leg or contralateral quadratus lumborum inhibition. Is the patella in line with the dorsum of the foot? Are the knees caving in? Or is there tibial torsion? Amongst others, this could indicate a gluteus maximus weakness. Do the eyes look anywhere other than straight ahead? This might be caused by eye muscle fasciculation which is very common in post-traumatic neck injuries. Lastly, repeat the test with the patient’s eyes closed. Holding with good form for 20 seconds with eyes closed in an acceptable range, 40 seconds with the eyes opened. Many of the principles of posture analysis, such as head positioning for example, apply to the single leg assessment as well. So be sure to watch our video on observation and posture analysis, as well as our video on functional assessment. Now if you liked this video and you want to see more of it, leave a thumbs up, subscribe to our channel if you haven’t by clicking below and visit us on social media or on our website. This was Andreas from PhysioTutors, I’ll see you next time, bye.

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