Effectiveness of prowling with proprioceptive training on knee hyperextension among stroke subjects using videographic observation- a randomised controlled trial

Gait Posture. 2018 Mar:61:232-237. doi: 10.1016/j.gaitpost.2018.01.018. Epub 2018 Jan 31.


Introduction: Knee hyperextension is seen in 40-68% of ambulating hemiparetics. If left untreated it may lead to laxity of posterior structures of knee resulting in early degeneration of knee leading to pain, reduced independence in activities of daily living (ADL), deformities and instability. In this study we hypothesize walking with bent knee attitude (prowling) along with proprioceptive training may help to reduce knee hyperextension during the stance phase of gait cycle.

Objective: To test the efficacy of prowling along with proprioceptive training on knee hyperextension range, dorsiflexion range and spatio temporal parameters of gait using Wisconsin gait scale (WGS) as compared to routine physiotherapy.

Method: 32 subjects were randomized into 2 groups- experimental and control groups. Both the groups were given routine physiotherapy. Experimental group received an additional treatment consisting of prowling along with proprioceptive training. Knee hyperextension and ankle dorsiflexion ranges were videotaped and analysed using Kinovea software, and for spatio-temporal gait parameters WGS was used.

Results: In our study, the experimental group showed significant improvement over the control group with regards to knee hyperextension, dorsiflexion range and WGS score. Pre post intervention analysis, within the group, for time taken to cover the distance revealed significant improvement, however between group analysis did not reveal any significant difference.

Conclusion: Prowling along with proprioceptive training is effective in reducing knee hyperextension, increasing dorsiflexion range and improving spatio-temporal gait parameters.

Keywords: Genu recurvatum; Hemiplegic gait; Knee hyperextension; Proprioceptive training; Stroke.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gait
  • Gait Disorders, Neurologic / physiopathology
  • Gait Disorders, Neurologic / rehabilitation*
  • Hemiplegia / etiology
  • Hemiplegia / physiopathology
  • Hemiplegia / rehabilitation*
  • Humans
  • Joint Diseases / etiology
  • Joint Diseases / physiopathology
  • Joint Diseases / rehabilitation*
  • Knee
  • Knee Joint / physiopathology*
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Proprioception / physiology*
  • Range of Motion, Articular
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke Rehabilitation / methods*
  • Video Recording
  • Walking