Maximising Independence with Lower Limb Rehabilitation

How PhysioFunction can help improve Lower Limb Function

Lower limb rehabilitation aims to restore as much function and independence as possible for each individual client. 

At PhysioFunction we use our skills in movement analysis and assessment to identify specific problems and provide bespoke, focused and goal-based physiotherapy.  

A thorough assessment is essential to guide client rehabilitation. This typically includes:

• Neurological and musculoskeletal examination: Evaluating tone, strength, reflexes, range of motion, and coordination.
• Gait analysis: Observing walking patterns, use of assistive devices, and energy efficiency.
• Balance and proprioception testing: Using tools like the Berg Balance Scale or Functional Reach Test.
• Functional assessments: Measuring endurance, speed, and independence in mobility (e.g., Timed Up and Go test, 6-Minute Walk Test).

From this information, a personalised rehabilitation plan is developed based on the individual's goals, condition severity, and functional potential.

The interventions we use include:

• Physiotherapy

Hands on physiotherapy for the lower limb involves therapeutic handling of the body to increase or decrease muscle tone, release tight muscles, increase confidence in load bearing through a joint and improve the ability of the individual to use their muscles effectively.

• Exercise Therapy

Exercise is a key component of any rehabilitation program as it allows an individual to assist with their own recovery and make the benefits they have gained in clinic continue at home. For the lower limb, exercises would commonly involve stretches, lying or sitting exercises to build strength and, where suitable, standing, weight bearing and balance exercises.

• Gait Training

Gait re-education is central to lower limb rehab. Techniques may include treadmill training, often with body weight support, to promote repetitive and symmetrical stepping. Overground walking with verbal or tactile cues to improve stride length, foot clearance, and rhythm and also the use of parallel bars, LiteGait, or harness systems to provide safety and support during early ambulation.

• Functional Electrical Stimulation (FES)

FES can assist in activating specific muscle groups (such as the tibialis anterior in foot drop), enabling more effective gait and reducing compensatory strategies. At PhysioFunction we utilise the Bioness Go, Alfess and PACE for foot drop.

• Balance and Proprioception Training

Challenging static and dynamic balance through exercises such as standing on uneven surfaces (foam pads, wobble boards), reactive balance drills (e.g., Blaze Pods or perturbation-based tasks) or dual-task activities to improve balance under cognitive load.

• Advice on Assistive Devices and Orthotics

When needed, devices such as ankle-foot orthoses (AFOs), canes, or walkers support mobility, improve safety, and encourage proper limb alignment.

• Task-Specific Training

Rehabilitation is most effective when exercises mimic daily activities. Sit-to-stand transitions, stair climbing, or navigating obstacles are practiced repeatedly to enhance carryover into real-life situations.

Psychosocial and Motivational Considerations - Lower limb rehab isn’t just physical; it requires motivation, confidence, and psychological resilience. Incorporating goal-setting, positive feedback, and elements of fun or competition (e.g., gamified balance tools) can significantly boost engagement. Education and support for families and caregivers are also key to long-term success.

Impact of Neurological Conditions on the Lower Limbs

Neurological conditions can disrupt communication between the brain, spinal cord, and muscles, leading to a wide range of impairments in the lower limbs:

• Muscle weakness or paralysis, especially in muscles responsible for hip flexion, knee extension, and ankle dorsiflexion.
• Spasticity or increased muscle tone, which can restrict range of motion and lead to abnormal movement patterns.
• Poor balance and coordination, increasing the risk of falls and limiting safe ambulation.
• Altered sensation or proprioception, reducing awareness of limb position in space and impacting movement control.
• Fatigue and endurance issues, particularly in progressive conditions like MS.

Goals of Lower Limb Rehabilitation

The primary goals of lower limb rehabilitation include:

• Improving functional mobility: This includes walking, transfers (e.g., bed to chair), and climbing stairs.
• Enhancing strength and motor control: Targeting specific muscle groups to improve voluntary movement.
• Correcting gait deviations: Addressing foot drop, knee hyperextension, scissoring gait, and other abnormalities.
• Promoting neuroplasticity: Engaging in repetitive, task-specific movements to help the nervous system reorganize and adapt.
• Reducing the risk of complications: Such as joint contractures, pressure injuries, and deconditioning.

Lower limb rehabilitation plays a vital role in the recovery and long-term management of individuals with neurological conditions. These conditions such as stroke, multiple sclerosis (MS), Parkinson’s disease, spinal cord injury, and Charcot-Marie-Tooth (CMT) often result in impaired mobility, muscle weakness, balance deficits, and altered gait patterns. Effective rehabilitation aims not only to restore movement but also to promote independence, prevent secondary complications, and improve overall quality of life.