With this update I want to tell you about an exercise of the Perfetti Method, which is very important to me, and that I consider very important, colloquially we
call it the “floorboard” exercise and it is a fundamental exercise on the recovery of the wandering around after a cerebral stroke. I remember Professor Perfetti’s words who told me in one of my first rounds
when I was telling him what exercises I had done with a patient who had suffered a CVA, and in that occasion he told me:
“Sarmati, there are two exercises that if you do them you will never make a mistake, the “floorboard” for walking, and the “board” for the gripping in the
This is because they are two very complete exercises, and I hope that in the near future, I will have something to tell you about the board.
Unload the PDF for the instructions on building the leaning piano for the recovery of walking.
The “floorboard” is such a complete exercise that I never miss teaching it during the learning sessions with the relatives who have the need of learning how to do
recovery at home for the patient who suffered the cerebral stroke. Whenever I can, I use it as the first learning session, where I tell them the
exercises which we call “trustworthy”.
In fact, in the first sessions that I do with the relatives and their loved ones, I must teach them, the simplest exercises, in order to create confidence for the
relative-therapist, thus I call them trustworthy exercises, allowing them to have and develop trust on this manner of doing rehabilitation.
Why the hemiplegic gait?
Because the leg is rigid, due to the spasticity, the knee does not articulate well enough, so the leg is brought forward blocked, because in order to do this
properly, the movement has to come from the hip since it is a semi circular type of movement and the leg´s oscillation remind us of the scythe movement.
For more information about the hemiplegic gait, please, read this article .
All of this is aggravated by the situation of the ankle and the foot, in fact, the rigid ankle determines the flexion of the foot, then in this case a not very pleasant
terminology is used, the “clubfoot”, which obliges to move the leg through the pelvis.
Walking in this manner, with the leg blocked, does not allow using the walking action correctly, thus not making it, trustworthy, safe and fluent.
You should know that the main functions during walking are the oscillation of the the articulation and the load.
The Floorboard exercise specially improves the oscillation function of the articulation, in fact, if you pay attention during the time when the foot is brought forward, the leg shortens and then lengthens thanks to the knee articulation, and in order to do this, our brain uses the information which comes from the leg but above all from the knee.
The “floorboard” exercise, as you will see, offers the patient who suffered the stroke, the opportunity to rebuild such needed information in order to handle the distance between the floor and the body.
I will tell you a simple methodology in order to do this exercise, but I remind you
that each exercise of the Perfetti method is adapted to each specific situation.
- 1) The patient is lying in bed, while the therapist is sitting beside him on the
bed facing the leg that has the problems.
- 2) The therapist establishes 6 small reference points for himself. Personally I use this “Cardboards”, because I also use them for other
exercises, for the hands, and also because I got used to them, but you can use
six coins, six playing cards, I mean anything small that you can use as a
- 3) Place the reference points on the inside of the extended legs of the
patient, No 1 will be at the heel, while No 6 between the knees, the other
4 reference points, you have to place them so they are at the same
distance one from the other.
- 4) Tell your loved one that he will have to know from time to time, in what
position he will find his leg.
- 5) Now you can hold your loved one’s leg one hand under the knee and the
other holding the sole of the foot.
- 6) You have to make a “first turn” as a test, that is to say, that the starting
point is having the legs extended and in the No 1 position using the hand
under the knee as the turning tool and helping it with the other hand on the
sole of the foot taking the heel close to point No 2, telling him that it is No 2,
after that proceed to No 3 not forgetting to remind him that it is in point No 3
afterwards it would be him who will have to remember and know with
his eyes closed what position is he in beginning with point 1 until point 6. In
order to be precise always use the heel as a reference point for the
movements between points.
- 7) Do the movement in a slow and gentle manner and from time to time, change the heel to a different position asking him in what position it is. This as I had told you is one of the many ways to do the exercise, though this is in my opinion the simplest to do at home.
- And if he makes a mistake?
The mistake is a moment to enjoy in order for our loved one to better learn the
information that is coming from our body.
I will give you an example, if the heel is at position 4 and when asked he answered
6 you should just say, “no, it is not 6, I will make you feel 6 and you take the heel
to position 6, but no we are in position 4 then you take the heel to position 4 so
he can compare, face, and feel the mistake. Go back to another position and
continue asking what position he is in”.
If he makes a mistake again, for example he says 5 and you were in 4 just reply,
“no it was 4 but let us just continue”.
The exercise is too difficult:
Reduce the quantity of positions from 6 to 4.
The leg is stiff
It is frequent, just reduce the speed of the movements, and slowly but surely, the
rigidity will diminish, one of the reasons why the leg is stiff is due to the
difficulty of perceiving the leg in the space.
If your relative has aphasia problems, it is obvious that doing an exercise like the above mentioned will not be possible, but there are other ways, like using a sheet of paper with the positions drawn and then the patient will just point out the position.
Why is the floorboard important for walking?
In order to answer this question, I want you to reason about a very important
aspect; if you do not know exactly where your leg is in the space, how do you
move it from one point to another in a precise manner?
In the Video Guide, you will learn how to do this exercise at all possible difficult
levels, which will allow the relative – patient, perform the exercise from being in
bed to doing it standing up.
This image refers to the “floorboard” that it is used sitting down or standing up.
Please let me know how you do it or just make a comment below in order to
share your experience with everybody else.