I'm a trainer and here are 4 stair exercises to help strengthen your knees after 60

 To keep living in your own home and travel in Europe your competent? doctor better write these up as EXACT PROTOCOLS! 

Can't do that; PURE INCOMPETENCE!

I'm a trainer and here are 4 stair exercises to help strengthen your knees after 60

1. Supported Step-Up

Step-ups are one of the most direct ways to build knee strength because they train the same pattern you use on stairs. One leg pushes, the knee tracks well, and the hip helps finish the movement. The railing lets you practice with support, so you can focus on clean reps instead of fighting for balance. Start with a low step and make the working leg do the climb.

Muscles Trained: Quads, glutes, hamstrings, calves, core.

How to Do It

1. Stand facing the stairs.
2. Hold the railing lightly.
3. Place your right foot fully on the first step.
4. Press through your right foot and step up.
5. Bring your left foot to the step.
6. Step back down with control, then repeat before switching sides.

Recommended Sets and Reps: Perform 2 to 3 sets of 6 to 10 reps per side.

Best Variations: Lower step-up, slower step-up, step-up with a brief pause.

Form Tip: Keep your whole foot on the step.

2. Supported Stair Toe Tap

Lowering is where many knees feel the most unsure. A stair toe tap helps you train that control in a small range before moving into bigger step-downs. The leg on the step does the work as the other foot taps the floor. This builds confidence because you can use the railing, shorten the range, and keep every rep smooth.

Muscles Trained: Quads, glutes, calves, hamstrings, core.

How to Do It

1. Stand on the bottom step with your right foot planted.
2. Hold the railing lightly.
3. Let your left foot hover near the floor.
4. Bend your right knee and tap your left toes to the floor.
5. Press through your right foot to stand tall again.
6. Complete your reps, then switch sides.

Recommended Sets and Reps: Perform 2 to 3 sets of 5 to 8 reps per side.

Best Variations: Smaller-range toe tap, supported step-down, slower toe tap.

Form Tip: Bend the standing knee slowly.

RELATED: 3 Simple Exercises That Rebuild Bone Strength Better Than Calcium Supplements After 60

3. Stair Calf Raise

The calves help your knees more than most people realize. They support your ankles, help control each step, and make walking or climbing feel steadier. A stair calf raise gives you a simple way to strengthen the lower legs with the railing close by. Use a controlled lift and lower so the calves do real work through each rep.

Muscles Trained: Calves, ankles, feet, quads.

How to Do It

1. Stand on the bottom step while holding the railing.
2. Place the balls of your feet on the edge of the step.
3. Let your heels lower slightly.
4. Press through the balls of your feet and lift your heels.
5. Pause briefly at the top.
6. Lower with control.

Recommended Sets and Reps: Perform 2 to 3 sets of 10 to 15 reps.

Best Variations: Floor calf raise, smaller-range stair calf raise, single-leg assisted calf raise.

Form Tip: Lift and lower without bouncing.

4. Supported Stair March

A stair march keeps the movement basic while adding balance and hip control. One foot stays on the step as the other knee lifts, which makes the standing leg work harder to keep you steady. This helps the knee because strong hips and better balance reduce the wobble people often feel on stairs. Keep the railing close and move at a pace you can control.

Muscles Trained: Quads, glutes, hip flexors, calves, core.

How to Do It

1. Stand facing the stairs.
2. Place your right foot on the first step.
3. Hold the railing lightly.
4. Press through your right foot and lift your left knee.
5. Lower your left foot back to the floor.
6. Repeat your reps, then switch sides.

Recommended Sets and Reps: Perform 2 to 3 sets of 6 to 10 reps per side.

Best Variations: Lower knee lift, slower stair march, step-up march.

Form Tip: Stand tall before each knee lift.

RELATED: 7 Daily Drills That Keep Your Mobility Decades Younger After 60

5. How to Build Knee Strength on Stairs After 60

Stair training works when the reps stay controlled, and your knee feels supported through the whole range. Use the railing, start with the lowest step, and stop a set before your form gets sloppy. The goal is steady progress, not rushing into a higher step before your legs are ready.

• Use the railing every time: Support lets you train the knee without turning each rep into a balance test.
• Start on the bottom step: A lower height gives your quads and hips a better chance to control the movement.
• Slow down the lowering: Step-downs and toe taps build more knee control when you slow down.
• Watch your knee path: Keep the knee pointing in the same direction as your toes.
• Train both legs evenly: Give the weaker side the same number of reps, even if the range has to be smaller.
• Stop if pain changes your movement: Muscle effort is fine. Sharp pain, limping, or shifting away from one leg means you need to stop the set.
• Practice a few days per week: Two to four short sessions give your knees regular strength work without overloading them.

References

• Park, Soo Yeon et al. "Aging-related changes in knee flexor muscle strength and cross-sectional area." Medicine vol. 101,42 (2022): e31104. doi:10.1097/MD.0000000000031104
• Solan, Matthew. "Strength Training Tied to Smaller Risk of Knee Osteoarthritis and Pain Later in Life." Harvard Health Publishing, Harvard Medical School, 1 Feb. 2024, www.health.harvard.edu/diseases-and-conditions/strength-training-tied-to-smaller-risk-of-knee-osteoarthritis-and-pain-later-in-life. Reviewed by Howard E. LeWine.

Predictive value of the pendulum test for assessing knee extensor spasticity

So fucking what about predictions? We want solutions, not this lazy crapola. Does no one understand the only goal in stroke? It is incredibly simple; 100% recovery.  Prediction does nothing for that goal.

Predictive value of the pendulum test for assessing knee extensor spasticity

• Alyssa Whelan,
• Andrew Sexton,
• Melony Jones,
• Colleen O’Connell and
• Chris A. McGibbonEmail authorView ORCID ID profile

Journal of NeuroEngineering and Rehabilitation201815:68

https://doi.org/10.1186/s12984-018-0411-x

©  The Author(s). 2018

• Received: 10 January 2018
• Accepted: 5 July 2018
• Published: 18 July 2018

Abstract

Background

The pendulum test is commonly used to quantify knee extensor spasticity, but it is currently unknown to what extent common pendulum test metrics can detect spasticity in patients with neurological injury or disease, and if the presence of flexor spasticity influences the test outcomes.

Methods

A retrospective analysis was conducted on 131 knees, from 93 patients, across four different patient cohorts. Clinical data included Modified Ashworth Scale (MAS) scores for knee extensors and flexors, and years since diagnosis. BioTone™ measures included extensor strength, passive and active range of motion, and pendulum tests of most affected or both knees. Pendulum test metrics included the relaxation index (RI), 1st flexion amplitude (F1amp) and plateau angle (Plat), where RI=F1amp/Plat. Two-way ANOVA tests were used to determine if pendulum test metrics were influenced by the degree of knee flexor spasticity graded by the MAS, and ANCOVA was used to test for confounding effects of age, years since injury, strength and range of motion (ROM). In order to identify the best pendulum test metrics, Receiver Operator Characteristic analysis and logistic regression (LR) analysis were used to classify knees by spasticity status (none or any) and severity (low/moderate or high/severe).

Results

Pendulum test metrics for knee extensors were not influenced by degree of flexor spasticity, age, years since injury, strength or ROM of the limb. RI, F1amp and Plat were > 70% accurate in classifying knees by presence of clinical spasticity (from the MAS), but were less accurate (< 70%) for grading spasticity level. The best classification accuracy was obtained using F1amp and Plat independently in the model rather than using RI alone.

Conclusions

We conclude that the pendulum test has good predictive value for detecting the presence of extensor spasticity, independent of the existence of flexor spasticity. However, the ability to grade spasticity level as measured by MAS using the RI and/or F1amp may be limited. Further study is warranted to explore if the pendulum test is suitable for quantifying more severe spasticity.

Keywords

• Spasticity
• Knee extensor
• Knee flexor
• Pendulum test
• Relaxation index
• Modified Ashworth scale
• Classification
• Logistic regression
• Receiver operator characteristic

Background

Muscle spasticity can be a painful and debilitating complication that negatively impacts function and quality of life in people with upper motor neuron injury from neurological disease or trauma [1], such as acquired brain injury (trauma, stroke), cerebral palsy, multiple sclerosis and spinal cord injury. Management of spasticity typically involves pharmacologic intervention a

nd/or ongoing physical therapy [2, 3], but a significant barrier to effective treatment prescription is the inability to quantify spasticity in the clinic [4].

Spasticity is typically assessed by inducing a rapid stretch of the muscle, or administering a “stretch-reflex” test. Clinical tests such as the Modified Ashworth Scale [5] and Tardieu Scale [6] apply this method to quantify spasticity subjectively, but their inter-rater reliability [7, 8, 9, 10] and validity [11] have been questioned. Several studies have examined objective approaches to quantifying spasticity in the clinic using wearable sensor technologies during passive muscle stretches [9, 12, 13, 14, 15], but there is not yet a clear consensus on testing protocol and how to best translate the resulting electrophysiological and biomechanical signals into clinically relevant measures of spasticity. As such, the Modified Ashworth Scale remains a commonly used method of quantifying spasticity in clinical settings.

For the knee joint, the Wartenberg pendulum test [16] offers a potential solution for translation to clinical assessment. The pendulum test offers a simple approach whereby gravity induces the stretch-reflex of knee muscles by dropping the lower-leg from a resting horizontal position, and observing its oscillatory behavior throughout the passive movement [17, 18]. The test’s easy implementation and execution with commonly available sensors (e.g. electromyography with video [19], goniometry [20, 21], and other accessible devices such as the Wii remote [22]) has contributed to it emerging as an objective and reliable way to quantify spasticity in the knee extensors [17, 23, 24, 25]. Nevertheless, there is still a lack of consensus on what pendulum test metrics are most relevant to clinical spasticity assessment, and importantly, whether the pendulum test is sensitive to knee flexor spasticity. Thus the purpose of this study was two-fold:

1. 1)
   To determine if the measurement of extensor spasticity is influenced by flexor spasticity during the pendulum test in patients with neurological injury or disease; and
2. 2)
   To determine which pendulum test metrics are the closest indicators of clinical muscle spasticity, as represented by the Modified Ashworth Scale (MAS).

Methods

This is a retrospective analysis of knee spasticity measurement data from a multi-site study to evaluate wearable sensor-based systems for acquiring objective measures of muscle tone in the clinic.

Analysis for Sit-to-Stand Performance According to the Angle of Knee Flexion in Individuals with Hemiparesis

I'm sure your therapist is already using some form of objective analysis on your sit-to-stand performance.  For me right now it's almost exclusively my right leg.

Analysis for Sit-to-Stand Performance According to the Angle of Knee Flexion in Individuals with Hemiparesis

J Phys Ther Sci. 2013 December; 25(12): 1583–1585.

Published online 2014 January 8. doi:  10.1589/jpts.25.1583

PMCID: PMC3885844

Mi Young Lee, PhD¹ and Hae Yong Lee, MS^2,*

Author information ► Article notes ► Copyright and License information ►

Go to:

Abstract

[Purpose] 

Sit-to-stand (STS) is one of the important functional tasks people perform throughout the day. This study investigated whether varying angles of knee flexion affect STS patterns in individuals with hemiparesis by using a foot plantar pressure measurement system. 

[Methods] 

Fifteen stroke patients with hemiparesis participated for this study. They performed sit-to-stand with three angles of knee flexion (70°, 90°, and 110°). We measured the trajectory of the center of pressure, peak plantar pressure, and symmetry index using a Mat-scan system (Tekscan, South Boston, MA, USA). [Results] 

As a result, we found that there were significant differences among the three angle conditions (trajectory of center of pressure, peak plantar pressure on the affected side, and symmetry index). However, there was no significant difference in peak pressure according to the knee flexion on the unaffected side. [Conclusion] 

In the current study, we found that stroke patients with hemiparesis had a compensated STS pattern according to knee flexion angles. This indicates that the peak value of plantar pressure increased and that the trajectory of the center of pressure widened as the angle of knee flexion increased. We also suggest that hemiparesis patients should be more concerned about proper knee angle for symmetrical STS pattern.

Hyperextension of knee in hemiplegic and Paraplegic

I thought this blogger had a good description of this. In case you didn't get this from your doctor and therapist. I never had it although my PT must have thought I was coming close once because he jacked the AFO ankle hinge all the way open once which totally destroyed my gait. Since it was just a screw I decided I knew more than he did and reversed it. Don't do the stuff I do, I'm not qualified for anything.
http://gajananbhalerao.blogspot.com/2012/11/causes-and-management-of-hyperextension.html

Corticospinal tract integrity correlated with knee extensor weakness in chronic stroke survivors

I would love to have them write this at an eighth grade level.
http://www.naric.com/research/rehab/record.cfm?search=2&type=all&criteria=J62508&phrase=no&rec=117188
NARIC Accession Number: J62508. What's this?
ISSN: 1388-2457.
Author(s): Madhavan, Sangeetha; Krishnan, Chandramouli; Jayaraman, Arun; Rymer, William Z; Stinear, James W..
Project Number: H133E070013, H133F090009.
Publication Year: 2011.
Number of Pages: 7.
Abstract: Study investigated the role of corticospinal tract (CST) integrity on knee extensor weakness in chronic stroke survivors. Knee extensor strength and activation testing were performed at 90 degrees of knee flexion using an interpolated triplet technique. CST integrity was evaluated using data obtained from diffusion tensor imaging and transcranial magnetic stimulation. Recordings in nine stroke subjects indicated substantial knee extensor weakness and activation deficits in the paretic legs of the stroke survivors. Regression analysis revealed that asymmetry in CST integrity was strongly related to between-leg differences in knee strength. The results suggest a strong link between CST integrity and lower extremity strength, and add to the growing evidence of substantial knee extensor weakness and activation impairments in stroke survivors. The findings from this study further our understanding of the anatomical and neurophysiological contributions to motor impairments after stroke, which may benefit clinicians and researchers in the field of stroke rehabilitation.
Descriptor Terms: ELECTRICAL STIMULATION, ELECTROPHYSIOLOGY, IMAGING, LIMBS, NEUROMUSCULAR DISORDERS, STROKE.