Exercise 10: Forward Walking Lunges in the Solo-Step

Setup: Fit the patient into the Solo-Step harness and connect the lanyard to the trolley on the overhead track. Position the patient at one end of the track, facing forward. Adjust the lanyard length to allow for the full downward movement of a lunge while ensuring the system can engage immediately if balance is lost. Ensure the patient has adequate space along the length of the track to complete the prescribed number of steps.

Starting Position: Have the patient stand tall with feet hip-width apart, core lightly engaged, and arms relaxed at their sides or extended slightly forward for counterbalance. Instruct the patient to look straight ahead and find a fixed focal point to help maintain an upright posture throughout the exercise.

The Exercise:

1. Cue the patient to take a large step forward with the lead foot, landing with the heel first and the foot flat on the floor.
2. Lower the body by bending both knees simultaneously. The front knee should track directly over the front foot and should not extend past the toes, while the back knee lowers toward, but does not touch, the floor.
3. Both knees should reach approximately 90 degrees at the bottom of the movement. Instruct the patient to keep the chest up, the trunk upright, and the hips squared forward throughout the descent.
4. Pause briefly at the bottom of the lunge to establish control before rising.
5. Drive through the heel of the front foot to push forward and up, bringing the back foot forward to step into the next lunge. Do not return to the starting position between steps.
6. Continue walking forward in this lunging pattern along the full length of the track, alternating legs with each step.
7. Repeat for the prescribed number of repetitions or lengths of the track.

Progressions: As strength and confidence improve, the therapist can advance the exercise by increasing stride length to deepen the lunge, adding a brief pause at the bottom of each repetition, incorporating light hand weights to increase the resistance demand, introducing a torso rotation at the bottom of the lunge to challenge rotational stability, adding an overhead reach at the bottom of each step, or increasing the pace to elevate the cardiovascular and coordination demands of the exercise.