Table 2 Home exercise program protocol

2 knee extensor strengthening exercises

1 hip abductor strengthening exercise

1 hamstring strengthening exercise

1 calf strengthening exercise

1 other exercise chosen based on assessment findings

1. Quads strengthening (each program must include 2 exercises)

Knee extension

Non weight-bearing

A. Seated knee extension (with resistance) with 5 second hold

Indications: suggested as an initial exercise

Progression: Increase cuff weight or theraband resistance – red through to black

Simplification: eliminate weight or see 1B

Non weight-bearing

B. Inner range quads over roll (with resistance) with 5 second hold

Indications: Usually only required when any flair ups with seated knee extension (1A)

Progression: Use appropriate level of ankle cuff weight

Simplification: eliminate weight if flare up

Sit-to-stand

Weight-bearing

C. Sit to stand without using hands

Indications: suggested as an initial exercise

Progression: lower chair height, hover above the seat without touching down, more weight on affected leg, slit leg position (affected leg closer to seat)

Simplification: use hands

Steps

Weight-bearing

D. Step-ups

Indications: suitable progression from sit to stand (1C)

Progression: Increase step height, hold extra weight (in hands or backpack)

Simplification: sit to stand (1C)

Weight-bearing

E. Forward touchdowns from a step

Indications: suitable progression from step-ups (1D)

Progression: Increase step height, hold extra weight (in hands or backpack), don’t touch down

Simplification: step-ups (1D)

Partial squats

Weight-bearing

F. Partial wall squats

Indications: suitable progression from sit to stand (1C)

Progression: Increase to 5 sec hold, more weight on study side)

Simplification: if find flare/problematic step back to sit to stand (1C)

2. Hip abductor strengthening (1 exercise)

Standing hip abduction

Non weight-bearing

A. Side leg raises in standing

Indications: suggested as an initial exercise

Progression: Increase cuff weight or theraband resistance – red through to black

Simplification: eliminate weight

Side stepping

Weight-bearing

B. Crab walk with resistance band

Indications: good progression from standing leg side raises (2A)

Progression: Increase theraband resistance – red through to black

Simplification: side leg raises in standing (2A)

Standing hip abduction

Weight bearing

C. Wall push standing on study leg

Indications: good progression from crab walking (2B) and for variety at final session

Progression: Increase step height. Hold extra weight (in hands or backpack)

Simplification: If unable to tolerate static standing on joint then avoid and use 2B or 2A. Precaution in those with increased varus.

3. Hamstring strengthening (1 exercise)

Standing knee flexion

Non weight-bearing

Standing over bench knee curls with weight

Progression: Increase cuff weight or theraband resistance – red through to black

Simplification: eliminate weight

4. Calf strengthening (1 exercise)

Standing plantar-flexion

Weight-bearing

Double heel raises

Progression: single heel raises, raises from the edge of a step

5. Others (1 exercise if appropriate)

Knee ROM

Weight bearing

A. Deep squats holding onto a bench/chair

Progression: increase squat depth

Hip ROM

Weight bearing

B. Deep lunges holding onto back of chair/bench

Progression: increase lunge depth

Hip extensors

Weight-bearing

C. Bridging

Progression: split leg bridge, single bridge with a hold, bridging one leg