{"id":12340,"date":"2025-06-06T13:31:06","date_gmt":"2025-06-06T11:31:06","guid":{"rendered":"https:\/\/www.wheeleo.eu\/clinical-case-lateropulsion-and-wheeleo\/"},"modified":"2025-06-19T11:59:38","modified_gmt":"2025-06-19T09:59:38","slug":"clinical-case-lateropulsion-and-wheeleo","status":"publish","type":"post","link":"https:\/\/www.wheeleo.eu\/en\/clinical-case-lateropulsion-and-wheeleo\/","title":{"rendered":"Lateropulsion and Wheeleo\u00ae"},"content":{"rendered":"\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\" style=\"margin-top:0;margin-right:0;margin-bottom:0;margin-left:0\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"Utilisation d&#039;un Wheeleo\u00ae\ufe0f et d&#039;un bande Velpeau contre la lat\u00e9ropulsion.\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/AAWxYLxvbdQ?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n<p class=\"wp-block-paragraph\">Following the use of a <strong>gait training ramp<\/strong> (beginning of rehabilitation), I selected the <strong>one-handed walker Wheeleo\u00ae<\/strong> as the <strong>first mobility device<\/strong> for this hemiplegic patient.<\/p>\n\n<p class=\"wp-block-paragraph\">This choice was necessary due to a <strong>complex motor profile<\/strong>. The patient presents several gait alterations:  <\/p>\n\n<ul class=\"wp-block-list\">\n<li><strong>A marked lateropulsion<\/strong><\/li>\n\n\n\n<li><strong>A deficit in hip flexion during the (pre)swing phase<\/strong><\/li>\n\n\n\n<li><strong>A tendency for leg adduction during the swing phase<\/strong><\/li>\n\n\n\n<li><strong>Knee hyperextension during the stance phase<\/strong><\/li>\n<\/ul>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<h3 class=\"wp-block-heading\"><strong>Adapting the Wheeleo\u00ae to Counter Lateropulsion<\/strong><\/h3>\n\n<p class=\"wp-block-paragraph\">To compensate for lateropulsion, I <strong>adjusted the Wheeleo\u00ae to a low position<\/strong>. This strategy aims to promote <strong>the body&#8217;s natural inclination towards the handle<\/strong>, which counterbalances the inclination induced by the pathology. In other words, <strong>a controlled inclination towards support can correct a pathological inclination<\/strong>: <em>minus by minus equals plus<\/em>.  <\/p>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<h3 class=\"wp-block-heading\"><strong>Using a Velpeau<strong>\u00ae<\/strong> Bandage to Optimize Alignment<\/strong><\/h3>\n\n<p class=\"wp-block-paragraph\">To <strong>limit falling towards the paretic side<\/strong>, I positioned a <strong>Velpeau\u00ae bandage<\/strong> to counter leg adduction. By placing the <strong>foot more outward<\/strong>, we optimize support and <strong>prevent adduction from amplifying lateral imbalance<\/strong>. This phenomenon is common in patients with <strong>gluteal muscle weakness<\/strong>.  <\/p>\n\n<p class=\"wp-block-paragraph\">The <strong>Velpeau<strong>\u00ae<\/strong> bandage also helps me during step-taking<\/strong>:<\/p>\n\n<ul class=\"wp-block-list\">\n<li>It <strong>guides foot progression<\/strong> (range, rhythm, alignment),<\/li>\n\n\n\n<li>It <strong>corrects rotation<\/strong> during heel contact with the ground,<\/li>\n\n\n\n<li>And it allows me to <strong>preserve my own back<\/strong>, by intervening from a distance while maintaining a <strong>rhythm close to normal walking<\/strong>, an essential factor for <strong>reactivating locomotor automatisms<\/strong>.<\/li>\n<\/ul>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<h3 class=\"wp-block-heading\"><strong>Orthosis and Strategy for Hyperextension<\/strong><\/h3>\n\n<p class=\"wp-block-paragraph\">The patient wears a <strong>BlueRocker\u00ae orthosis<\/strong>. A <strong>small heel wedge<\/strong> could reduce <strong>hyperextension<\/strong>, but in this specific case, <strong>the hyperextension provides stable knee locking<\/strong>, ensuring some security during the stance phase. As often, this is a <strong>compromise between stability and physiology<\/strong>, to be evaluated on a case-by-case basis.  <\/p>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<h3 class=\"wp-block-heading\"><strong>Specific Advantages of Wheeleo\u00ae in this Context<\/strong><\/h3>\n\n<p class=\"wp-block-paragraph\">The Wheeleo\u00ae allows for a <strong>two-step gait<\/strong>, which represents a <strong>significant progress<\/strong> compared to the <strong>three-step gait<\/strong> often observed during ramp exercises or with aids like <strong>tripod canes<\/strong> or <strong>quadripod canes<\/strong>. The latter sometimes reinforce <strong>a degraded gait pattern<\/strong>. <\/p>\n\n<p class=\"wp-block-paragraph\">On the other hand:<\/p>\n\n<ul class=\"wp-block-list\">\n<li>The <strong>Wheeleo\u00ae provides constant support<\/strong>, even in motion.<\/li>\n\n\n\n<li>It <strong>reduces lateropulsion<\/strong> (low height and + security).<\/li>\n\n\n\n<li>It <strong>promotes better gait fluidity<\/strong>, without sacrificing safety.<\/li>\n<\/ul>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<h3 class=\"wp-block-heading\"><strong>Conclusion: a Key Tool for Optimizing Hemiplegic Gait<\/strong><\/h3>\n\n<p class=\"wp-block-paragraph\">In the context of this complex rehabilitation, <strong>the Wheeleo\u00ae has proven to be a central tool<\/strong>. It not only allows <strong>addressing the patient&#8217;s specific deficiencies<\/strong> but also <strong>stimulates a more fluid, natural, and secure gait<\/strong>. <\/p>\n\n<p class=\"wp-block-paragraph\"><strong>Every adjustment counts<\/strong>, and this type of device <strong>should be part of the modern rehabilitator&#8217;s toolkit<\/strong>.<\/p>\n\n<figure class=\"wp-block-pullquote\"><blockquote><p>It&#8217;s about finding the right moment to introduce the Wheeleo\u00ae: the lateropulsion must be sufficiently \u201cmanageable\u201d. If using the Wheeleo\u00ae doesn&#8217;t work, it&#8217;s rare that a quadripod cane would do better. In this case, it&#8217;s better to return to working on a ramp, against a wall, with a visual reference on the ground to guide foot positioning.  <\/p><\/blockquote><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Following the use of a gait training ramp (beginning of rehabilitation), I selected the one-handed walker Wheeleo\u00ae as the first mobility device for this hemiplegic patient. This choice was necessary due to a complex motor profile. The patient presents several gait alterations: Adapting the Wheeleo\u00ae to Counter Lateropulsion To compensate for lateropulsion, I adjusted the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":12333,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[109],"tags":[],"profils-type":[],"expertise":[],"situation":[358],"profils-et-pathologies":[289],"class_list":["post-12340","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article","situation-clinical-cases","profils-et-pathologies-hemiplegie-en"],"_links":{"self":[{"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/posts\/12340","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/comments?post=12340"}],"version-history":[{"count":2,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/posts\/12340\/revisions"}],"predecessor-version":[{"id":12556,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/posts\/12340\/revisions\/12556"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/media\/12333"}],"wp:attachment":[{"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/media?parent=12340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/categories?post=12340"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/tags?post=12340"},{"taxonomy":"profils-type","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/profils-type?post=12340"},{"taxonomy":"expertise","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/expertise?post=12340"},{"taxonomy":"situation","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/situation?post=12340"},{"taxonomy":"profils-et-pathologies","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/en\/wp-json\/wp\/v2\/profils-et-pathologies?post=12340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}