We will often have kids who have a very strong preference for one leg over the other when they are doing functional activities. Because they rely so heavily on the one leg, it gets stronger and that continues the cycle of them wanting to use just that leg. While it would be great for them to use both sides equally as they are progressing their function, there are times that we really want them to have success with an activity so we let them focus on the one side for a while. Then we have the fun task, once they have achieved the function, of encouraging the use of the non-dominant leg.
Some ideas we have used (these will vary depending on where the child’s functional level is) are:
- Staggered standing – We will use a phone book, a stool, or some other elevated surface and have them place their dominant leg on the elevated surface so that they increase their weight bearing through the non-dominant leg. You can use drawing at a white board, pulling squigz off a surface, toys, etc to keep them motivated. You just want to make sure that they aren’t compensating by leaning on things to put more of the weight back onto the elevated leg. This can also be a tricky one for some of the older kids who have learned to compensate really well because they will use the dominant leg at all costs so you will have to get really creative!
- Staggered sit to stand – Similar to above except you start in a sitting position and have the dominant leg on an elevated surface and then have them stand up. Ideally you will find the right height so they can do this without using their hands to decrease their chances of compensation. Once standing you can have them play in the staggered standing position.
- Staggered bridges – When they are in a bridging position (on their back with their knees bent) place the phone book or elevated surface under their dominant foot. Also move it a little further away from them than the foot that is staying on the floor so that the lever arm makes it a little harder to activate. Then have them bridge up. As always, keep an eye on things to make sure they aren’t compensating.
Some ideas that aren’t about ‘tricking’ the non-dominant leg to go but are just about making them use it are:
- Pull to stand – Physically place the non-dominant foot flat on the ground so they have to lead with that foot. You may need to give some help in the beginning to have them go through the full motion. One compensation you may see is that they will quickly pull their dominant leg up too so they are in a squat position and can push with both feet at the same time.
- Crawling up stairs – We have a lot of kids pushing with one foot to help them boost up to the next step. We generally encourage switching between both feet but if we are trying to encourage one foot more than the other we will just keep placing the non-dominant foot on the surface so that is the one that they push with. Look for similar compensations that we mentioned above.
- Step ups – Have a sequence of steps (same or varying heights) and have the child step up onto them. Don’t let them use their dominant leg so that they are focused on the non-dominant one. You may notice that they will try to compensate by lifting up enough to get the dominant leg up on the step and then pushing up with both legs at the same time.
Those are just a few ideas. We’d love to hear any ideas you have!