Abstract
A patient with a trochanteric fracture of the left femur presented at our hospital. Initially, muscle strengthening of the left lower leg was attempted. This led to subsequent improvement in muscle weakness, and the patient could walk by herself with a cane. However, when she tried walking without a cane, the movement of her first step seemed unstable. We realized that the major impairment was instability at the first step of walking. To resolve this issue, we aimed at practical improvement of the instability. We focused on alignment of the pelvis and trunk, and on the center of pressure at the first step of walking. Efficient, smooth walking is possible due to a reverse reaction phenomenon derived from the standing position in a healthy person. However, in the present case, the movements of the center of pressure and the patient’s standing position at the first step were different from the general pattern. We concentrated on improving her posture and control in the standing upright position. Thereafter, the patient’s standing upright position and the center of pressure at the first step changed remarkably and she acquired smooth walking following the first step.
