I've discussed in previous posts (Tips to Improve Hip Strategies, The Body's 4 Natural Defenses to Fight Falls, & 5 Ways to Make Balance Rehab Hip) the importance of hip strategies in balance rehab. Though important, hip strategies can be challenging to retrain. Patients often skip over hip strategies in favor of stepping and/or reaching/grabbing strategies. This tendency was recently highlighted by a patient recovering from a hip fracture. Every time his ankle strategies would get overwhelmed, he would reach and grab the parallel bars (instead of giving the hips a chance to do their job). I thought about moving out of the bars entirely, so he wouldn't have anything to grab, but ultimately felt he needed the security of the bars. Instead, I decided to lower the parallel bars. The lower bars were awkward to grab, but still provided a sense of security. Lowering the bars proved very helpful with this patient - instead of grabbing the bars, he was able to let the hips have a chance to work. As a result, his hip strategies improved much faster. For better results with hip strategies, try lowering the bar with your patients too.
NOTE: picture shown with ADL Hip Stick.