Pulse Routine: Supporting Leg Lifting & Foot Clearance

Using targeted vibration to support muscle awareness, leg lifting, and controlled stepping during everyday movement.

1. Who Is This Routine For?

This routine is designed for individuals who experience difficulty lifting their legs during movement, particularly when stepping forward, navigating small obstacles, or practicing controlled walking.

It may be worth exploring for individuals who:

• Have difficulty lifting their leg high enough to comfortably clear the ground or small obstacles.

• Experience reduced awareness or coordination of their leg movements.

• Have trouble lifting the front of their foot during stepping.

• Want additional sensory feedback while practicing leg lifting and controlled stepping.

• Are working with a physical or occupational therapist on mobility, muscle engagement, or walking exercises.

How Pulse Fits In

Pulse uses targeted mechanical vibration to stimulate sensory receptors in the skin and underlying tissues, providing additional sensory input to the nervous system.

When paired with intentional leg movements, this feedback may help support body awareness and muscle engagement during exercises involving leg lifting, ankle movement, and stepping.

For this routine, we'll focus on two areas:

• Quadriceps: The muscles on the front of the thigh, which help straighten and control the knee.

• Tibialis Anterior: The muscle on the front-outside of the shin, which helps lift the front of the foot toward the shin.

These muscles contribute to different parts of the stepping movement. Hip flexors also play an important role in lifting the thigh.

The goal: Incorporate sensory feedback into exercises that encourage intentional leg lifting, foot clearance, and controlled stepping.

Pulse is not intended to restore lost muscle function or treat an underlying neurological or musculoskeletal condition.

2. Where to Place Your Pulse Devices

Placement 1: Quadriceps (Front of Thigh)

Position one Pulse Device over the fleshy muscle area on the front of the thigh, between the hip and knee.

Purpose: Provide sensory feedback over the quadriceps during exercises involving knee control, leg movement, and stepping.

Placement 2: Tibialis Anterior (Front of Shin)

Position the second Pulse Device over the tibialis anterior muscle on the front-outside portion of the shin, below the knee and above the ankle.

Avoid placing it directly over the shinbone.

Purpose: Provide sensory feedback over a muscle involved in lifting the front of the foot, an important component of foot clearance during walking.

Placement Instructions

1. Identify the leg you want to focus on.

2. Secure one Pulse Device comfortably over the quadriceps.

3. Secure the second device over the tibialis anterior.

4. Ensure both devices remain comfortably positioned without restricting movement or circulation.

5. Begin with gentle, supported movements before progressing to stepping exercises.

Why These Placements?

The quadriceps and tibialis anterior contribute to different components of lower-extremity movement.

Providing sensory feedback over these areas may help individuals focus on the muscles and movements involved in lifting, positioning, and controlling the leg during stepping exercises.

These placements have not been established as a clinically validated combination for improving leg lifting.

Watch Pulse in Action: Leg Lifting & Stepping

See how Pulse can be incorporated into leg-lifting and stepping exercises.

In this demonstration, a woman wears one Pulse Device over her quadriceps and another over her tibialis anterior while practicing controlled leg movements.

The video illustrates how targeted vibration can be incorporated into intentional movement exercises.

https://www.instagram.com/p/DeHnE91s_DP/

This video demonstrates one example of Pulse being used during movement practice. Individual experiences may vary.

3. Recommended Pulse Settings

Option 1: Muscle Engagement During Movement

App setting: Performance → Select Target Muscle

Placement: Quadriceps and tibialis anterior.

This setting can be explored while practicing intentional leg lifting, knee control, and ankle dorsiflexion.

Start at a low, comfortable intensity that provides noticeable vibration without interfering with movement.

Option 2: Sensory Awareness

App setting: Rehab → Sensory Feedback & Tissue Health → Indirect

Placement: Quadriceps and/or tibialis anterior.

This option may be useful to explore when the primary goal is additional sensory feedback and awareness of leg positioning during movement.

Getting Started: Begin with comfortable settings and progress gradually based on individual tolerance and professional guidance. The recommended settings are exploratory options, not a clinically validated protocol.

4. Exercises to Try

Exercise 1: Seated Marching

Goal: Practice controlled leg lifting in a stable, supported position.

1. Sit comfortably in a sturdy chair with your feet resting on the floor.

2. Position Pulse over the quadriceps and tibialis anterior.

3. Activate your selected comfortable setting.

4. Slowly lift one knee upward, bringing the foot slightly off the floor.

5. Lower the foot back down with control.

6. Repeat 5–10 times, or as comfortably tolerated.

Focus: Pay attention to the sensation of the vibration and the movement of your thigh, knee, and foot.

If lifting the entire leg is difficult, begin with small, comfortable movements or therapist-assisted variations.

Exercise 2: Supported Standing Marches

Goal: Practice lifting the leg while maintaining balance and postural control.

1. Stand near a sturdy handrail, countertop, or other stable support.

2. Hold the support securely with your hands.

3. Position Pulse over the quadriceps and tibialis anterior and activate the selected setting.

4. Slowly lift one knee upward as though marching in place.

5. Keep the movement controlled and avoid leaning excessively backward or sideways.

6. Lower the foot gently to the floor.

7. Repeat for a few comfortable repetitions, resting as needed.

Focus: Concentrate on lifting the leg intentionally while maintaining stability.

Safety Tip: If standing balance is limited, perform this exercise only with appropriate assistance from a physical therapist or trained caregiver.

Exercise 3: Supported Obstacle Stepping

Goal: Practice lifting the leg high enough to clear a small obstacle during controlled stepping.

1. Choose a flat, non-slip surface with a sturdy handrail or other fixed support.

2. Begin with a very low, soft, collapsible obstacle, such as a foam strip or low therapy hurdle approved by your therapist.

3. Position Pulse over the quadriceps and tibialis anterior.

4. Activate your selected comfortable setting.

5. While holding the support, slowly lift your leg and move your foot over the obstacle without touching it.

6. Place your foot securely on the other side.

7. Pause to regain stability before returning to the starting position or taking another step.

8. Repeat a few times, resting as needed.

Focus: Pay attention to lifting the leg, positioning the foot, and clearing the obstacle with control.

Important: If you have difficulty clearing your foot, catching your toes, or maintaining balance, do not attempt obstacle stepping independently. Work with a physical therapist who can provide hands-on assistance and select an appropriate obstacle height.

Progression: Once the movement is consistently safe and comfortable, your therapist may gradually adjust the obstacle height or stepping pattern.

5. Tips for Getting the Most Out of This Routine

• Prioritize stability: Use a sturdy handrail or fixed support when practicing standing and stepping movements.

• Start small: Begin with seated leg lifting before progressing to supported standing exercises.

• Focus on movement quality: Controlled, intentional movements are more important than lifting the leg as high as possible.

• Pay attention to sensory feedback: Notice how your thigh, shin, and foot feel during each movement.

• Avoid rushing: Give yourself time to complete each step safely.

• Follow professional guidance: A physical therapist can help determine appropriate placements, settings, exercises, and progression.

• Stop if needed: Discontinue the exercise if you experience pain, dizziness, increased muscle tightening, fatigue that affects control, or worsening balance.

Important Safety Information

Pulse is a general wellness device and is not intended to diagnose, treat, or cure conditions that affect walking, leg strength, or mobility.

Difficulty lifting a leg or clearing the foot may result from muscle weakness, neurological conditions, reduced joint mobility, or other factors that require professional evaluation.

Individuals with significant weakness, foot drop, impaired balance, or a history of falls should consult their healthcare professional before beginning this routine.

Use a fixed handrail or stable support for standing activities. Walking sticks and canes may be appropriate for some individuals, but they do not provide the same stability as a fixed support and should only be used for obstacle exercises if a therapist determines they are safe.

Do not use obstacles that are rigid, unstable, or high enough to create a significant tripping hazard. Do not remove prescribed braces or mobility aids without clinician approval.

Feel Better. Move Better. With Pulse.