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Neuromuscular Practice 3.1 > 3 Sit to Stand > Flashcards

3 Sit to Stand Flashcards

1
Q

What are prognostic indicators for sit to stand with hemiplegia?

A
  • Knee extension force
  • Standing balance
  • Symmetry in standing
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2
Q

What are the critical events for STS?

A
  • Flexion Momentum
  • Momentum Transfer
  • Extension
  • Stabilization
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3
Q

What is the requirement for flexion momentum?

A

Initial foot placement backwards (10cm behind knee)

Momentum generation at the trunk

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4
Q

What is the requirement for momentum transfer?

A

Continued flexion of the hips with ankle dorsiflexion

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5
Q

What is the requirement for extension in STS?

A

Sequence lower limb extension (hip, knee, ankle)

  • ankle PF
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6
Q

What is the requirement for stabilization?

A

Ankle strategy

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7
Q

Which activity measures require efficiency in movement?

A
  • 5 times STS (poor efficiency if more than 12sec)
  • Timed Sit to Stand (poor efficiency if more than 4.5 sec)
  • 30 second sit to stand
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8
Q

What activity measures alllow for AD during transtion?

A

TUG

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9
Q

What measure examines ability to transition?

A

Berg Balance

Functional Independence (FIM)

Gross motor function measure, Dimension D (children and peds)

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10
Q

What is proper intensity for STS practice? What are some ways to prepare the system for STS?

A
  • 50-100 reps
  • Aerobic exercise/Mental imagery
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11
Q

What are some feedback priniciples you should use in STS?

A
  • Can use assitance, Extrinsic and intrinsic feedback
    • Must Fade feedback
    • Visual feedback can improve kinematics
  • Moving feet back improves symmetry of movement
  • EMG can be used with spasticity
    *
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12
Q

What are atypical patterns of flexion momentum?

A
  • Insufficient ankle DF (get feet back)
  • Insufficient Trunk momentum (speed/flexion)
  • Reliance on arms
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13
Q

How far is foot placement in flexion momentum?

A

around 10cm behind the knee

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14
Q

What are interventions for poor timing of the TA?

A
  • Rhythmic auditory stimulation
  • FES to TA
  • EMG biofeedback
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15
Q

What are the intervetions for reduced RA activation/Force production?

A
  • Decrease friction (trash bag/socks on tile)
  • Target training
  • FES to TA
  • Seated stool walking
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16
Q

What are interventions for reduced Gastroc-soleus flexibility?

A
  • whole practice with active dynamic stretching
  • HEP for stretching
17
Q

What are interventions for reduced ankle propioception?

A
  • Visual or joint position feedback
  • Target training with eyes open and closed
    • can used tactile cure as target with eles closed
  • Approximation
18
Q

What are interventiosn for excessive Gastroc/soleus activation/spasticity?

A
  • EMG biofeedback while moving feet backwards
19
Q

What are atypical pattersns for inability to generate trunk momentum?

A
  • poor amplitude
  • poor speed
20
Q

What many degrees of flexion is needed for trunk momentum?

A

60

21
Q

What are interventions for cognitive fear of falling in trunk momentum?

A
  • STS exercises
  • PT position in front of patient
  • Part practice
    • postural control off seat at different speeds
    • trunk target training forward trunk momentum change
  • Mental imagery
22
Q

What are interventions for impaired ankle proprioception for trunk momentum?

A

Visual or joint position feedback

Mental imagery pushing through on floor and pulling up the toes

approximation through joint

23
Q

What are interventions for impaired force production of the Rectus femoris and paraspinals in trunk momentum?

A
  • add resistance to increase motor unit recruitment
    • manual or weighted
  • C curve tracking (marking on wall)
    • backwards C
24
Q

What are interventions for impaired fractionation for trunk momentum?

A
  • impaired sequencing of gastric TA
  • Impaired Timing and sequencing of rectus femoris and paraspinals

Intervention

  • Rhythmic auditory stimulation
  • Target training and visual feedback
  • forced use
    • lowering seat height, increase the need for momentum
25
Q

What are atypical movements in momentum transfer?

A
  • Insufficnet flexion of the hip knee ankle
  • Asymmetry in loading
26
Q

How many ROM is needed for the hip knee and ankle in momentum transfer?

A
  • hip 90
  • knee 90
  • ankle 23
27
Q

What interventions are used for reduced force/power of the TA in momentum transfer?

A
  • manual facilitation and approximation to drive knees forward
  • target training to drive knees forward
  • pulling forward on rolling stool with affected limb
28
Q

What interventions would you use for gastroc soleus spasticity for momentum transfer?

A
  • EMG biofeedback
  • FES to TA
    • inhibit gastroc muscle
29
Q

What interventions would you use for reduced limb loading for symmetry in momentum transfer?

A
  • Mental practice (task specific)
  • Forward reach training in sitting for increasedload through affected leg
  • Destabilize stronger LE
  • Place stronger foot FORWARD or on a small step
30
Q

What atypical patterns do you see in extension phase?

A

insufficnet extension of trunk hip knee and ankle

asymmetry in extension

31
Q

What impairments do you see with the extension phase?

A
  • reduced power of glute max, quad femoris and gastoc soleus
  • reduced flexibility of iliopsoas, rectus fem, and hamstrings
32
Q

What are interventions for reduced flexibility of Gastroc Soleus for symmetry in extension?

A

Joint mobs did not improve STS even though it increased ROM

MORE RELATED TO POWER and how fast you can get through ROM

33
Q

What are the impairments for symmetry in extension?

A
  • poor orientation to longitudinal axis of body
  • reduced limb loading
  • gastroc soleus spasticity
  • reduced flexibility of gastroc soleus
34
Q

What is the atypical movement in stabilization?

A
  • Excessive Sway
35
Q

What are the impairments for ankle strategy?

A
  • impaired proprioception (use target AP tib movement EO and EC, approximation of weight shifts, cues to push down into floor, weighted belt, mental imagery)
  • Impaired TA activation
  • Reduced Gastroc Flexibility (mini squats + ankle DF on floor)
  • Impaired timing/sequencing of TA and gastroc (wall sways + vary amplitude)
  • Spasticity

Neuromuscular Practice 3.1 (15 decks)

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