Handling Techniques Flashcards
discuss the assumptions underlying the neurotherapeutic approaches
brain controls movements not muscles
can alter movements by applying specific pattern of sensory stim
CNS in heirarchally organized
recovery from brain damage follows predictable sequence and mimics infantile motor dev
what is phelps muscle education and braces
concept of muscle educ - teach muscle action and braces
unable to move s braces and calipers - to correct deformity, stand and control athetosis
what are the modalities of phelps
15
massage - hypotonic
PROM, AAROM, AROM
resisted motion
conditioned, confused and combined motion
relaxation techniques
reciprocation
balance in sitting and standing in brace
RGR
ADLs
discuss deaver
any AD or brace for amb
eliminate brace components as child’s control improves
indep w/c use
discuss pohl
focus child’s attention on indiv muscles for training
selecting muscles/group to focus
standing: know muscle groups needed
discuss temple fay progressive pattern movements
training of motion according to ontogenetic dev or milestones
5 stages:
prone lying
homolateral stage
contralateral stage
on hands and knees
walking pattern
cant progress if not achieved
discuss plum
strengthening spastic muscles and their antagonists
discuss doman-delecato system
DELIKADO
CO2 inhalation
restriction of fluid intake
= dev of cerebral hemispheric dom or BA 4
whirling and hanging child upside down stims vestib system
discuss karel and berta bobath NDT
RIPs
facilitation of mature postural reflexes
key points of control
sensory-motor exp
dev sequences
all-day management
discuss rood sensory stim and inhib
always adjunct to another technique - bobath + roods for reaching
use of sensory techniques to inhib or faci
ontogenic dev sequence in rood
total flexion in supine
roll over
pivot prone
neck co-contraction
on elbows
all 4s
standing
walking
discuss vojta reflex creeping
trigger reflex zones to faci creeping
resistance and stim on myotomal and dermatomal destrib to faci motion
discuss peto conductive education
conductor + group therapy
usually all-day program
uses rhythmic intention to faci movement - dances
discuss ayres
sensory integ - somatosensory and vestib
modalities:
brushing
deep pressure
joint compression/traction
vibration
vestib stim
ES IS ABNORMAL STIM - AVOID DAPAT
discuss collis neuromotor dev
for CP
focus on child’s mental capacity bcs motor skills beyond dev level are never used
early management - good prog if walks by 2 yo (blecks)
discuss ecclectic therapy general principles
teamwork
early treatment
repetition of motor activity
training and motivation of child and parent
discuss ecclectic therapy specific principles
dev training
treatment of abnormal tone
training of movement patterns
use of afferent stim
use of passive or active movement
faci abnormal and normal overflow
discuss movement science approach
movement arises from ITE - PT as change agent
ability to solve motor probs is present at brith or earlier
disabled infant may only have limited repertoire of actions
early emphasis on erect body positions
methods used in training in movement science approach
instruction and goal identification
feedback and manual guidance
practice and environmental mods
discuss the principles of pedia rehab
from child-centered to family-centered
form deficit/disease based to ability based
habilitation and rehab
focus on perceived weakness of individuals
discuss positioning as therapeutic tool
consider pos that child can engage in feeding, play, dressing, bathing or play
use positioning to evaluate postures and offer solutions to help engage in age-appropriate activities
principles of positioning children
variety of pos options throughout the day
consider pos that enhance function
avoid pos that restricts motion
provide pos that is comfortable
consider safety of child
ensure proper skeletal and body symmetry
recommend pos equipment that provides external trunk stab to faci movement
discuss to motor control model
multidimensional view
analysis from outside - biomechanical and behavioral level
discuss handling techniques
PTs hands or equipment to provide initial support to dec infant’s impediment - gentle and playful
maintain alignment
initiate weight shifts
position and support
aid transitions and directing movements
effective and economical use of the hands
tactile and proprioceptive info
provide stab and control
light pressure: guide movement
firm pressure: control movement
guidelines in handling technique
support should be altered intermittently - allow child to do as much as possible
encourage head and trunk control
in the absence of body part stab PT can support
support can be from proximal to distal
moving support distal = more control from child
lessen support if you want to improve control
discuss prompting
MC technique used to encourage children to perform actions
physical
gestural
verbal
handling technique in spastic pt
(+) spasticity - slowly move proximal joints first and use key points of control
handling technique in hypotonic pt
handle more vigorously
supine is discouraged
