Lab Midterm Flashcards
hands at met heads/ball of foot facilitates
PF
hands at heel/calcaneus facilitates
DF
hands at navicular and 1st met head fascilitates
inversion
hands at 5th met heads, cuboid, lateral calcaneus facilitates
eversion
how to facilitate hooklying with LE
use hand at lateral border of 5th met with finger pads to facilitate eversion OR
index & middle finger on plantar surface of lateral 4 toes –> eversion
when would it be contraindicated to do bed mobility with the bed flat?
pt with EG tube
swelling precautions
If the direction of the therapist’s pressure is such that that the patient’s femur aDducts, what functional activity is being facilitated?
rolling
If the direction of the therapist’s pressure is such that that the patient’s femur aBducts, what functional activity is being facilitated?
standing (gait prep)
how can trapping be beneficial?
hold weak foot with strong
prevent overuse of less involved
encourage WB through involved
draw sensory awareness & attention to involved
how to progress 1/2 and full briding
timing for emphasis and primitive repeated concrations
T/F: it can be very hard to ween a pt from a more supportive AD
T
which principle is used with timing for emphasis during bridging to facilitate the more involved LE?
irradiation
what is Raimiste’s phenomena?
- resisted ABD on the strong side will reinforce ABD on the weaker side
- resisting ADD on the strong side will “irradiate” to ADD on the weak side
what compensation should you look for when doing Raimiste’s phenomena?
excessive lordosis
ensure no breaks are given between switching ab and ad
T/F: neuro pts always have weak hips
T
how should pt be positioned for scooting?
banana shape
it is easier to roll towards to _____ side
affected
where should PT always be when rolling?
on the side toward which the pt is rolling
how to cue core engagement during bed mobility?
lift chin
how to facilitate abs when sitting up?
downward pressure with thumbs at clavicle
reach across to opposite knee
lift head
how to align uninvolved pelvis after pt just sat up?
facilitate trunk shortening
what does maintaining the more involved scapula in protraction and depression help with when supine to sit?
head righting and protecting involved arm
Once hips are ____ and feet are _______, it is easier to bring the trunk into erect sitting
flexed
completely off the bed
considerations for supine to sit if extension synergy
- Keep involved leg as flexed as possible throughout
- Trap involved foot with uninvolved
when scooting back, if the pt ankles DF, the COG is too far _____
posterior
when scooting back, if the pt ankles PF, the COG is too far _____
anterior
what type of pressure is given to cue pt to lift bottom when scooting back?
approximation pressure at hips
what does PT’s leg do during scooting back?
give pressure to push back
Scooting and weight shift unilaterally is pre _____
gait
lift off (bilateral) is pre ____
standing
why is there less chance of falling with a scoot transfer?
pt COG is kept lower than stand pivot
what does the pt need for scoot transfer?
- Dynamic trunk with anterior weight shift
- Upper extremities in weight bearing
- Lower extremities and hips angled so that knees point away from surface patient is going towards
- Feet appropriately positioned for dynamic activity
T/F: The squat/scoot transfer represents a lower level of function than a stand pivot transfer.
F
From a “forced use” perspective, to which side should the patient be transferring most frequently?
towards weak side
leg hold for modified stand pivot transfer
anteriolateral aspect of patient’s tibia with anterio-lateral aspect of therapist’s tibia
how to do alternating isometric in prone on elbows
- Apply approximation pressure at top of shoulders down to elbows
- Apply resistance to lateral aspect of 1 scapula and medial aspect of other scapula
how to do slow reversals in prone on elbows
- Start with rhythmic initiations
- Weight shift between elbows
- Add resistance during weight shifts
- apply quick stretch for mobility
how to do rhythmic stabilization in quadruped?
apply resistance on opposite shoulder and hip
when is it contraindicated to place a ball under the pt in quadruped?
PEG tube
when is prone on elbows contraindicated?
continuous feed PEG tube
how should the LEs be positioned in kneeling to be more functional?
staggered
from a forced use standpoint, how should pt stand from kneeling?
weaker leg on UP side of half kneeling
what is successive induction (used with standing)?
effort in 1 direction with quick transition overflows successively into next direction
How to set up the environment to optimize the patient’s learning abilities?
base of support
visual inputs
challenging or supportive environment
safety
how to encourage motor learning verbally?
ask questions to pt about performance, feelin weight, etc
use your hands _____
wisely
You cannot superimpose ______ on abnormal _______.
normal movements
postural alignment
The more _____ your hand placements are, the more assistive you are for the patient
proximal
_____& _____feedback are consistent with NDT principles of manual facilitation for motor learning
faded & bandwidth
during trunk mobs, how should the shoulder be positioned?
flexion; humerus anterior to body
if pt has dominant UE synergy, how should UE be positioned with trunks mobs?
hands on PT’s knees to facilitate abduction and ER
PT hand and arm movements for anterior pelvic tilt failitation
hand vertical just above pelvis
pressure mostly with fingers 3 & 4
pressure with palmar side of pink
NO FLEXION OF PINKY
supination and wrist flexion
anterior pelvic tilt:
Apply ___ and _____ pressure;
Little fingers draws ____ and ____ pressure
up and forwards
down and back
a ____ is needed to begin all activities
dynamic trunk
what are the essential components of lateral weight shift?
dynamic shortening on one side followed by elongation on other
lateral weight shift movement should be occurring where
lower trunk
T/F: Always return to midline before starting weight shifts again
T
lateral weight shifts: Shift to patient’s _____ side first
more involved (or to the side through which the patient tends not to bear sufficient weight)
when will you not lateral shift to pt’s more involved side?
Pusher’s syndrome
PNF Stages of Motor Control
mobility
stability
controlled mobility
skill
How can PNF be progressed from a stability exercise to controlled mobility exercise?
add quick stretch for mobility
T/F: rhythmic stabilization has more complex muscle activation than reversals
T
where do patients with Pusher syndrome push?
towards weak side and back
body alignment of pushing side for pusher syndrome
PF and shortened trunk
which side does the swiss ball go on for pusher pt?
strong/uninvolved side
arm position of pushing side on swiss ball
shoulder ER
keep hand off ball
prefer: elbow bent and hand on head
PT position when working with pusher pt with swiss ball
posterior and to more involved side
how to prevent pushing when weight shifting with pusher pt
stop at midline or just before
1st cue to give when sitting from standing
bend knees
the hands should be ___ than the elbows when doing a sit to stand with a table
lower
the elbows should be ___ to the body when doing a sit to stand with a table
anterior
how to prevent synergy from occurring at UE when doing a sit to stand with a table
widely spaced hands (ER, abduction)
stand to sit:
facilitate ____ pelvic tilt
once knee flexed, facilitate dynamic ___ & ___
posterior
trunk & leg
pre-gait sequence for stance phase
1) proper positioning
2) bilateral knee flexion
3) lateral weight shift w/ reciprocal knee bend (hold at midline)
4) unweight strong leg & heel out, toe out
5) weight shift to weak leg & step with strong
6) A/P weight shifts in stride position
7) step back with strong even with weak
8) step behind weak in staggered
9) step strong even with weak
10) step strong behind weak
11) full swing with strong
pre-gait sequence for swing phase
start in pre-swing with less involved forward
1) weight shift anterior keeping back foot on floor
2) facilitate pelvic drop, knee flexion, PF
3) graded extension and flexion of involved knee in stride
4) assist sliding foot forward
5) step forward with involved
which position is a critical position for swing phase pre-gait sequence?
trailing limb
forced use when turning
pivot on involved LE and step around with less involved
Active training ingredients for Neuroplasticity/Motor learning
task-specific training
repetitive practice
intensity
saliency
