Lab (rebby) Flashcards
Use your hands _____
wisely
Avoid touching the ball of the foot because _____
It stimulates PF
Avoid touching the plantar aspect of the heel because _____
It stimulates DF
Avoid touching the plantar aspect of MTP 1, Calcaneus, and Navicular because _____
It stimulates Inversion
Touching the plantar aspect of MTP 5, Cuboid, and Calcaneus because _____
It stimulates Eversion
Where can the PT place their hands on the patient’s foot?
- lateral border of 5th metatarsal
- plantar surface of lateral four toes
(don’t fight me, it’s on the document)
What is the purpose of half-bridging?
- To facilitate co-contraction around the hip and better placing responses in the leg with increased WB into the foot
What is the purpose of bridging?
- To develop proximal control of the body and improve functional potential for bed mobility –> selective movements of LE
Which principle of Neurophysiological Basis (from Lecture 3) can we connect Timing for Emphasis to?
Irradiation: maximum effort of stronger muscles within a pattern facilitate or overflow into weaker muscles
When bridging, when side do you put greater pressure on when using timing for emphasis?
The less affected side/stronger side
When bridging, what side do you perform successive quick stretches when performing primitive repeated contractions?
The involved side/weaker side
What is this an example of:
Resisted ABDuction on the strong side will reinforce ABDuction on the weaker side?
Ramiste’s phenomen (irradiation)
You cannot superimpose _____ _____ on abnormal postural alignment.
Normal Movements
What is faded feedback?
Feedback given at first after every trial, and then less frequently
What is Bandwidth Feedback?
Feedback given only when performance is outside a given error range
____ should be under knees for sitting activities.
____ should be under knees for transfers/standing.
Heels should be under knees for sitting activities.
Toes should be under knees for transfers/standing.
To facilitate Anterior Pelvic Tilt, presence of adequate PROM of what (2) things are required?
1) Lumbar extension
2) Hip flexion greater than 90 degrees (newer NDT courses refer to hip flexion when the femur is fixed as “anterior rotation of the pelvis on the femur”
What are 3 ways for UE to be in WB?
1) Mat
2) Thighs/knees
3) Pillow
Is there a functional purpose for performing the anterior pelvic tilt?
Preparing for Sit-to-Stand
When the PT is facilitating a patient performing lateral shift to the RIGHT, the patient’s Right side is ______ and the Left side is ______.
Elongating
Shortening
After performing any kind of weight shift, we must emphasize ______
Midline orientation
When performing weight shifts, why do we shift to the more involved side first (or the side the patient tends not to bear sufficient weight through)?
- Involved side = weaker = easier to LENGTHEN on that side and to SHORTEN on the strong side
- If we did shift to the strong side, it will be harder for the weak side to shorten and then hard to eccentrically lengthen as well as we move to midline
What are the 3 purposes of trunk mobilization?
- To gain flexibility
- To prepare the patient’s body to be able to learn a movement or function
- To release spasticity by stretching muscles and/or moving joints
During lift-off (aka STS), if your patient’s ankle is dorsiflexing, their center of gravity is too far _______
Posterior
During lift-off (aka STS), if your patient’s ankle is plantarflexing, their center of gravity is too far _______
Anterior
When scooting (or other transfers) do not resort to placing your hand ____ unless they are max assist BECAUSE the patient will sink more into your HAND
under their glutes
so stay ABOVE their pelvis
With the anterior scoot, you can use the Lift-Off Method if they have _____ ____ tightness
Plantar flexors
The scoot transfer provides more opportunity for appropriate and symmetrical ____ _____
Weight bearing
- Improved quality of Tone w/ WB
- Facilitation of voluntary control w/ WB
What 4 things does a patient need for squat/scoot transfers?
- Dynamic trunk w/ anterior weight shift
- UE in WB
- LE and hips angled so that knees point away from the surface the patient is going towards
- Feet appropriately positioned for dynamic activity
What is the therapeutic goal for a scoot transfer?
Multiple repetitions in a controlled WB environment to promote recovery
What is the rationale for a modified stand pivot transfer?
Provides an alternate method when time and/or space is limited
Difference between squat and scoot transfer?
Squat: the pt is transferred in 1 movement once prepared by the PT
Scoot: as many repetitions are emphasized for therapeutic activity
What are the 4 PNF stages of motor control?
1) Mobility
2) Stability
3) Controlled Mobility
4) Skill
What PNF stage would we use the 2 techniques we learned from bridging? (Timing for emphasis/Primitive Repeated contractions)
Mobility or Controlled Mobility
Which PNF technique did we learn for stability?
Reversal of Isometrics (aka Alternating Isometrics)
Rhythmic Stabilization
What is PNF commandment we use to facilitate Stability?
Approximation
What PNF technique did we learn for Mobility/Controlled Mobility?
Rhythmic Initiation – > Slow Reversals
What PNF commandment do we use to signal a change in direction for Mobility techniques?
Quick Stretch
Lecture Review: What are the 7 Commandments of PNF?
- Manual Contacts
- Commands/communication
- Stretch
- Traction/Approximation
- Maximal Resistance
- Normal Timing
- Reinforcement
PTs can help to assist in lateral weight shift in people with pusher syndrome towards ____ _____ side
Less Involved
What is the PT’s position (assuming there’s a ball and a tech) for a Pusher’s patient?
Posterior and to a more involved side
In severe Pusher’s syndrome, we can use a ___ to block plantarflexion
stiff AFO
In quadruped, if the pt has high tone in their hand, _____
they may need help holding their hand flat
In quadruped, if the patient has a difficult time extending their wrist at 90 degrees, how can we help?
Place their hands over the edge of the bed to allow fingers to curl around the side
Place their hands on a half roller/bolster
From kneeling to half-kneeling, do we want the pts strong side on the up or on the down side?
Depends what we emphasize
- strong side UP = hip extension on weak side = working on midstance and weight acceptance
- weak side UP = pt may be able to initiate hip flexion but toes/ankle may get stuck
What a combo special SPECIAL technique that we can use in standing?
Slow Reversal HOLD
Purpose: controlled mobility & add hold to reinforce stance phase of gait
Progression
* Push forward –> Hold, hold, hold (stand tall on front leg) –> Quick stretch (on back) –> Pull back –> Hold, hold, hold (stand tall on back leg) –> Quick Stretch
