Lecture 7-Improving Function-bed mobility, prone, quadruped, hook lying Flashcards
Side lying to prone is minimally ______ by gravity
Assisted
Supine is a very stable posture because it has a
____ BOS and _______ COM
Large BOS
Low COM
More people roll using what kind of pattern?
Segmental rolling pattern
The least common type of rolling pattern is?
Log-rolling pattern
What are the common strategies to generate momentum in rolling? (Due to trunk weakness)
- Lifting upper or lower extremities up and across the body (reaching across)
- Positioning 1 LE in hip and knee flexion with foot flat to push uff
- From prone to supine use flexed abducted UE to push off
- Head positioning-body will follow the head so incorporate head/neck movements
Should you start with large or small movements when rolling?
Small movements
What is rhythmic initiation? And what is it used for in rolling?
Passive-active assistive-resisted-independent
-used to instruct the patient desired movement and facilitate initiation of movement
What is replication? And what is it used for in rolling?
Passive to end range-hold against resistance-active movement
-used to teach the end result of a movement and improve coordination
What is dynamic reversals? And what is it used for in rolling?
Active concentric movement in one direction followed by active movement in reverse direction without relaxation & add resistance in both directions
-to progress from small range to full-range control (full prone to full supine)
How can you increase the BOS in side lying?
Flexing either LE
What are the different techniques to improve trunk strength/stability/control in side lying?
- Stabilizing reversals
- rhythmic stabilization
- upper or lower trunk rotation with dynamic reversals
- trunk counter rotation using rhythmic initiation
Prone extension (pivot prone) has a ______BOS and _____COM with ______WB
Large BOS
Low COM
No WB in any joints
*side note-extremity lifts used for strengthening
What may limit pivot prone or prone on elbows?
Hip flexor and lumbar spine tightness may limit assumption and maintenance of position
Why may a prone position be contraindicated?
Cardiopulmonary involvement or respiratory weakness as it could compromise their breathing and compress chest wall
Prone on elbows has a _____BOS and _____COM
Large BOS
Low COM
Very stable posture
What are some considerations when using prone on elbows? (Sorry there’s a lot)
- scapular and/or shoulder weakness
- shoulder pain or limited ROM
- can inc support with pillow under shoulders
- UE spasticity may interfere with positioning (use inhibitory strategies)
- abnormal reflex activity may interfere with patient’s ability to assume or hold position
- contraindications in presence o elbow pathology, recent chest surgery or trauma, cardiopulmonary impairments
- tightness in hip flexion may limit extension
- tightness in thoracic and cervical mobility may also limit alignment
- DJD in spine
What are the different stability techniques with prone on elbows? And describe
- Stabilizing reversals: medial/lateral OR ant/post resistance
- rhythmic stabilization: twisting/rotation
What are the different controlled mobility techniques with prone on elbows? And describe
-dynamic reversals: medial-lateral or diagonal weight shift
-combination of isotonics: ant-post shifts
Concentric-isometric hole-eccentric control back to starting position
-dynamic reversals: UE D1 thrust and withdrawal pattern
-other limb movements and weight-shifting activities:
Reaching, cone stacking, hitting visual targets
Explain what quadruped is? position wise with extremities
Kneeling on all fours, hands and knees
- shoulders and hips flexed to 90
- elbows extended
- knee positioned directly under hips
Quadruped has a ______BOS and COM is ____ than prone on elbows
Large BOS
COM is higher than prone on elbows but still low
What are the prerequisites for quadruped?
Head/neck control, upper trunk control, UE (shoulder/elbow) control and lower trunk/hip control
What are static (holding)/stability activities or techniques for quadruped? And describe
- Stabilizing reversals: medial/lateral resistance, ant/post resistance, diagonal resistance
- Rhythmic stabilization: twisting
What are the weight-shifting/controlled mobility activities or techniques for quadruped? And describe
- dynamic reversals: medial/lateral shifts, ant/post shifts, diagonal shifts
- dynamic reversals: movement from quadruped to heel-sitting position (bilateral or one side) && movement from quadruped to side-sitting
- static-dynamic control, upper and lower extremity active limb lift
- Application of PNF patterns: dynamic reversals with UE D2F and D2E or LE D1F and D1E patterns
What is a movement that you can do in quadruped with manual resistance or resistance bands?
Creeping
Hook-lying has a _______BOS and ____COM & is controlled by?
Large BOS and low COM & is controlled by lower trunk, hips and knees
Very stable
Hook lying is important for what?
Lead up activities for controlled bridging, kneeling, and gait
What can alter the hook lying position stability?
Shoulder abd to 90 vs arm crossed at chest
What are static techniques for hook lying?
- static hold of position
- stabilizing reversals
What are lower trunk rotation activities in hook lying?
- rhythmic initiation
- replication
- dynamic reversals
Explain bridging moving from the hook lying position
Bridging involves extending the hips and elevating the pelvis from the support surface with the lumbar spine in neutral position
Why is bridging important?
- prerequisite requirement for moving in bed and for moving to edge of bed
- lead up activities for later functional activities
What are considerations for bridging?
- allows early WB at foot and ankle without full body weight
- breath holding is common so breathing should be closely monitored
- elevating hips higher than head may be contraindicated with patients with uncontrolled HTN or elevated ICP
- abnormal reflexes may interfere with assumption or maintenance of posture
- bridging promotes selective control and may be indicated for patients recovering from stroke who demo abnormal mass movement synergies
What are interventions/activities for bridging? (There’s a lot)
- Stabilizing reversals:ant/post resistance & medial/lateral resistance
- rhythmic stabilization
- active pelvic shifts:lateral movement
- bridge and place
- combination of isometrics
- Bridging and single leg lifts
- bridging and alternating leg lifts Or marching
- bridging with mobile base of support
- modified bridge: static and dynamic activities using ball under upper trunk
Supine side lying is minimally _____ by gravity?
Resisted
