Lecture 8-Improve Function-sitting And Kneeling

Question 1

During normal sitting how is weight distributed?

Answer 1

Equally over both buttocks with pelvis in neutral position or tilted slightly anteriorly

Question 2

What increases sitting BOS?

Answer 2

Using one of both hands for support

Question 3

What are common deficits in sitting?

Answer 3

• Alignment
• weight bearing
• extensor muscle weakness

Question 4

What is the most important thing to do when the patient is in sitting? And why?

Answer 4

make sure the patient feels safe!! (FEET ON GROUND)

-will prevent injury and decrease anxiety & fear

Question 5

What are the 3 instructions when teaching sitting?

Answer 5

• give the patient a reference of correctiveness
• focus their attention on a task
• improve sensory awareness of correct posture (sit up tall like me)

Question 6

What are different techniques to improve stability and control with sitting?

Answer 6

• static sitting
• stabilizing reversals
• rhythmic stabilization

Question 7

What are different techniques to improve controlled mobility in sitting?

Answer 7

• active weight shift
• weight shifts with extended arm support
• weight shift with hands on ball
• weight shifts with voluntary limb movement (reaching)
• dynamic reversals (ant/post, lateral, PNF-lift, chop, d1 or d2)

Question 8

Sitting has a ____COM and _____BOS

Answer 8

Moderate high COM

Moderate BOS

Question 9

What are other activities in sitting?

Answer 9

• Manual perturbations
• sitting on a moveable surface
• dual task activities
• sitting on a ball (with feet on floor): UE lifts, LE lifts, head/trunk rotation, marching, “jumping jacks”, kicking a ball

Question 10

The head and hip relationship move in what direction?

Answer 10

OPPOSITE

Question 11

What is a benefit of kneeling? And what is it useful for?

Answer 11

• benefit of achieving improved trunk and hip control without demands required to control knee and ankle
• useful for developing initial upright postural control, hip ext and abd stabilization control required for standing
• floor to stand transfer

Question 12

In what direct is posture more stable in?

Answer 12

Posteriorly than anteriorly

*be in front of the patient!

Question 13

Kneeling/half kneeling has a _____COM (compared to standing)

Answer 13

Low cOM (higher than quad)

Question 14

Why might kneeling/half-kneeling be contraindicated?

Answer 14

-RA, OA, knee joint instability, recovery from recent knee surgery

Question 15

Prolonged kneeling provides strong inhibitory influence through WB on what?

Answer 15

Patellar tendon

Question 16

kneeling can dampen what?

Answer 16

Hypertonicity for patients with LE extensor spasticity

Question 17

What are the different techniques for stability in kneeling?

Answer 17

• active holding
• stabilizing reversals
• rhythmic stabilization

Question 18

What are the different techniques for controlled mobility in kneeling?

Answer 18

• active weight shifting

- dynamic reversals

Question 19

What are some movement transition activities in kneeling?

Answer 19

• combination of isotonics (kneeling to/from bilateral heel sitting & kneeling to/from side sitting)
• heel sitting to kneeling using PNF lift and reverse lift patterns
• resisted progression (kneel walking forward and backward)

Question 20

What are some balance activities in half-kneeling and kneeling?

Answer 20

• manual perturbations (nudges)
• kneeling on unstable dynamics or foam pad
• UE activities: ball toss, cone stacking, activity of interest to patient

Question 21

What are some activities or interventions in half-kneeling?

Answer 21

• active holding
• stabilizing reversals
• weight shifting with diagonal shifts using dynamic reversals