Lecture 8-Improve Function-sitting And Kneeling Flashcards
During normal sitting how is weight distributed?
Equally over both buttocks with pelvis in neutral position or tilted slightly anteriorly
What increases sitting BOS?
Using one of both hands for support
What are common deficits in sitting?
- Alignment
- weight bearing
- extensor muscle weakness
What is the most important thing to do when the patient is in sitting? And why?
make sure the patient feels safe!! (FEET ON GROUND)
-will prevent injury and decrease anxiety & fear
What are the 3 instructions when teaching sitting?
- give the patient a reference of correctiveness
- focus their attention on a task
- improve sensory awareness of correct posture (sit up tall like me)
What are different techniques to improve stability and control with sitting?
- static sitting
- stabilizing reversals
- rhythmic stabilization
What are different techniques to improve controlled mobility in sitting?
- 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)
Sitting has a ____COM and _____BOS
Moderate high COM
Moderate BOS
What are other activities in sitting?
- 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
The head and hip relationship move in what direction?
OPPOSITE
What is a benefit of kneeling? And what is it useful for?
- 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
In what direct is posture more stable in?
Posteriorly than anteriorly
*be in front of the patient!
Kneeling/half kneeling has a _____COM (compared to standing)
Low cOM (higher than quad)
Why might kneeling/half-kneeling be contraindicated?
-RA, OA, knee joint instability, recovery from recent knee surgery
Prolonged kneeling provides strong inhibitory influence through WB on what?
Patellar tendon
kneeling can dampen what?
Hypertonicity for patients with LE extensor spasticity
What are the different techniques for stability in kneeling?
- active holding
- stabilizing reversals
- rhythmic stabilization
What are the different techniques for controlled mobility in kneeling?
- active weight shifting
- dynamic reversals
What are some movement transition activities in kneeling?
- 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)
What are some balance activities in half-kneeling and kneeling?
- manual perturbations (nudges)
- kneeling on unstable dynamics or foam pad
- UE activities: ball toss, cone stacking, activity of interest to patient
What are some activities or interventions in half-kneeling?
- active holding
- stabilizing reversals
- weight shifting with diagonal shifts using dynamic reversals