Mechanics, Analysis and Training of Sitting and Standing Flashcards
Important components: sitting
- Feet and knees close together
- Head balanced on level shoulders
- Weight evenly distributed
- Flexion of hips with extension of trunk
Important components: reaching in sitting
- Shifts head, arms, trunk (HAT) towards object by moving at the hip
- Loads foot/feet ipsilateral to direction of reach
Adaptive strategies: sitting and reaching in sitting
- Widens BoS (use of arms, externally rotated hips, knees/feet wide)
- Shifts onto intact foot/buttock
- Flexes forwards in side reaching tasks
- Shuffles feet
- Uses arms for balance prematurely
- Avoids threats to balance (holding stiffly, holding breath)
How do we assess for impairments in sitting/reaching in sitting?
- Timed unsupported sitting
- Item 3 of MAS
- Reach distance (25cm straight w/ 90 shoulder)
What is the effect of foot placement on reaching in sitting?
We can reach further when both feet are on the floor. An intervention appropriate for foot placement is to have the feet supported, the feet pointing forward and a little apart, and ankles slightly dorsiflexed
What is the effect of targets on sitting?
The target distance and nature of target (press vs grasp) changes the vertical force through the feet. As reach distance increases, there is increased loading through the feet. An appropriate intervention for targeting involves three aspects:
- Reach distance
- Reach direction
- Nature of task
What is the effect of thigh support on sitting?
Decreased thigh support increases the difficulty of a task. An appropriate intervention for support would be to vary the amount of thigh support through a movement
Important components: standing
- Feet a few inches apart
- Head balanced on level shoulders
- Weight evenly distributed
- Hips in front of ankles
Important components: reaching in standing
- Shifts HAT and legs towards the object by moving at the ankle
- Loads feet/foot ipsilateral to direction of mvoement
Adaptive strategies: standing and reaching in standing
- Widens BoS (feet wide, externally rotated hips)
- Shifts weight at hips and/or protracts shoulder instead of moving at ankles when forward reaching
- Moves trunk instead of hips and ankles when side reaching
- Takes premature step
- Shuffles feet
- Uses arms for balance prematurely
- Avoids threats to balance (holds stiffly, holds breath)
What is the effect of external support on standing?
Rails and harnesses impact the work level for different muscles, making the arms work harder than legs. Interventions should only use external support if absolutely necessary
What is the effect of foot position on standing?
By varying the base of support size, we promote flexibility. Parallel and tandem stances are also good for this. By decreasing the base of support we increase the difficulty of standing. An appropriate intervention for foot position involves having the feet pointed forwards about 10cm apart works as it constrains the base of support
