Neuro Rehab techniques: Prone on Elbows, Quadruped and Kneeling Flashcards
What are the objectives for Prone on Elbows?
Improve control at head/neck/upper trunk and UE shoulder stability, trunk mobility and stability, hip extension ROM, lead up for independent position changes, quadruped activities, and floor to stand transfers.
What are the objectives for Quadruped?
Provide a stable position for weight shifting, preparation for standing and walking, relax tone, and engage in UE and LE movements.
What are the objectives for Kneeling?
Use for stability with isometric reversals and rhythmic stabilization, transitional mobility, heel sitting to kneeling, kneel walking, and advanced exercises.
What are the objectives for Half-Kneeling?
Use for stability, greater weight-bearing and stability demands, transitional mobility from kneeling to half-kneeling, and advanced kneeling exercises.
What are the general benefits of Prone on Elbows?
Very stable with a large base of support and low center of mass, opportunity for early weight bearing, and lead up to independent position changes.
What are the general benefits of Quadruped?
Useful for relaxation of tone, weight shifting, and as a lead-up activity to standing and walking or hand and finger activities.
What are the general benefits of Kneeling?
Develops initial upright position, less demanding than standing, reduces fear of falling, and can be a precursor for upright positions and floor transfers.
What are the general benefits of Half-Kneeling?
More stable than kneeling, with a wider base of support, useful for developing upright postural control and as a precursor for standing.
Describe the position for Prone on Elbows.
The patient is prone with the head and upper trunk elevated off the supporting surface, bearing weight on the elbows. UEs are in a bilateral symmetrical position with elbows flexed to 90 degrees under the shoulders.
Describe the technique to assist a patient into Prone on Elbows.
Assist the patient to roll onto their stomach and bring their elbows under them. Support under each arm below the axilla and cup around the anterior aspect of the rib cage.
Describe the position for Quadruped.
The patient is on hands and knees with hips and knees flexed to 90 degrees. Weight is evenly distributed between the hands and knees.
Describe the technique to assist a patient into Quadruped from side-sitting.
From side-sitting, the patient rotates the lower trunk, moving the hips over the knees to assume the quadruped position with assistance or resistance from the therapist.
Describe the technique to assist a patient into Quadruped from Prone on Elbows.
From prone on elbows, the patient ‘walks’ backward on elbows, lifting the hips until over the knees, then weight shifts to one side, straightening the opposite elbow and repeating on the contralateral side.
Describe the position for Kneeling.
The patient is upright with head, trunk, and hips in alignment, weight bearing through hips, knees, and legs. Hips are extended and knees are flexed.
Describe the technique to assist a patient into Kneeling from Heel-Sitting.
From heel-sitting, the patient moves forward into kneeling with support from the therapist on the ischial tuberosities, guiding the patient into an upright position.
Describe the position for Half-Kneeling.
The patient is upright with one hip extended and weight bearing on the stance limb, the opposite hip and knee flexed to 90 degrees with foot flat on the support surface.
Describe the technique to assist a patient into Half-Kneeling from Kneeling.
Shift weight onto one knee and bring the opposite knee up, placing the foot flat on the mat. Elastic bands can be used to assist ankle dorsiflexion and hip/knee flexion.
What are the contraindications for Prone on Elbows?
Elbow pathology, recent chest surgery or trauma, winging of scapula, inability to assume the position due to cardiac precautions, increased tone, or limited mobility.
What are the considerations for Prone on Elbows?
Limited hip extension ROM, shoulder pain or ROM impairments, scapular/shoulder weakness, UE hypertonia. Supports can be used to reduce UE loading.
What are the contraindications for Quadruped?
Presence of wrist, shoulder, or knee pathology that limits weight bearing on those joints.
What are the considerations for Quadruped?
Ensuring even weight distribution, using supports if necessary, and monitoring for excessive tone or pain in the supporting joints.
What are the contraindications for Kneeling?
Rheumatoid arthritis or osteoarthritis affecting the knee, knee joint instability, apophysitis of the tibial tubercle, or recent knee surgery.
What are the considerations for Kneeling?
Monitoring for discomfort or pain, using padding to reduce pressure on patellar tendons, and ensuring adequate strength of trunk and hip extensors.
What are the contraindications for Half-Kneeling?
Similar to kneeling, with additional caution for any instability or pain in the weight-bearing leg.
What are the considerations for Half-Kneeling?
Monitoring for balance and stability, using supports as needed, and ensuring even weight distribution between the knee and foot.
Describe the stabilization techniques for Prone on Elbows.
Stabilizing reversals, rhythmic stabilization with resistance applied to shoulder external rotation to promote scapular stability.
Describe the weight shifting techniques for Prone on Elbows.
Isotonic reversals with lateral weight shifts, facilitating weight shift towards the therapist, and adding isometric holds.
Describe the stabilization techniques for Quadruped.
Isometric reversals and rhythmic stabilization to promote stability in the quadruped position.
Describe the weight shifting techniques for Quadruped.
Forward/backward and side-to-side weight shifts to increase stability demands and prepare for reaching activities.
Describe the stabilization techniques for Kneeling.
Isometric reversals and rhythmic stabilization, maintaining upright posture against resistance.
Describe the weight shifting techniques for Kneeling.
Forward/backward, medial/lateral, and diagonal weight shifts, promoting pelvic motion needed for normal gait.
Describe the stabilization techniques for Half-Kneeling.
Isometric reversals and rhythmic stabilization, holding head and trunk upright with even weight distribution.
Describe the weight shifting techniques for Half-Kneeling.
Isotonic reversals in different directions, facilitating reaching activities while maintaining postural stability.
Describe the movement transition from Quadruped to Heel-Sitting.
From quadruped, move shoulders, hips, and knees into further flexion until buttocks contact heels, with therapist providing resistance on ischial tuberosities.
Describe the movement transition from Heel-Sitting to Kneeling.
From heel-sitting, move forward into kneeling with support on ischial tuberosities, guiding the patient into an upright position.
Describe advanced techniques and progressions for Kneeling.
Weight shifting, reaching, anticipatory balance control, reactive postural control, and activities on compliant surfaces or with therapy balls.
Describe the movement transition from Kneeling to Half-Kneeling.
Shift weight onto one knee and bring the opposite knee up, placing the foot flat on the mat, using elastic bands for assistance if needed.
Describe the movement transition from Half-Kneeling to Standing.
Shift weight onto the foot in front, extend the hips and knees to stand up, using supports as needed for stability and balance.
Describe advanced techniques and progressions for Half-Kneeling.
Weight shifting, reaching activities with weighted balls, anticipatory and reactive balance control exercises.
