NSF guidelines Retraining Everyday Activities

Question 1

What are the NSF guidelines for retraining standing?

Answer 1

B - task specific training with feedback

Question 2

What are the NSF guidelines for retraining sit to stand?

Answer 2

A - repetitive task specific training (moderate benefit) with biofeedback (some evidence)

Question 3

What are the NSF guidelines for retraining walking?

Answer 3

A - tailored repetitive task specific practice of walking or components of walking
One or more of:
B - cueing of cadence
B - mechanically assisted gait

Question 4

What are the NSF guidelines for retraining reaching and manipulation?

Answer 4

A - CIMT in selected people 
B - repetitive task specific training 
B - mechanically assisted training 
One or more of:
B - mental practice 
C - EMG biofeedback plus conventional therapy 
C - ES 
C - mirror therapy 
C - bilateral training

Question 5

What are the common KDs in standing?

Answer 5

Decreased ability to maintain an erect trunk and falling to affected side
Decreased WB on affected side and CoM towards unaffected side
Decreased hip E
Decreased knee E
Excessive co-activation of LL muscles, rather than activating in a directionally specific manner
Delayed or absent response to perturbations
Delayed stepping response

Question 6

What are the common KDs in sitting?

Answer 6

Decreased ability to maintain an erect trunk
Decreased WB on affected side
Decreased ability to reach beyond arm’s length or to the affected side

Question 7

What are the common KDs in sit to stand?

Answer 7

Decreased ankle DF for initial foot placement
Decreased fwd trunk inclination with trunk in E
Decreased WB on affected leg in preparation for standing and in final standing alignment
Decreased hip E, knee E and ankle PF in final standing alignment
Changed muscle activation patterns

Question 8

What are the common KDs in walking?

Answer 8

Decreased ankle DF at IC to TO
Decreased knee E or increased Knee hyperE in MS
Decreased hip E in MS to TO
Decreased ankle PF at end of stance
Decreased or increased lateral pelvic shift at IC to MS
Decreased ankle DF in early swing
Decreased hip F in early to mid swing
Decreased knee E in swing
Shortened stance on affected leg and increased propulsion of unaffected leg to shorten swing phase
Decreased propulsion of affected leg prior to swing, compensatory circumduction or pelvis elevation
Asymmetrical step length
Increased step width

Question 9

What are the common KDs in reaching and manipulation?

Answer 9

Reaching:
Decreased shoulder fwd F
Decreased shoulder Ex R
Decreased elbow E
Decreased forearm supination
Manipulation:
Decreased wrist E
Decreased MCP F or E (with IPs in E)
Decreased thumb opposition
Decreased finger 4/5 opposition
Decreased force through finger 2 (with IPs in F)
Decreased modification of force through fingers
Decreased individual finger movements
Arm movements slow, jerky, less direct, less well timed, often involve trunk movement
Hand movements have a wider aperture than required

Question 10

What are the NSF guidelines for retraining sitting?

Answer 10

B - practice reaching beyond arm’s length in sitting