Progression of Therapeutic interventions

Question 1

Basic principles of progression of therapeutic interventions

Answer 1

• what are the functional goals you are addressing
• what are the impairments you need to address
• does the way you plan to address impairments related back to the functional problem
• what are the patients goals/ultimate outcomes

Question 2

Consider patients motor control: mobility

Answer 2

• early movement
• flexibility

Question 3

Consider patients motor control: static postural control

Answer 3

• static stability
• static postures
• stable surface
• quiet environment
• isometric contractions
• extensors

Question 4

Consider patients motor control: Dynamic stability

Answer 4

• static patient in busy environment
• static patient on compliant or moving surface
• moving patient on static surface
• moving patient on compliant or moving surface
• concentric and eccentric contractions: consider functional needs

Question 5

Motor control- transitional mobility

Answer 5

• requires motor planning
• tansition from one posture to another requires concentric and eccentric control
• increase complexity by modifying: environment, surface, adding a task

Question 6

motor control: skill

Answer 6

• locomotion
• functional task
• ADL
• IADL
• participation: work, school, play

Question 7

other parameters to modfiy and progress activity

Answer 7

• intensity/load
• speed
• additional tasks
• predictability: ball, balloon, rebounder
• reps/time
• perturbations

Question 8

intensity/load as parameter

Answer 8

• increase reps: maintain quality of movement/signs of fatigue or pain
• increase resistance: body weight, external weight
• open vs closed chain
• manual resistance: allows you to customize resistance needed in different parts of range, modify for fatigue

Question 9

speed

Answer 9

• increasing speed increases intensity, promotes improved anticipatory and reactive postural control
• decreasing speed can increase need for control of movement and dynamic postural control