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Neuro Eval > Final - Sitting/ Sitting Balance > Flashcards

Final - Sitting/ Sitting Balance Flashcards

1
Q

4 Major Goals for Siting

A
  • Stable static sitting balance (be aware of initial conditions, optimize)
  • Trunk postural adjustments for maintenance of balance
  • Trunk postural adjustments for restoration of balance
  • Combining trunk and extremity movement to accomplish seated tasks or for transitional movements such as transfers and preparation for sit to stand
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2
Q

Stable sitting position

A
  • LOS greater than in standing
  • COG is lower, BOS is higher
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3
Q

What is sitting LOS affected by?

A

thigh support, feet support, UE support

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4
Q

48% of patients following CVA cannot do what at the start of rehab?

A

sit independently

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5
Q

the greater the sitting deficit…

A

the lower the functional scores at discharge are likely to be

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6
Q

What we want for initial conditions of sitting?

A
  • normal postural alignment
  • normal behavioral arousal
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7
Q

What should you do if the patient has decreased attention (depression)

A

provide verbal support, positive goal setting, referral

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8
Q

what should you do if the patient has decreased attention (disinhibition)

A

redirect, ignore, reinforce positive behavior

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9
Q

How can neglect present?

A
  • Failure to report, respond, or orient to stimuli
  • Failure is not due to sensory or motor deficits
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10
Q

What should you do for decreased body orientation?

A

Reorient/recalibrate sensory system, provide movement, provide cues for
midline/vertical

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11
Q

How can alignment/posture affect sitting?

A
  • Spasticity/Tone in extremities and trunk may cause poor sitting posture
  • Flaccid UE may pull body forward or to the side resulting in flexion or lateral flexion
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12
Q

What should you do for weakness/insufficient muscle tone?

A
  • Weightbearing, weight shifting
  • Tactile/Proprioceptive cues, Tapping
  • Isometric holds in sitting posture
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13
Q

What should you do for too much muscle tone

A

Slow stretch
Prolonged traction

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14
Q

What should you do if the initiation is too fast

A

alter your instructions

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15
Q

what should you do if initiation is slowed due to delayed postural adjustments?

A

Practice tasks of increasing difficulty
Maximize BOS to start; provide tactile cues to start
Provide feedback

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16
Q

What should you do if initiation is slowed due to behavioral/cognitive deficits?

A

Break down task
Decreased amount of instructions
Automatic activities

17
Q

What should you do if execution has reduced speed/amplitude

A

Weakness- consider type of contraction; weightbearing, strengthen functionally,
facilitation

18
Q

what should you do if execution has altered direction

A
  • Abnormal synergies- consider where patient is and work to isolate
  • Closed chain activities
  • Bilateral activities
19
Q

Missing components in termination

A
  • typically delayed breaking
  • motor planning
  • use of sensory feedback/information during task
20
Q

what should you do for motor planning deficits in termination

A

practice slow, controlled and less challenging activities

21
Q

what should you do for deficits in termination due to lack of sensory feedback/information during task?

A

Mirror, sensation
Augment, substitute, and predict

22
Q

task requirements for seated reaching

A
  • proactive control: forward weight shifting, lateral weight shifting, scooting
  • reactive control: surface stability
23
Q

Considerations for sitting balance:

A
  • intrinsic and extrinsic factors that influence seated postural control
    -environment, person, and task
  • Consider ability to maintain postural control and make ongoing postural adjustments
24
Q

Normal Postural Alignment starts with good initial conditions:

A
  • Pelvic Position- Weight symmetrically distributed, Pelvis in a neutral position (not retracted),
    Pelvis in neutral or slight anterior tilt
  • Hips and knees flexed in approximately 90 degrees
  • Thigh supported
  • Feet flat on floor (or if unable to reach floor step stool)
  • Upright/midline trunk position
  • Head in upright midline position
  • Behavior/Attention- Consideration of alertness, attentional deficits, agitation
25
Q

anticipatory sitting postural control activities

A
  • anterior weight shifting
  • Lateral weight shifting
  • sitting down to elbow transitions
  • scooting
  • reaching activities
  • addition of tasks

Neuro Eval (18 decks)

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