Lecture 7-Improving Function-bed mobility, prone, quadruped, hook lying

Question 1

Side lying to prone is minimally ______ by gravity

Answer 1

Assisted

Question 2

Supine is a very stable posture because it has a

____ BOS and _______ COM

Answer 2

Large BOS

Low COM

Question 3

More people roll using what kind of pattern?

Answer 3

Segmental rolling pattern

Question 4

The least common type of rolling pattern is?

Answer 4

Log-rolling pattern

Question 5

What are the common strategies to generate momentum in rolling? (Due to trunk weakness)

Answer 5

1. Lifting upper or lower extremities up and across the body (reaching across)
2. Positioning 1 LE in hip and knee flexion with foot flat to push uff
3. From prone to supine use flexed abducted UE to push off
4. Head positioning-body will follow the head so incorporate head/neck movements

Question 6

Should you start with large or small movements when rolling?

Answer 6

Small movements

Question 7

What is rhythmic initiation? And what is it used for in rolling?

Answer 7

Passive-active assistive-resisted-independent

-used to instruct the patient desired movement and facilitate initiation of movement

Question 8

What is replication? And what is it used for in rolling?

Answer 8

Passive to end range-hold against resistance-active movement

-used to teach the end result of a movement and improve coordination

Question 9

What is dynamic reversals? And what is it used for in rolling?

Answer 9

Active concentric movement in one direction followed by active movement in reverse direction without relaxation & add resistance in both directions

-to progress from small range to full-range control (full prone to full supine)

Question 10

How can you increase the BOS in side lying?

Answer 10

Flexing either LE

Question 11

What are the different techniques to improve trunk strength/stability/control in side lying?

Answer 11

• Stabilizing reversals
• rhythmic stabilization
• upper or lower trunk rotation with dynamic reversals
• trunk counter rotation using rhythmic initiation

Question 12

Prone extension (pivot prone) has a ______BOS and _____COM with ______WB

Answer 12

Large BOS
Low COM
No WB in any joints

*side note-extremity lifts used for strengthening

Question 13

What may limit pivot prone or prone on elbows?

Answer 13

Hip flexor and lumbar spine tightness may limit assumption and maintenance of position

Question 14

Why may a prone position be contraindicated?

Answer 14

Cardiopulmonary involvement or respiratory weakness as it could compromise their breathing and compress chest wall

Question 15

Prone on elbows has a _____BOS and _____COM

Answer 15

Large BOS
Low COM
Very stable posture

Question 16

What are some considerations when using prone on elbows? (Sorry there’s a lot)

Answer 16

• scapular and/or shoulder weakness
• shoulder pain or limited ROM
• can inc support with pillow under shoulders
• UE spasticity may interfere with positioning (use inhibitory strategies)
• abnormal reflex activity may interfere with patient’s ability to assume or hold position
• contraindications in presence o elbow pathology, recent chest surgery or trauma, cardiopulmonary impairments
• tightness in hip flexion may limit extension
• tightness in thoracic and cervical mobility may also limit alignment
• DJD in spine

Question 17

What are the different stability techniques with prone on elbows? And describe

Answer 17

• Stabilizing reversals: medial/lateral OR ant/post resistance
• rhythmic stabilization: twisting/rotation

Question 18

What are the different controlled mobility techniques with prone on elbows? And describe

Answer 18

-dynamic reversals: medial-lateral or diagonal weight shift
-combination of isotonics: ant-post shifts
Concentric-isometric hole-eccentric control back to starting position
-dynamic reversals: UE D1 thrust and withdrawal pattern
-other limb movements and weight-shifting activities:
Reaching, cone stacking, hitting visual targets

Question 19

Explain what quadruped is? position wise with extremities

Answer 19

Kneeling on all fours, hands and knees

• shoulders and hips flexed to 90
• elbows extended
• knee positioned directly under hips

Question 20

Quadruped has a ______BOS and COM is ____ than prone on elbows

Answer 20

Large BOS

COM is higher than prone on elbows but still low

Question 21

What are the prerequisites for quadruped?

Answer 21

Head/neck control, upper trunk control, UE (shoulder/elbow) control and lower trunk/hip control

Question 22

What are static (holding)/stability activities or techniques for quadruped? And describe

Answer 22

• Stabilizing reversals: medial/lateral resistance, ant/post resistance, diagonal resistance
• Rhythmic stabilization: twisting

Question 23

What are the weight-shifting/controlled mobility activities or techniques for quadruped? And describe

Answer 23

• dynamic reversals: medial/lateral shifts, ant/post shifts, diagonal shifts
• dynamic reversals: movement from quadruped to heel-sitting position (bilateral or one side) && movement from quadruped to side-sitting
• static-dynamic control, upper and lower extremity active limb lift
• Application of PNF patterns: dynamic reversals with UE D2F and D2E or LE D1F and D1E patterns

Question 24

What is a movement that you can do in quadruped with manual resistance or resistance bands?

Answer 24

Creeping

Question 25

Hook-lying has a _______BOS and ____COM & is controlled by?

Answer 25

Large BOS and low COM & is controlled by lower trunk, hips and knees Very stable

Question 26

Hook lying is important for what?

Answer 26

Lead up activities for controlled bridging, kneeling, and gait

Question 27

What can alter the hook lying position stability?

Answer 27

Shoulder abd to 90 vs arm crossed at chest

Question 28

What are static techniques for hook lying?

Answer 28

- static hold of position | - stabilizing reversals

Question 29

What are lower trunk rotation activities in hook lying?

Answer 29

- rhythmic initiation - replication - dynamic reversals

Question 30

Explain bridging moving from the hook lying position

Answer 30

Bridging involves extending the hips and elevating the pelvis from the support surface with the lumbar spine in neutral position

Question 31

Why is bridging important?

Answer 31

- prerequisite requirement for moving in bed and for moving to edge of bed - lead up activities for later functional activities

Question 32

What are considerations for bridging?

Answer 32

- allows early WB at foot and ankle without full body weight - breath holding is common so breathing should be closely monitored - elevating hips higher than head may be contraindicated with patients with uncontrolled HTN or elevated ICP - abnormal reflexes may interfere with assumption or maintenance of posture - bridging promotes selective control and may be indicated for patients recovering from stroke who demo abnormal mass movement synergies

Question 33

What are interventions/activities for bridging? (There's a lot)

Answer 33

- Stabilizing reversals:ant/post resistance & medial/lateral resistance - rhythmic stabilization - active pelvic shifts:lateral movement - bridge and place - combination of isometrics - Bridging and single leg lifts - bridging and alternating leg lifts Or marching - bridging with mobile base of support - modified bridge: static and dynamic activities using ball under upper trunk

Question 34

Supine side lying is minimally _____ by gravity?

Answer 34

Resisted