The document discusses proprioceptive neuromuscular facilitation (PNF), a technique developed by Herman Kabat that uses movements and patterns to improve neuromuscular function. It defines key PNF terms and outlines principles such as motor development occurring from head to toe. The basic procedures are described, including manual contacts, stretch, and maximal resistance. Upper and lower extremity diagonal patterns are explained along with their component motions. Rhythmic initiation is also summarized.
This document describes various mat activities (MAT) used in physical therapy. It discusses 9 principles of MAT including concentration, control, fluidity, etc. It then describes different MAT positions and exercises including rolling, prone on elbows, prone on hands, supine on elbows, pull ups, lifting, quadruped position, kneeling, and sitting. The goals of MAT are to facilitate balance, promote stability, mobilize and strengthen the trunk and limbs, and train for functional activities. Details are provided on how to perform several example MAT exercises and positions.
The document discusses the scapulohumeral rhythm, which is the coordinated movement between the glenohumeral joint and scapulothoracic joint during shoulder movement. Specifically, it notes that for every 2 degrees of shoulder abduction or flexion, the scapula upwardly rotates approximately 1 degree. This ratio maintains proper shoulder range of motion and prevents impingement. Clinical issues like frozen shoulder and scapular winging can result from impairments affecting the scapulothoracic joint.
The elbow complex is designed to provide mobility and stability for the hand. It consists of three joints - the humeroulnar joint between the humerus and ulna, the humeroradial joint between the humerus and radius, and the superior and inferior radioulnar joints. These joints allow for flexion-extension, pronation, and supination movements. The elbow is stabilized by ligaments and muscles like the biceps brachi, triceps, and pronators. Common problems affecting the elbow include tennis elbow, golfer's elbow, nursemaid's elbow, and cubital tunnel syndrome.
This document provides an overview of biomechanics of the elbow, including its structure, function, kinematics, muscle actions, and stability mechanisms. It describes the three joints that make up the elbow complex - the humeroulnar joint, humeroradial joint, and proximal radioulnar joint. It details the motions of elbow flexion/extension and forearm pronation/supination, identifying the muscles, ligaments, and bony structures involved in each motion. Common injuries to the elbow from direct stresses and repeated stresses are also summarized.
The document defines and describes various aspects of resistance exercises. It discusses types of muscle contractions like isotonic, isometric and eccentric. It explains principles of resistance training like overload and specificity. It describes adaptations to resistance training including neural, muscular and bone changes. Determinants of resistance training programs are outlined including intensity, time, volume and periodization. Guidelines for progressive resistance exercises and precautions are provided.
The document provides information on functional re-education exercises that progress a patient from lying down positions to standing and walking. It begins with exercises in supine positions like bridging and progresses to side lying, prone, quadruped, sitting and eventually standing and walking. Each position includes descriptions of how to achieve it, example exercises to improve strength, coordination and proprioception, and the functional goals of that position. The overall goal of the functional re-education program is to make the patient independent through systematic strengthening and training of positions and movements.
This document discusses joint mobility and range of motion exercises. It defines types of range of motion including active, passive, and active-assisted. It describes causes of limited mobility like injury, immobilization, or lifestyle. The principles, preparation, and techniques for range of motion exercises are outlined, including positioning, monitoring the patient's response, and moving joints smoothly through their pain-free range. Guidelines are provided for applying range of motion exercises to individual joints. The goals are to maintain joint mobility and function while avoiding further injury.
The document discusses gait and the gait cycle. It defines gait as a person's pattern of walking and notes walking patterns can differ between individuals. The gait cycle is defined as the period from one heel strike to the next heel strike of the same limb. The gait cycle consists of the stance phase, when the foot is on the ground, and the swing phase, when the foot is off the ground. Temporal and distance variables are used to analyze gait, including single limb support time, stride length, and degree of toe out. The document also reviews the kinematics and kinetics of normal gait.
a detailed description on theory behind Strength duration curve, along with procedure for plotting SD Curve and measuring the Rheobase and Chronaxie of the plotted graph.
The document discusses open and closed kinetic chain exercises. It defines an open kinetic chain as having a free distal segment, like in a knee extension where the lower leg can move freely. Open chain exercises isolate single joints with rotary motion in one plane. Closed kinetic chain exercises have both segments stationary, like in a squat where the feet don't move. Closed chain exercises work multiple joints simultaneously and produce linear motion patterns at joints from axial loading. Examples of both open and closed chain upper and lower body exercises are provided.
The document discusses principles of joint mobilization including using lower grades to reduce pain and higher grades to increase mobility. It outlines convex-concave rules for determining glide direction in different joints. Treatment glides are described to improve range of motion in various joints like the shoulder, knee, ankle and elbow. Open-packed positions and grades of movement are also defined. The goal of a joint mobilization treatment is to increase range of motion through appropriate gliding techniques.
A chronicle on muscle strengthening:
MMT is a procedure for the evaluation of strength of individual
muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM.
Joint mobilization refers to a technique of manual therapy by which a therapist applies a brief stretch of 30s or less through traction and gliding along a joint surface.
This document discusses interferential therapy (IFT), a type of electrical stimulation treatment. IFT involves applying two medium frequency currents to generate a low frequency interference current in the tissues for therapeutic effects. It provides pain relief and motor stimulation while avoiding skin irritation experienced with other currents. IFT is indicated for various painful conditions and edema and uses specific frequencies for different treatments, like 1-10Hz rhythmic mode for reducing swelling. Precautions include avoiding direct electrode contact and proper placement to ensure current passes through tissues as intended.
This document discusses posture and postural alignment. It defines posture and describes the development of spinal curvature from birth. Good posture is defined as a position with stability, balance and minimal effort. Poor posture results from deviations from good alignment. Factors like muscles, nerves, reflexes and the central nervous system contribute to postural control. Techniques for assessing and correcting posture include exercises, stretching, strengthening, taping and myofascial release. Maintaining mobility, muscle balance and retraining awareness can help improve poor posture.
The document discusses the principles and techniques of resisted exercise. It describes the overload principle which challenges muscles to perform at a greater level by applying loads that exceed their metabolic capacity. The SAID (specific adaptation to imposed demand) principle states that the body adapts to the specific stresses placed upon it. Resistance can be applied through different ranges of motion including full, inner, outer, and middle ranges. Progressive resistance exercises gradually increase the load over time to continue challenging muscles. Resisted exercises provide benefits like increased strength, endurance, weight management, improved mobility and reduced disease risk.
Joint mobilization is a manual therapy technique used to modulate pain, increase range of motion, and treat joint dysfunctions. It involves passive movement of joints and surrounding soft tissues at varying speeds and amplitudes. There are 5 types of joint movement - roll, slide, spin, compression, and distraction. Mobilization techniques are graded based on amplitude and location within the range of motion. Lower grades are used for pain modulation while higher grades aim to increase mobility. Proper positioning, stabilization, direction, and patient response are important considerations when applying mobilization.
The document describes various mat activities used in functional re-education programs to progressively improve patient independence. It outlines activities like rolling, side-lying, prone-lying, and transitions between positions that mimic normal development sequences. Exercises in each position target improving coordination, balance, strength, and stability. The goal is to teach patients to maintain positions independently and perform movements within positions. Later activities include kneeling, sitting, standing, and parallel bar walking to build up to independent walking.
Re-education means educating something, which is already known by an individual.
Here the patient knows the activities or movements or functions that has, to be performed but due to his ailment or diseased pathology he could not perform it properly.
Range of motion and strengthening exercises are presented. There are two types of range of motion exercises - active done by the patient, and passive done with assistance. Range of motion exercises involve moving each joint through its full range of motion. Muscle strengthening exercises include exercises for the upper and lower limbs like quadriceps setting, gluteal setting, and dangling to prepare patients for ambulation. Exercises are to be done under supervision, with precautions like proper clothing and stopping if the patient experiences discomfort.
This document describes various positions derived from standing that are used in physical therapy. It discusses 15 specific positions including wing standing, low wing standing, bend standing, and lunge standing. For each position, it outlines the muscle activity involved, effects on the body, and therapeutic applications. The overall purpose is to explain how modifications to the basic standing position can achieve different therapeutic goals through changes in balance, range of motion, or muscle engagement.
This document discusses body mechanics and mobility. It defines body mechanics as using correct muscles to safely and efficiently complete tasks without strain. Maintaining proper body alignment and mobility is important to avoid health issues. The document outlines principles of body mechanics for various activities like lifting, pushing, pulling and carrying. It also discusses range of motion exercises and factors that can affect body alignment and mobility such as age, injury and disease.
This document discusses different types of crawling exercises used in physiotherapy. It describes five types of crawls - dog's crawl, low dog's crawl, arm stretch crawl, leg shift crawl, and low 'S' crawl. Each type is explained, including starting position and technique. Crawling exercises are used to improve coordination, endurance, spinal mobility, and control excessive mobility. They also help build reciprocal arm and leg movement like walking. Resistance can be added and different starting positions impact the effects. Crawling provides a safe way to move for those with poor balance.
This document provides descriptions of various standing, kneeling, sitting and lying positions used in kinesiology. It discusses the key muscle groups engaged in each position and their effects and uses. Some of the positions described include standing, stride standing, half kneeling, kneel sitting, prone kneeling, stride sitting and cross sitting. For each one, the document outlines the muscles worked, the biomechanical advantages of the position, and how it can be used for specific exercises.
The document discusses various positions and activities used in functional re-education therapy, including crawling, kneeling, half-kneeling, and getting up from the floor. Crawling builds coordination, stimulates joints, and is a safe way to move. Kneeling establishes vertical alignment and corrects hip and back control. Half-kneeling progresses balance by lifting one leg while supported on the other knee. Getting up from the floor involves transitions from side-sitting or kneeling to standing using chair or bed support.
Starting Position.pptx(Fundamental position or Posture required for physiothe...nidhiagarwal260755
Position is assumed by the body and take movement to come in a equilibrium.
Posture follows movements like a shadow.
Movement- Every movement begin with posture and end with posture.
Posture- Posture is an attitude either with support or without support.
The posture from which movement is initiated are known as standing position.
The movement may be either by active or passive.
STARTING POSITION- The movement either active or passive which comes our body in equilibrium with attitude and with less effort then the position is known as starting position.
There are five types of starting position that is known as Fundamental position. These are:-
Standing
Kneeling
Sitting
Lying
Hanging
This PPT helps the students to learn the different type of postures which are needed to treat the patient. Easy to understand the importance of Starting positions. Easily to understand the muscle effects in different fundamental positions and their benefits
This document provides an overview of body mechanics and basic exercises presented by Dr. George Boghozian. It covers principles of body mechanics, proper lifting techniques, pushing/pulling and carrying objects, and maintaining proper posture. The goal is to teach techniques that conserve energy, reduce stress on the body, and prevent back injuries by keeping the spine in a neutral position. Instructions are given for lifting, pushing, reaching, and carrying objects close to the body to avoid strain. Proper posture is also emphasized, such as keeping the back straight and shoulders back.
In this presentation, we have included transtibial amputation & its management, goals of prosthetic gait training, stages of rehabilitation for transtibial amputees, pre prosthetic rehabilitation, various gait & activity training like applying the prosthesis correctly, balancing on the definitive prosthesis ,specific gait training exercises, functional exercises/activities, advance exercises, & advice and patient education & follow up.
Fon body mechanics, positions, rom exerciseP V GREESHMA
Body mechanics involves coordinating muscles, joints, and posture to maintain balance and reduce injury risk. Proper body mechanics principles include maintaining a stable center of gravity over a wide base of support, keeping the back straight, and lifting objects close to the body. Improper body mechanics can lead to muscle strains, injuries to joints or spine, and increased fatigue. Nurses must follow principles of body mechanics when moving or transferring patients to prevent injuries to both patients and staff.
The document summarizes a session on dynamic warm-ups and sport-specific drills for physical education. It provides descriptions and instructions for 19 low to high intensity dynamic warm-up exercises. It then discusses how to incorporate agility drills and additional activities into physical education lessons to develop students' sport-specific skills and fitness while increasing physical activity levels. The document aims to assist teachers in addressing national physical education standards.
The document summarizes a session on dynamic warm-ups and sport-specific drills for physical education. It provides descriptions and instructions for 19 low to high intensity dynamic warm-up exercises. It then discusses how to incorporate agility drills and additional activities into physical education lessons to develop students' sport-specific skills and fitness while increasing physical activity levels. The document aims to address national physical education standards through lessons focused on improving speed, agility, quickness, and motor skills.
The document provides information on rolling and crawling/creeping movements. It defines rolling as moving forward along a surface by revolving on an axis or repeatedly turning over, and defines crawling as moving slowly on hands and knees while creeping is slow movement by dragging the prone body. The document outlines the typical development sequence of these movements in infants from 2-10 months. It describes mat activities to strengthen muscles and mobilize the body that incorporate these movements in different positions.
Ventilation Perfusion Ratio, Physiological dead space and physiological shuntMedicoseAcademics
In this insightful lecture, Dr. Faiza, an esteemed Assistant Professor of Physiology, delves into the essential concept of the ventilation-perfusion ratio (V˙/Q˙), which is fundamental to understanding pulmonary physiology. Dr. Faiza brings a wealth of knowledge and experience to the table, with qualifications including MBBS, FCPS in Physiology, and multiple postgraduate degrees in public health and healthcare education.
The lecture begins by laying the groundwork with basic concepts, explaining the definitions of ventilation (V˙) and perfusion (Q˙), and highlighting the significance of the ventilation-perfusion ratio (V˙/Q˙). Dr. Faiza explains the normal value of this ratio and its critical role in ensuring efficient gas exchange in the lungs.
Next, the discussion moves to the impact of different V˙/Q˙ ratios on alveolar gas concentrations. Participants will learn how a normal, zero, or infinite V˙/Q˙ ratio affects the partial pressures of oxygen and carbon dioxide in the alveoli. Dr. Faiza provides a detailed comparison of alveolar gas concentrations in these varying scenarios, offering a clear understanding of the physiological changes that occur.
The lecture also covers the concepts of physiological shunt and dead space. Dr. Faiza defines physiological shunt and explains its causes and effects on gas exchange, distinguishing it from anatomical dead space. She also discusses physiological dead space in detail, including how it is calculated using the Bohr equation. The components and significance of the Bohr equation are thoroughly explained, and practical examples of its application are provided.
Further, the lecture examines the variations in V˙/Q˙ ratios in different regions of the lung and under different conditions, such as lying versus supine and resting versus exercise. Dr. Faiza analyzes how these variations affect pulmonary function and discusses the abnormal V˙/Q˙ ratios seen in chronic obstructive lung disease (COPD) and their clinical implications.
Finally, Dr. Faiza explores the clinical implications of abnormal V˙/Q˙ ratios. She identifies clinical conditions associated with these abnormalities, such as COPD and emphysema, and discusses the physiological and clinical consequences on respiratory function. The lecture emphasizes the importance of understanding these concepts for medical professionals and students, highlighting their relevance in diagnosing and managing respiratory conditions.
This comprehensive lecture provides valuable insights for medical students, healthcare professionals, and anyone interested in respiratory physiology. Participants will gain a deep understanding of how ventilation and perfusion work together to optimize gas exchange in the lungs and how deviations from the norm can lead to significant clinical issues.
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...rightmanforbloodline
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
Causes Of Tooth Loss
PERIODONTAL PROBLEMS ( PERIODONTITIS, GINIGIVITIS)
Systemic Causes Of Tooth Loss
1. Diabetes Mellitus
2. Female Sexual Hormones Condition
3. Hyperpituitarism
4. Hyperthyroidism
5. Primary Hyperparathyroidism
6. Osteoporosis
7. Hypophosphatasia
8. Hypophosphatemia
Causes Of Tooth Loss
CARIES/ TOOTH DECAY
Causes Of Tooth Loss
CAUSES OF TOOTH LOSS
Consequence of tooth loss
Anatomic
Loss of ridge volume both height and width
Bone loss :
mandible > maxilla
Posteriorly > anteriorly
Anatomic consequences
Broader mandibular arch with constricting maxilary arch
Attached gingiva is replaced with less keratinised oral mucosa which is more readily traumatized.
Anatomic consequences
Tipping of the adjacent teeth
Supraeruption of the teeth
Traumatic occlusion
Premature occlusal contact
Anatomic Consequences
Anatomic Consequences
Physiologic consequences
Physiologic Consequences
Decreased lip support
Decreased lower facial height
Physiologic Consequences
Physiologic consequences
Education of Patient
Diagnosis, Treatment Planning, Design, Treatment, Sequencing, and Mouth Preparation
Support for Distal Extension Denture Bases
Establishment and Verification of Occlusal Relations and Tooth Arrangements
Initial Placement Procedures
Periodic Recall
Education of Patient
Informing a patient about a health matter to
secure informed consent.
Patient education should begin at the initial
contact with the patient and should continue throughout treatment.
The dentist and the patient share responsibility for the ultimate success of a removable partial denture.
This educational procedure is especially important when the treatment plan and prognosis are discussed with the patient.
Diagnosis, Treatment Planning, Design, Treatment, Sequencing, and Mouth Preparation
Begin with thorough medical and dental histories.
The complete oral examination must include both clinical and radiographic interpretation of:
caries
the condition of existing restorations
periodontal conditions
responses of teeth (especially abutment teeth) and residual ridges to previous stress
The vitality of remaining teeth
Continued…..
Occlusal plan evaluation
Arch form
Evaluation of Occlusal relationship through mounting the diagnostic cast
The dental cast surveyor is an absolute necessity in which patients are being treated with removable partial dentures.
Mouth preparations, in the appropriate sequence, should be oriented toward the goal of
providing adequate support, stability,
retention, and
a harmonious occlusion for the partial denture.
Support for Distal Extension Denture Bases
A base made to fit the anatomic ridge form does not provide adequate support under occlusal loading.
The base may be made to fit the form of the ridge when under function.
Support for Distal Extension Denture Bases
This provides support
Ontotext’s Clinical Trials Eligibility Design Assistant helps with one of the most challenging tasks in study design: selecting the proper patient population.
Chair, Benjamin M. Greenberg, MD, MHS, discusses neuromyelitis optica spectrum disorder in this CME activity titled “Mastering Diagnosis and Navigating the Sea of Targeted Treatments in NMOSD: Practical Guidance on Optimizing Patient Care.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/4av12w4. CME credit will be available until June 27, 2025.
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
Descoperă Bucuria Vieții Sănătoase cu Jurnalul Fericirii Life Care - Iulie 2024!
Gata să te bucuri de o vară vibrantă și plină de energie? Life Care îți vine în ajutor cu Jurnalul Fericirii din Iulie 2024, un ghid complet pentru o viață armonioasă și echilibrată.
Pe parcursul a cateva de pagini pline de informații utile și inspirație, vei descoperi:
Sfaturi practice pentru o alimentație sănătoasă:
Rețete delicioase și ușor de preparat: Bucură-te de preparate gustoase și nutritive, perfecte pentru zilele călduroase de vară.
Recomandări pentru o alimentație echilibrată: Asigură-ți aportul necesar de nutrienți esențiali pentru un organism sănătos și plin de vitalitate.
Sfaturi pentru alegeri alimentare inteligente: Învață cum să faci cumpărături sănătoase și să eviți tentațiile nesănătoase.
Trucuri pentru un stil de viață activ:
Rutine de exerciții fizice adaptate nevoilor tale: Găsește antrenamente potrivite pentru a te menține în formă și energic pe tot parcursul verii.
Idei de activități în aer liber: Descoperă modalități distractive de a te bucura de vremea frumoasă și de a petrece timp de calitate cu cei dragi.
Sfaturi pentru un somn odihnitor: Asigură-ți un somn profund și reparator pentru a te trezi revigorat și pregătit pentru o nouă zi.
Sfaturi pentru o stare de bine mentală:
Tehnici de relaxare și gestionare a stresului: Învață cum să te relaxezi și să faci față provocărilor zilnice cu mai multă ușurință.
Sfaturi pentru cultivarea optimismului și a gândirii pozitive: Descoperă cum să abordezi viața cu o perspectivă optimistă și să atragi mai multă bucurie în ea.
Recomandări pentru a te conecta cu natura: Bucură-te de beneficiile naturii asupra stării tale mentale și emoționale.
Bonus:
Oferte exclusive la produsele Life Care: Beneficiază de reduceri și promoții speciale la o gamă largă de produse pentru o viață sănătoasă.
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Jurnalul Fericirii Life Care - Iulie 2024 este mai mult decât o simplă revistă. Este un ghid complet și personalizat pentru a te ajuta să obții o viață mai sănătoasă, mai fericită și mai plină de satisfacții.
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Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptxFFragrant
Not all women with hydrosalpinx should choose laparoscopy. Natural medicine Fuyan Pill can also be a nice option for patients, especially when they have fertility needs.
Pharmacotherapy of Asthma and Chronic Obstructive Pulmonary Disease (COPD)HRITHIK DEY
This PowerPoint presentation provides an in-depth overview of the pharmacotherapy approaches for managing asthma and Chronic Obstructive Pulmonary Disease (COPD). It covers the pathophysiology of these respiratory conditions, the various classes of medications used, their mechanisms of action, indications, side effects, and the latest treatment guidelines. Designed for students, healthcare professionals, and anyone interested in respiratory pharmacology, this presentation offers a comprehensive understanding of current therapeutic strategies and advancements in the field.
2. Rolling in Lying
Lying to Sitting
Activities in Mat/Bed
Movement and stability at floor level
Sitting activities
Gait
Lower Limb activities
Upper Limb Activities
3. Functional – related to day-to-day functions
Re-education – re-training
Here the patient knows the activities or
movements that has to be performed but due
to his ailment or diseased pathology he could
not perform it properly
4. Based on patient’s clinical condition.
Specific
Individuality: patient specific
Team work: co-operation from relatives and
other care takers
Adapted and modified movements based on
patient’s need
5. Train coordination and balance.
Increase strength and endurance of muscle.
Train pelvic stability.
Improve the dynamic and static stability.
Augment the proprioceptive function.
Promote postural stability.
Re-educate Gait.
6. Functional Training:
Developing and progressing exercise
programs that improve a patient’s
muscle performance in order to regain
an individual’s pre-injury level of
function.
7. Sequential:
Supine – to – Rolling
◦ Supine to side-lying
◦ Supine to prone lying
◦ Supine – Bridging
Supine – to – Sitting
◦ Supine to side-lying
◦ Supine to bedside sitting
Prone – to – Rolling
◦ Prone to side lying
◦ Prone to supine
Prone – to – Kneeling
◦ Prone to creeping
◦ Prone to crawling
◦ Prone to Kneeling
8. Side-lying – forearm supported side-lying
Kneeling
◦ Kneeling from standing
◦ Kneeling from sitting
◦ Kneeling from Side-sitting
◦ Kneeling from Prone lying
Transfers
◦ Bed to chair; Chair to bed
◦ Bed to floor
◦ Chair to floor
◦ Chair to toilet seat
Standing
Standing from sitting
Standing from Floor
9. Supine to side-lying
Sequence: roll head and neck on movement side –
trunk rotation – Hand movement – Leg
movement.
Purpose and uses:
1. To assist in nursing procedures
2. To gain independence
3. Surrounding environment reach
4. Reduce constant pressure on back
5. Reduce leg stiffness
6. Comfortable sleeping posture
10. Supine to side-lying to prone
Sequence: Initiate with reaching support with
hand on the side of roll – reach side-lying –
continue head roll and extension to reach
prone – extension-rotation of upper trunk.
Purpose and uses:
1. Reduce effects of long term re-cumbancy –
pressure sores.
2. Maintain extension range in trunk and hips.
3. Optional exercise position while at bed-
rest.
11. Supine: Bridging
Bridging: Lifting of pelvis from crook-lying position.
Position: Back arched from knee to shoulders – Foot
supported – Knees praced – arma supported –
extension through legs to hip and lower back lift the
buttocks off the bed.
Purpose and Uses:
1. Bedpan routines
2. Relieve lower back pressure areas
3. Trunk control
4. Avoid prolong flexor posture
5. Maintained efficiency of extensor muscles.
6. Dressing in bed
7. Pressure on soles demands leg activity as in body
weight bearing positions.
12. Supine – Sitting: On the side of Mat/Bed
Sequence: Supine – Side-lying – Forearm support
Side-Lying – Sitting.
Side-lying – to – forearm supported side-lying:
Push the shoulder in extension and abduction
and elbow in flexion to support the upper trunk.
Forearm – supported side-lying to sitting:
Extend the supporting arm and push the trunk in
upright position while lowering the foot on bed
side, or in side-sitting on mat.
Purpose and Uses:
Functional position to train UL functions.
13. Prone – Side-Lying – Supine
Just the reversal of Supine to prone.
Take care of affected hand in hemiplegics
while rolling.
14. Prone – to – Creeping (Forearm supported Prone
Kneeling)
Method 1: Elbow supported side lying to forearm
supported prone lying .
Method II: Prone lying to forearm supported
prone lying.
Purpose and uses:
1. Counter stooping od head and shoulders.
2. Shoulder muscles stimulation.
3. Maintain extensibility of hip and lumbar spine.
4. Pulling body forwards in this position demands
coordination and strength.
15. Prone Kneeling or “Four foot position” or “On all
fours”:
Pulling up from prone/Creeping position by
extending arms at elbows and flexing hip &
Knee.
Needs widespread and coordinated isometric
activity of various muscles.
Purpose and Uses:
1. Starting for crawling.
2. Partial weight bearing through hip joints.
3. Strength and mobility at shoulders.
4. Activities at ground level.
16. CRAWLING:
Balance and stability training by alternate lifting
of one hand and/or leg.
Spontaneous forward walking by comfortable
weight transfer as per the patient’s comfort.
Purpose and uses:
1. Coordination with use of reciprocal arms and
leg movements.
2. Mobilization and/or learning mobility control
3. Retraining limb functions.
4. Mobility for patients with poor erect balance.
5. Independence of mobility in vicinity of house.
17. Before Kneeling:
◦ Supporting surface
◦ Knee ROM: min 1000
◦ Firm furniture
◦ Any other disability restricting the movement:
Kneeling from Standing.
Kneeling from Sitting.
Kneeling from Prone Kneeling.
Kneeling from Side Sitting.
Purpose and Uses:
1. Verticle alignment of trunk and thighs.
2. Promote Hip and lumbar control.
3. Half kneeling, weight transfers can be initiated.
4. Forward, backward and side walking can be progressed.
18. Normal sitting posture: Active stability and
balance of head and trunk in erect position.
Trunk stability leads to effective movement of
extremities.
Sitting without back support – challenges normal
body alignment.
Sitting with back support – without arm support –
pulls the trunk in flexion and buttocks slide
forwards – causes prolong stretching of back
extensors and loss of normal lumbar lordosis –
hyperextension at atlanto-occipital joint.
19. Sitting from
◦ Lying down
◦ Getting up from floor
◦ From standing
Sitting for work
◦ Bending forward with a turn from sitting and raising
◦ Sitting with legs crossed
◦ Sitting weight transfers from buttocks to buttocks
◦ Lifting body weight forward towards the front of
chairseat, using the arms.
20. Lifting objects from ground and placing back
Reciprocal crossing legs
Assisting dressing activities
Buttock walk
Side-to-side weight transfer
Front-to-back weight transfer
Lifting buttocks up by elbow extension and
shoulder depression
Readiness for standing, shifting weight in
front on chair
21. Standing from sitting:
◦ Factors to consider: Shoes, Clothing, ROM, Stability
Activity:
◦ Placement of foot.
◦ Push-up or pull-up from arm.
◦ Posture in standing.
◦ Amount of support.
◦ Returning to seated position.
Common mistakes:
◦ Failure to complete extension
◦ Failure to push down
◦ Uneven balance on both feet
22. General principles:
◦ Correct walking pattern to be insisted. Avoid trick
movements.
◦ Sufficient support and/or aids.
◦ Withdraw aid only when patient can confidently
perform without aid.
Normal gait pattern should be emphasized.
Correction of faulty gait pattern
Diagnose the cause of faulty Gait Pattern and
correct.
23. Walking with flexed hip:
Lateral shift of pelvis
The flat footed shuffle
Climbing Stairs or Ramp.
24. LOWER LIMB ACTIVITIES:
Lower Limb Functions:
a. Support body in weight bearing
b. Lift or lower body from floor or ground
c. Propel body in any direction
d. Non-weight bearing functions
Considerations:
◦ Majority functions are weight bearing
◦ Weight bearing initiated from “FIXED FOOT”
◦ NON-weight bearing “FREE FOOT”
25. UPPER LIMB ACTIVITIES:
Upper Limb Functions:
Support or help body support in various
positions
Move or help move the body
Stabilise the positions of the objects
Considerations
Majority of functions are NON-weight bearing
Weight-bearing initiated with “Fixed Hand”
Non-weight bearing “Free Hands”
26. The Principles of Exercise Therapy
M. Dena Gardiner; 4th Ed.
Practical Exercise Therapy
Margaret Hollis; 4th Ed.