Interventions to improve sitting
Static Sitting
see ch51
Varying UE/LE Support
See ch51
Varying BOS
Varying the BOS: Long-sitting, Short-sitting, Side-sitting1
Applying Resistance to Promote Stability
Dynamic Sitting
Active Weight Shifts
Adding resistance ch51
Voluntary movement & Task Orientation
Resisted Limb Movements
For patients lacking stabilization, resistance may be contraindicated and the clinician should focus on active movements1.
A clinician can add resistance to the extremities with a variety of changes.
Changes
- Enhances control of the limbs1
- Enhanes automatic trunk control
Enhancement of limb control
- This is helpful when working with patients who are experiencing extremity weakness (i.e. brain injury)
- You should use this in order to simultaneously work balance and limb strengthening
Automatic Trunk Control
Regression
Complexity
The therapist typically starts with unilateral movements and progresses to combination (bilateral and reciprocal) movements1
PNF Patterns Progression
Unilateral Patterns
- Unilateral PNF patterns are often used initially, when dynamic control is lacking or when one extremity is used for support1.
- Even if the C/L arm is not being used for support, it can still be used as a counterbalance, thus reducing the requisite trunk control, which is why unilateral patterns are considered easier.
Bilateral Patterns
- As the patient’s control improves, progress to bilateral patterns, which will be more challenging1. Examples:
Examples
In addition, there is a weight shift from one side (buttock) to the other. Emphasis is on using the combined arm movements to enhance control and range of the trunk movements. See Chapter 3: Proprioceptive Neuromuscular Facilitation for a description of patterns and techniques.
flexion with rotation) combined with bilateral asymmetrical patterns of both UEs. In addition, there is a weight shift from one side (buttock) to the other. Emphasis is on using the combined arm movements to enhance control and range of the trunk movements. See Chapter 3: Proprioceptive Neuromuscular Facilitation for a description of patterns and techniques.1