Practical Rationales

Question 1

Transfer

Answer 1

Multiple repetitions and scooting allow the patient to require less assistance in a shorter period of time due to increased time in controlled weight bearing.

Question 2

STS

Answer 2

Facilitates a normal postural alignment and gait.

Question 3

Ladder Sequence

Answer 3

Involves forced use, isometrics, concentrics, and eccentrics, functional for stairs and skilled mobility.

Question 4

Half-Bridging

Answer 4

Forced use of the involved side and rolling.

Question 5

Bridging

Answer 5

Develops proximal control of the body and improves functional potential for bed mobility and selective movements for lower extremities.

Question 6

Timing for Emphasis

Answer 6

Irradiation: max contraction of strong side will overflow to weak side

Question 7

Primitive Repeated Contractions

Answer 7

Irradiation - facilitating the weaker side by resisting the strong side.

Question 8

Raimiste’s phenomena

Answer 8

Develops increased control of hip abduction and adduction.

Question 9

Lower Trunk Rotation

Answer 9

Successive induction, trunk control, and stiff trunk (gait).

Question 10

Scooting sideways in bed

Answer 10

Referred to as ‘banana’.

Question 11

Rolling onto affected side

Answer 11

Increases weight bearing and proprioceptive input.

Question 12

Rolling onto unaffected side

Answer 12

Forced use of the affected side.

Question 13

Trunk mobilizations (anterior/lateral)

Answer 13

Gains flexibility, prepares the patient’s body to learn a movement or function, and releases spasticity by stretching muscles or moving joints.

Question 14

Scooting backwards

Answer 14

Preparation activity for stand to sit and repositioning self.

Question 15

Scooting forwards (unilaterally)

Answer 15

Combines stabilizing during weight acceptance and moving during unweighting of the side, excellent preparatory activity for gait.

Question 16

Reinforcement of balance, stability, and controlled mobility in sitting

Answer 16

Function in sitting depends on automatic postural reactions that make sitting balance a consistent and spontaneous behavior. Strengthening muscles in functional/coordinated patterns is desirable for improving the patient’s repertoire of purposeful sitting activities.

Question 17

Swiss Ball

Answer 17

Used to increase lumbar and thoracic extension.

Question 18

Prone progression

Answer 18

Promotes stability to mobility.

Question 19

Quadruped

Answer 19

Promotes stability to mobility.

Question 20

Kneeling progression

Answer 20

Excellent preparatory activity for gait.

Question 21

Involved LE behind

Answer 21

Working on hip extension.

Question 22

Involved LE in front

Answer 22

Working on weight bearing and weight acceptance.

Question 23

Standing slow reversal holds/repeated contractions

Answer 23

Involves successive induction.

Question 24

Pregait sequence

Answer 24

Maintenance of symmetry and good alignment of the shoulders over the pelvis as the body moves over the base of support allows increased stability. Maintenance of appropriate tone levels of the trunk and contact of the foot with the floor are necessary in facilitating tone and control of lower extremities.

Question 25

Pivoting Stepping Backwards

Answer 25

to improve the use of involved LE for improved speed, balance, and efficiency

Question 26

Stairs

Answer 26

functional activity forced use good activity to improve gait: SL balance needed for gait too

Question 27

hand mobilizations

Answer 27

done if inhibition of the hand is inadequate

Question 28

UE WB progression

Answer 28

tone management forced use

Question 29

UE movement progression

Answer 29

forced use working on isometrics, eccentrics, concentric functional

Question 30

HR/HRAC D2 flexion

Answer 30

to stretch tight pecs

Question 31

HR/HRAC D1 flexion

Answer 31

to stretch tight lats

Question 32

D1 flexion/extension slow reversal holds of scapula

Answer 32

proximal mobility and stability will facilitate function in the distal limbs