Patient was placed in seated position without support; give dynamic tasks to increased strengthen of core and self righting reaction.
Patient was progressed through coordination and motor task for right LE in seated to improve volitional movement and coordintation with functional mobility.
In order to improve dynamic postural control and improve safety during ambulation, patient was coached through balance and coordination exercises to improve hip and ankle strategies and proprioception input. Exercises included standing on parallel bars without BUE support with feet apart, feet together, tandem stance, and over foam surface with eyes open and eyes closed and stepping exercises via side-stepping and braiding. Patient required moderate visual and verbal cueing for increased step length and safe performance of exercises.
In order to increase participation to ADLs patient was progressed through sitting tolerance task for improved static postural control, trunk strength, righting/protective strategies, and tactile input to feet for improved proprioception. Patient required mod A for supine to/from sit transfers and maximal verbal and tactile facilitation to trunk and BUE in order to maintain sitting balance. FIST administered with resulting score = 13/56. Patient was able to tolerate sitting without back support for 4 minutes and sitting with back support for 20 minutes.
Patient was coached through stand-pivot transfers WC to/from mat in order to increase tolerance to sitting position without back support. Emphasis of treatment was to improve static postural control, trunk strength, and righting/protective reactions in sitting position for improved bed mobility and participation in ADLs. Patient required maximal verbal/tactile/visual facilitation in order to correct and maintain proper anatomical alignment. FIST performed with results 18/56.
Patient was progressed through sitting tolerance at edge of mat in order to assess and improve static and dynamic balance, proprioception, and righting reactions with improved upright posture. Activities in sitting with/without use of BUE included sitting eyes open/closed, reaching of objects in all directions, scooting forward/backwards/sideways, picking up objects from floor, accepting perturbations in all directions, and marching. Patient required RUE support in order to maintain balance and moderate verbal cueing for correct and safe performance of exercises.
In order to increase participation in ADLs with dressing, hygiene, grooming and feeding, patient was coached through bed exercises with min A via rolling to L/R using siderails and supine to/from sit for improved sequencing and independence of tasks. Patient was progressed through sitting tolerance at edge of mat in order to assess and improve static and dynamic balance via sitting with/without use of BUE, acceptance of perturbations, sitting with eyes open/closed, reaching of objects in all directions, scooting forward/backwards/sideways, reaching to floor for objects and marching. Additional goals for tx were to increase righting and anticipatory reactions, BLE strength, coordination, postural awareness, and functional activity tolerance. Patient required moderate verbal/tactile facilitation in order to initiate tasks and perform tasks correctly.
Patient was coached through stand-pivot transfers WC to/from mat in order to increase tolerance to sitting position without back support. Tasks in sitting included eyes open/closed, stabilizing self with perturbations, lifting feet, reaching, and scooting. Emphasis of treatment was to improve static postural control, trunk strength, and righting/protective reactions in sitting position for improved bed mobility and participation in ADLs. Patient required maximal verbal/tactile/visual facilitation for correct and safe performance of tasks. FIST performed with results 27/56.
Patient was facilitated in sitting at edge of bed with BUE in order to improve static/dynamic balance, righting/protective/anticipatory reactions, trunk control/stability, and postural awareness. Patient was able to maintain sitting postion without back support and accept manual perturbations to upper trunk in all directions x 10 minutes. Patient required maximal verbal/visual/tactile facilitation for improved upright posture and proper placing of BUE and BLE.
Patient was facilitated through static/dynamic activities in sitting without back support in order to improve static/dynamic postural control, upright posture, proprioception, righting/protective/anticipatory reactions and trunk control/stabilization for improved independence during sitting ADLs. Patient required maximal faciliation via visuals with demonstration and use of mirror and tactile cues for improved techniques.
In order to improve tolerance to functional activities in sitting, patient was facilitated during sitting at edge of bed with use of LUE for improved proprioception, righting/protective reactions, static dynamic postural control, and trunk stabilization. Patient required maximal tactile/visual/verbal cueing in order to improve techniques to regain balance and obtain proper anatomical alignment. Patient demonstrates tendency to list and lose balance to more involved R side; therefore, step was placed under RLE to encourage increased use of R UE and LE to maintain balance.