GENERAL BLE EXERCISE: Patient performed therapeutic resistance exercises, isotonic resistive exercises to hips and knees in all planes, and theraband resistive exercises for improved mobility task.
GENERAL AROM + TRANSFERS - Patient was coached through PROM and stretching to B hips, knees, ankles for improved flexibility and joint integrity. Patient was lead through AROM exercises via hip flex/ext/ABD/ADD, knee flex/ext, and ankle PF/DF in order to improve increase strength to BLE for increased independence in transfers. Patient was able to perform stand-pivot transfers bed to/from chair with max A.
GENERAL AROM - Patient was coached through AROM and isometric exercises to BLE hips, knees, and ankles to increase strength and improve motor control for improved functional mobility. Patient responded well to verbal and visual cueing and tapping technique to agonist musculature in order to initiate and enhance contractions in exercises.
GENERAL AROM KNEES LIMITED EX -Patient was lead through B AROM knee ext exercises and stretching to B hamstrings in order to increase B knee ext ROM and strengthen quads musculature for improved functional mobility in standing. Patient presented with increased tolerance to exercises; however continues with B knee ext ROM limitations that impair upright standing posture.
ISOMETRICS – Patient was coached through BLE strengthening exercises via isometric exercises to hips, knees, and ankles in all planes in order to improve strength, kinesthetic position sense, counteract muscle atrophy and joint health for improved functional mobility.
GENERAL BLE ISOMETRIC - Patient was coached through BLE strengthening exercises via AAROM and isometric exercises to hips, knees, and ankles in all planes in order to improve strength, kinesthetic position sense, and joint health for improved functional mobility. Patient required verbal and visual cueing with tapping technique to agonist musculature for enhanced contractions. Patient continues to present with decreased strength and motor control to BLE with more involvement to RLE with c/o numbness from the knee down.
GENERAL ISO + AROM - Patient was instructed through BLE strengthening exercises via isometric exercises and AROM to B hips, knees, and ankles in order to improve tolerance for functional mobility and counteract muscle atrophy. Patient tolerated treatment well with frequent rest breaks and required maximal verbal cueing to maintain attention to tasks.
GENERAL 3 EXERCISE + NUSTEP - Patient was lead through seated BLE strengthening exercises via marching, kicking, and ankle pumps in order to address muscle atrophy associated with immobility and increase tolerance to WB functional activities in ambulation, bed mobility, and transfers. Patient was coached through endurance exercise on NuStep in order to perform BLE reciprocal loading, increase tolerance to ADLs, and improve kinesthetic awareness. Patient required minimal verbal cueing for correct performance of exercises.
KNEE – TO – CHEST Patient was coached through supine ther ex. to B hip, knee, and ankle musculature for improved strength and tolerance to ADLs in bed mobility, transfers, and toileting. Patient was able to tolerate exercises well today and required min A with knee-to-chest exercises; all other exercises were performed with moderate verbal cueing for improved attention and performance of ex’s and without need for manual A.
4-WAY EX - In order to improve functional mobility, patient was coached through BLE strengthening to glutes, iliopsoas, quads, hams, ant. tib, and gastroc/soleus via standing 4-way exercises and leg curls and sitting LAQs, knee bends, ankle DF/PF with manual resistance. Treatment focused on increasing BLE strength, BLE AROM, and functional activity tolerance. Patient required moderate verbal/visual/tactile cueing for safe and correct performance of exercises.
PRE-GAIT BLE: In order to progress tolerance to ambulation, patient was instructed through ther ex to BLE in elevated sitting via LAQs and knee lifts
HAMSTRING STRETCH: Patient received slow static stretching to BLE knee flexors for increased Knee extension ROM.
SIT-STAND Patient performed therapeutic exercises that were progressed to closed chain exercises, therapeutic exercises progressed from sitting to standing.
SUPINE - Patient progress through bilateral LE AROM of hip, knee and ankle, to improve the strength, coordination and tolerance to activity in LE allowing for improved performance of functional activities and gait.
SUPINE - In order to increase patient participation in daily activities, patient was coached through the following: supine exercises via SAQs and ankle pumps;
SEATED - Patient was progressed through seated bilateral LE AROM of hips, knee and ankles; to improve strength, tolerance to activity and coordination; allowing for improved performance of functional mobility and ADLs.
STANDING – Patient coached through therapeutic exercises for LE to facilitate independence in mobility tasks in standing. Patient given verbal --- tactile cues for proper form, posture and count. Patient tolerated standing exercises ---- requiring --- therapeutic rest breaks.
Mod STANDING - modified standing exercises on high mat via weight shifting f/b and side-to-side; and standing exercises via mini-squats.
STANDING TOLERANCE + ENDURANCE EX- Patient was coached through standing activity using RW for B UE A in order to increase tolerance to functional standing activities. Patient was able to tolerate standing position for 30 seconds before reporting symptoms of dizziness. Patient was coached through endurance exercise using Omnicycle in order to increase BLE strength and tolerance to ADLs. Patient required moderate verbal and tactile cueing to B quads in order to equalize loading of LEs. Patient was lead through balance exercise in sitting on an elevated mat for modified WB in order to improve dynamic postural control and progress tolerance to standing position. Patient performed a dual motor task while on elevated mat and was able to hold position without UE support on mat. Patient tolerated treatment well and would benefit from continued PT for improved tolerance to functional activities.
DYNAMIC STANDING ACITIVITES + TRANSFERS-In order to improve balance, strength, and tolerance to ADLs, patient was instructed through sit-to-stands, reaching activities in sitting and standing, kicking ball in sitting with 3 lb ankle weights, marching in place, and resisted hip ABD using yellow T-band. Patient required one-step instructions and maximal visual cueing via mimicking desired movements in order to improve sequencing and attention to activites. Patient is demonstrating improved supine-to-sit and stand-pivot transfers with decreased need for manual A.
STATIC STANDING static standing for increased BLE strength, tolerance to standing position, and proprioception via WB positions.