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plor
Instructor
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Posted: Tue May 4th, 2010 08:35 pm |
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I have found remarkable change by having the client listen to their feet -- what kind of noise do you want this client to make that will demonstrate that (s)he is weight bearing? Sometimes an initial audible foot placement helps the client to stay weight bearing through the stance phase. This will also help for clients who are asymmetrical: listening to hear if they can get left and right to sound the same................
I will also ask the question "are you pushing the floor?" Or we'll chant "push,push, push" etc as the client steps...gives a more conscious awareness to weight bearing until it becomes more spontaneous
plo'r
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nkarman
Instructor
| Joined: | Sat Jul 15th, 2006 |
| Location: | New York USA |
| Posts: | 61 |
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Posted: Sun May 2nd, 2010 10:29 pm |
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| Just did a course in Canada where this was an issue with one child. We did some bouncing on a trampoline to increase LE activation. Worked pretty well.
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nkarman
Instructor
| Joined: | Sat Jul 15th, 2006 |
| Location: | New York USA |
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Posted: Wed Feb 24th, 2010 08:24 pm |
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"Mixing it up" in terms of how much support you are providing (i.e. if they start sitting, give more support or less support, so they do not rely on what is there any more than they have to).
This was a big benefit of the power actuator when I first got a model that had it... and I would never go back to a unit without that feature now, nor would I recommend it as a first choice investment for anyone in the market... I would encourage them to find the money for the feature (if that is why they are considering doing without), or to use it over the TM more than overground (if steering the heavier device overground is their concern). The difference in weight is really negligible over uncarpeted/smooth terrain.
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jkelly
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| Joined: | Fri Jun 20th, 2008 |
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Posted: Mon Nov 9th, 2009 08:21 pm |
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I've also found that with some patients, especially those with cognitive involvement, there seems to be a "sitting reflex"...If I get the harness too low and the patient perceives pressure on the glutes/gluteal fold, they tend to sit...
Another sugestion: Use elastic tubing or bungee cords to pull the hips into a more extended angle.
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kdmpt
Instructor
| Joined: | Fri Jul 7th, 2006 |
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Posted: Thu Nov 5th, 2009 08:10 pm |
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The first thing you should check is that the harness is properly placed, with the bottom side strap of the harness wrap at the level of the greater trochanter. It is easier to encourage hip extension with the harness in this position, rather than up higher where hip flexion is not blocked. Secondly, provide as much overhead support as you can without lifting the patient's heels off the floor. Next, provide cues and physical assistance to bring the pelvis forward and the knees into terminal extension. Sometimes physical assistance is the only way to keep a patient from sitting in the harness, at least initially. A mirror may be useful as a visual cue to the patient.
Any of you users out there have other tips that work for you? This particular patient has a L AKA with prosthesis.
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kdmpt
Instructor
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Posted: Thu Nov 5th, 2009 08:02 pm |
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| From a customer: My patient always sits in the harness. What can I do to help him stand upright?
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Current time is 04:30 am | |
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