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Yen -> Re: balance & mobilization (August 28, 2004 11:04:00 PM)
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How to bring balance in a more appropriate proper way?
Balance will definitely need work. He sounds paraplegic with G2 lower limb strength. Low level mobility right? Anyway, If so, try rehab on a bobath plinth, adjusting bed height/back rest as needed. Try muscle/joint stretches first and PNF exercises. Try active strenght exercises supine for the LL +/- manual support. Progress exercises with weights, inc reps/sets/holds etc. You can try some supine closed chain LL exercises.
So you mean muscle power less than 2? Upper limbs 4+? If so, gait orthosis eg rollator gutter frame thanks will be needed. Functional transfers (bed/chair mobility and transfers up-down bed, side-side, rolling, lie-sit, sit-stand) should all be part of your program and aim for independence +/- equipment (eg bed stick/overhead triangle bar) +/- assistance x1.
And utilise a PT assistant if you need the extra safety support when upright. It will take a while to get to this stage if he has muscle strenght 2/5. When u get here, try weightbearing exercises in parallel bars eg weight shift L-R, fwds-bwds,1/4 squats, hip/knee excercises. Offer manual facilitation if needed. Or attach a light weight on his ankle for limb dissociation awareness.
Um, is he of higher level mobility? If so, I have some other ideas for that kind of rehab. But for now, I'll leave it here.
Let us know how u go.
How to strengthen him periodically?
set a program for him to do. train a carer/family member/aide to help with the program. Theraband can help for auto assisted exercises (attach one end to foot/ankle and hands can help with SLR or hip Abdn, knee flexion exercises). Include stretches and joint PROM ex's.
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