Right in the middle : selective trunk activity in the treatment of adult hemiplegia
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Bibliographic Information
Right in the middle : selective trunk activity in the treatment of adult hemiplegia
Springer-Verlag, c1990
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Includes bibliographical references
Description and Table of Contents
Description
What is it that characterises Pat Davies' second book about hemi plegia and makes it so special? It is a book which committed ther apists can really use in their practical work with patients. We ther apists need such books. The engagement and enthusiasm must come from us. It is similar to a good cookbook. Admittedly one has to know something about cooking but when learning the secrets of haute cuisine - not just the expensive frills but the real refinement- then theoretical dissertations are not very helpful. In practice com ments like "you just have to have the right touch" are useless. Many books are disappointing because the reader cannot learn how to put theory into practice, as the author does not disclose the true secrets of his success, perhaps not really wanting the eager stu dents to "bake a good cake" for example. Such is not the case with this book. In the first theoretical chap ter "The Normal Trunk - Evolutionary and Anatomical Consider ations" the reader is given information about the significance of the normal anatomical relationships in the development of the body segments: the pelvis, thorax and head. The second chapter, "Aspects of Trunk Control", deals with the muscular control of movement within each of these inherently mobile segments. In the terminology of "Functional Kinetics" the different types of muscle activities are described, defining the importance of the selective use of the musculature in reaction to the pull of gravity.
Table of Contents
I Theoretical Antecedents.- 1 The Normal Trunk - Evolutionary and Anatomical Considerations.- 1.1 The Vertebral Column.- 1.1.1 Movements of the Vertebral Column.- 1.1.2 Movements of the Rib Cage.- 1.2 Conclusion.- 2 Aspects of Trunk Control.- 2.1 The Bridge.- 2.2 The Tentacle.- 2.3 The Bridge-Tentacle.- 2.3.1 Muscular Control of the Trunk.- 2.3.2 Anatomical Considerations.- 2.3.2.1 Extension.- 2.3.2.2 Shoulder Girdle.- 2.3.2.3 Abdominal Muscles.- 2.3.2.4 Respiration.- 2.4 Types of Muscle Action.- 2.5 Conclusion.- 3 Problems Associated with the Loss of Selective Trunk Activity in Hemiplegia.- 3.1 Possible Reasons for the Bilateral Loss of Abdominal Muscle Activity and Tone.- 3.2 Loss of Selective Activity.- 3.2.1 Muscles of the Trunk.- 3.2.2 Muscles of the Trunk and Limbs Acting Simultaneously.- 3.3 Inability to Move in Normal Patterns.- 3.4 The Most Commonly Observed Problems Seen in Relation to Normal Motor Development.- 3.4.1 Difficulties with Breathing and Speaking.- 3.4.1.1 Distorted Configuration of the Rib Cage.- 3.4.2 Difficulties Observed in Lying.- 3.4.3 Difficulties in Moving Between Lying and Sitting.- 3.4.4 Difficulties in Sitting.- 3.4.5 Difficulties in Standing Up from Sitting.- 3.4.6 Difficulties in Standing.- 3.4.7 Some Difficulties Observed in Walking.- 3.4.7.1 The Stance Phase.- 3.4.7.2 The Swing Phase.- 3.4.7.3 Slow and Effortful Walking with the Stride Width Increased.- 3.4.7.4 Associated Reactions in the Arm.- 3.4.8 Difficulties in Moving the Arm.- 3.5 Conclusion.- II Therapeutic Activities.- 4 Activities in Lying.- 4.1 Facilitating Breathing.- 4.1.1 Moving the Chest Passively.- 4.1.2 Assisting Expiration.- 4.1.3 Facilitating Diaphragmatic Breathing.- 4.2 Flexion/Rotation of the Upper Trunk.- 4.2.1 Assisting Passive Movement.- 4.2.2 Facilitating Active Movement.- 4.3 Retraining Active Protraction of the Scapula with Activation of the Oblique Abdominal Muscles.- 4.3.1 Lifting the Elbows into the Air.- 4.4 Rolling to Prone.- 4.4.1 Rolling Towards the Hemiplegic Side.- 4.4.2 Rolling Towards the Sound Side.- 4.5 Flexion/Rotation of the Lower Trunk.- 4.6 Activating the Oblique Abdominal Muscles in Crook Lying.- 4.7 Position of the Arms.- 4.8 Bridging, a Useful Activity for Regaining Selective Extension of the Hip Together with Abdominal Muscle Activity.- 4.9 Actively Controlling the Hemiplegic Leg Through Its Range of Movement.- 4.10 Conclusion.- 5 Moving Between Lying and Sitting.- 5.1 Sitting Up over the Side of the Bed.- 5.1.1 Fully Supported.- 5.1.2 Less Assistance.- 5.1.3 No Support.- 5.2 Lying Down from Sitting.- 5.3 Rocking in Crook Sitting.- 5.4 Moving the Trunk in Long Sitting.- 5.4.1 Long Sitting with Isolated Knee Extension.- 5.4.2 Moving Towards Supine Lying.- 5.4.3 Lying Down with the Trunk Rotated.- 5.5 Conclusion.- 6 Activities in Sitting.- 6.1 Sitting with Both Legs over the Side of the Plinth.- 6.1.2 Selective Flexion and Extension of the Lower Trunk.- 6.1.3 Trunk Rotation with Flexion.- 6.2 Rotation of the Trunk with Both Arms Supported on the Same Side.- 6.2.1 Rotating Towards the Sound Side.- 6.2.2 Rotating Towards the Hemiplegic Side.- 6.3 Active Movements of the Hemiplegie Arm Following the Inhibition of Spasticity.- 6.4 Weight Transference Sideways.- 6.4.1 Moving Towards the Hemiplegie Side.- 6.4.1.1 A Progressive Sequence to Teach the Correct Movement.- 6.4.2 Moving Towards the Sound Side.- 6.4.2.1 A Progressive Sequence to Teach the Correct Movement.- 6.5 Selective Side Flexion of the Lower Trunk.- 6.6 Active Side Flexion of the Trunk Against Gravity.- 6.7 Moving Forwards and Backwards.- 6.8 Conclusion.- 7 Standing Up from Sitting.- 7.1 Therapeutic and Functional Activities.- 7.1.1 Bringing the Extended Trunk Forwards.- 7.1.2 Standing Up from Sitting.- 7.1.2.1 Supported by the Therapist.- 7.1.2.2 Hands Supported on a Stool.- 7.1.2.3 Weight Bearing on the Hemiplegic Leg Alone.- 7.1.3 Alternating Between Selective Extensor and Flexor Activity of the Trunk and Hips.- 7.1.3.1 Incorporating Active Plantar Flexion of the Foot.- 7.1.3.2 Legs Crossed.- 7.1.3.3 Performing an Additional Task.- 7.1.4 Standing Up from a High Plinth or Bed.- 7.1.4.1 Transferring the Patient onto a High Bed.- 7.1.5 Standing Up and Returning to Sitting from a High Plinth or Bed.- 7.1.5.1 Weight Taken on the Hemiplegic Leg.- 7.1.5.2 Weight Taken on the Sound Leg.- 7.2 Conclusion.- 8 Activities in Standing.- 8.1 Important Considerations Before Standing Activities Are Begun.- 8.2 Activities to Train Selective Trunk and Leg Movement.- 8.2.1 Tilting the Pelvis Forwards and Backwards.- 8.2.2 Weight Bearing on the Hemiplegie Leg with Abduction and Adduction of the Contra-lateral Hip.- 8.2.3 Bending the Trunk Forwards and Bringing It to the Vertical Again.- 8.2.4 Bending the Trunk Forwards and Returning to an Upright Position While Standing on a Sloping Surface.- 8.2.5 Weight Bearing on the Hemiplegie Leg While Placing the Sound Foot on a Step.- 8.2.6 Weight Bearing on the Hemiplegie Leg with the Sound Leg Abducting.- 8.2.7 Hip Extension with Abduction and Outward Rotation.- 8.2.8 Active Plantar Flexion of the Ankles with Flexed Knees.- 8.2.9 Controlling the Hemiplegie Leg Actively Against Gravity.- 8.2.10 Active Control of the Hemiplegie Leg when the Hip Is Extended.- 8.2.11 Moving the Arms Actively While Standing.- 8.2.11.1 Holding a Pole in Both Hands.- 8.2.11.2 Hitting a Ball with a Pole.- 8.2.11.3 Hitting a Balloon Away with the Hemiplegie Hand.- 8.3 Conclusion.- 9 Ball Activities.- 9.1 Ball Activities in Supine Lying.- 9.1.1 Lifting the Ball off the Bed with Both Legs.- 9.1.2 Abducting and Adducting One Leg with the Other Leg Supported on the Ball.- 9.2 Ball Activities in Prone Lying.- 9.2.1 Lying Prone on the Ball with Weight Supported Through Both Arms.- 9.2.2 Lower Trunk and Hip Flexion with Both Knees Supported on the Ball.- 9.2.3 Rotating the Trunk Until Only One Trochanter Is Supported on the Ball.- 9.3 Ball Activities in Sitting.- 9.3.1 Flexing and Extending the Lumbar Spine.- 9.3.2 Lateral Flexion of the Lumbar Spine.- 9.3.3 Bouncing on the Ball.- 9.3.4 Walking Both Feet Forwards Until Only the Shoulders Are Supported on the Ball.- 9.4 Ball Activities in Standing.- 9.4.1 Standing on One Leg with the Other Foot on a Moving Ball.- 9.5 Conclusion.- 10 Walking.- 10.1 Observing, Analysing, and Facilitating Walking - Theoretical Considerations.- 10.1.1 Rhythm and Cadence.- 10.1.2 Step Length.- 10.1.3 Position of the Feet on the Floor.- 10.1.4 The Knee.- 10.1.5 The Pelvis.- 10.1.6 The Trunk.- 10.1.7 The Arms.- 10.1.8 The Head.- 10.1.9 Maintaining Balance.- 10.2 Facilitating Walking - Practical Considerations.- 10.2.1 Footwear.- 10.2.2 Assisting Hip Extension.- 10.3 Facilitating Walking Backwards.- 10.3.1 Tipped Backwards Without Taking a Step.- 10.3.2 Taking Steps Backwards.- 10.4 Facilitating Walking Sideways.- 10.4.1 Towards the Sound Side.- 10.4.2 Towards the Hemiplegic Side.- 10.5 Facilitating Walking Forwards.- 10.5.1 Stabilising the Thorax and Moving the Trunk Forwards.- 10.5.2 Facilitation to Prevent Side Flexion of the Trunk and Associated Reactions in the Arm.- 10.5.2.1 Supporting the Hemiplegic Arm.- 10.5.2.2 Holding a Ball.- 10.5.2.3 Holding a Pole in Both Hands.- 10.5.2.4 Applying Pressure to the Patient's Chest.- 10.5.3 Facilitation Using Stimulating and Inhibitory Tapping.- 10.5.3.1 Stimulating Tapping over the Hip Extensors.- 10.5.3.2 Stimulating Tapping for the Lower Abdominal Muscles.- 10.5.3.3 Inhibitory Tapping.- 10.5.4 Facilitation to Narrow the Stride Width.- 10.5.4.1 Walking Along a Line.- 10.5.4.2 Walking Along a Plank.- 10.5.5 Facilitation to Re-establish Rhythm.- 10.5.5.1 Using a Tambourine.- 10.5.5.2 Bouncing a Ball with the Sound Hand.- 10.5.5.3 Bouncing a Large Ball with Both Hands.- 10.5.5.4 Imitating the Therapist's Steps.- 10.5.6 Facilitating Walking on the Toes.- 10.5.7 Walking with the Head Moving Freely.- 10.5.7.1 Throwing and Catching a Ball.- 10.5.7.2 Beating a Tambourine.- 10.6 Conclusion.- References.
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