ESSENTIAL COMPONENTS OF STANDING UP:
Foot placement.
Forward trunk inclination by hip flexion with the neck and spine extended.
Hip extension (for final standing adjustment)
ESSENTIAL COMPONENTS OF SITTING DOWN:
Forward trunk inclination by hip flexion with the neck and spine extended.
Knee flexion
Common Problems:
Inability to shift the center of gravity forward sufficiently during the early stages of
standing up and the late stages of sitting down.
Failure to place the affected foot.
Common Compensatory Responses:
Weight borne primarily on the intact side which becomes accentuated when the
intact foot is positioned posterior to the affected foot.
Forward neck and trunk flexion or wriggling forward to the edge of the chair to shift
the weight forward.
SPECIFIC TECHNIQUES:
To Stimulate Trunk Inclination Forward at the Hips
Practice Standing Up
Practice Sitting Down.
BALANCED STANDING:
Appropriate body alignment
Correct adjustments made to changes in body alignment (with shifts in the center of gravity).
Increases awareness of bilaterality,position in space and positioning of body parts; may minimize the development of spasticity.
BALANCE:
Constant accurately balanced movement of the center of gravity on a stationary base to keep the line of gravity just in front of the ankles.
Standing without using undue muscle activity, to move about in standing, to move in and out of the standing position, and to walk without arm support.
Description of Normal Function:
ESSENTIAL COMPONENTS OF STANDING ALIGNMENT:
Feet a few inches apart
Symmetrical weight-bearing.
Extended knees and hips
Hips over feet
Erect trunk.
Shoulders over hips
Head balanced on level shoulders.
ESSENTIAL COMPONENTS OF BALANCE REACTIONS:
Lateral shift in the center of gravity
Lateral neck flexion.
Lateral trunk flexion (pelvic elevation, shoulder depression)
Backward shift in the center of gravity.
Neck extension
Forward trunk inclination at the hips.
Ankle dorsiflexion.
WHAT TO DO…
Observe standing alignment
Test the ability to adjust to self-initiated movement of head, trunk and limbs.
Looking behind, up Grasping an object from the floor.
Standing on one leg Reaching in various directions.
Test the displacement of weight sideways and backward (equilibrium reactions) with feet a few inches apart.
Common Compensatory Responses:
Wide base of support (placement of the feet and knees apart)
Voluntary restriction of movement (holding the breath or maintaining a stiff body
posture)
Shuffling of the feet instead of adjusting using appropriate body segments.
Stepping sideways or backward as soon as the center of gravity moves.
Leaning backwards when the center of gravity shifts sideways
Proximal (instead of distal) movement of parts when shifting the center of gravity.
Use of protective support by the upper limbs (grabbing for support, holding arms
out sideways or forward) with minimal shifts in the center of gravity.
SPECIFIC TECHNIQUES:
To Stimulate Hip Extension
To Maintain Knee Extension
To Stimulate Adjustments to Shifts in Center of Gravity.
To Stimulate Essential Aspects of Balanced Standing Alignment.
To Stimulate Protective Support through the Arm.
(AMBULATION WILL BE DISCUSSED AND COMPARED WITH PERIPHERAL NEURO-MUSCULAR FACILITATION AND THE NEURODEVELOPMENTAL TECHNIQUES)
PHYSIOHEALER. 