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Dynamic Stepping with Functional Reach and Controlled Movement

Occupational Therapy Intervention : Dynamic Stepping

Contralateral Aerobic Stepper

Neuromuscular Re-Education and Body Mechanics

Documentation and Activity Rationale

The patient engages in a static sitting open kinematic chain BUE strengthening exercise requiring her to use a cylindrical grasp to reach for, stabilize, and move a weightless bar from point a (anteriorly placed outside BOS) to point b (within BOS and proximal to her line of gravity) against the resistance of a yellow theraband. The patient performed pronated elbow flexion/extension exercise with sustained isometric shoulder flexion contraction at 90˚ got 2x12 repetitions. It is noted that the patient was able to maintain static sitting posture against gravity for the entirety of the activity with 3 verbal cues for re-engagement of postural muscles.

Grading Strategies

Grading Up:

  • Use ankle or wrist weights
  • Increase Weight on Batton
  • Use more Hurdles
  • Increase Speed

Grading Down: 

  • Decrease or eliminate weight 
  • Eliminate obstacles
  • Decrease Speed

Appropriate Diagnoses / Deficits

  • Generalized Weakness 
  • SCI
  • CVA
  • TBI
  • Balance deficits