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
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