Pt engaged in various seated activities (performed unsupported in w/c seated at EOM) to improve sitting balance, core MS, endurance, and weight shifting to improve safety/independence in seated ADLs and functional transfers. Activities include:
Scap retraction & sustaining midline
Initiated core strengthening MS exercises while seated unsupported in w/c (with w/c armrests removed) via 2 sets x 5 reps trunk extension and scap retraction with 3-second isometric hold of midline position to improve sitting balance to ease self-care ADLs. Therapist positioned laterally to provide anterior blocking to bilateral LE and provide tactile cues via downward input at lumbar spine to facilitate trunk extension.
Initiated core strengthening MS exercises while seated unsupported in w/c (with w/c armrests removed) via 2 sets x 5 reps trunk extension and scap retraction with 3-second isometric hold of midline position to improve sitting balance to ease self-care ADLs. Therapist positioned laterally to provide anterior blocking to bilateral LE and provide tactile cues via downward input at lumbar spine to facilitate trunk extension. Patient benefits from mirror positioned anteriorly to provide visual feedback to improve ability to sustain position in midline due to reduced postural awareness.
Reaching for cones & cones behind back
Initiated seated balance activities performed at EOM requiring reaching contralaterally for cones with alternating UE in horizontal plane within BOS.
Progressed sitting balance activities performed at EOM from reaching contralaterally with alternating UE within BOS, to bending and reaching in vertical/horizontal planes outside BOS (via retrieving items from the floor and placing them at varying heights/positions) to facilitate increased anterior/lateral weight shift in prep for increased participation in EOB ADLs.
Initiated dynamic standing balance activities (i.e., reaching across midline for cones with following internal rotation behind back) involving reaching outside BOS with physical support provided PRN to improve independence and safety with self-care ADLs (i.e., toileting).
Bolster taps
Seated unsupported in w/c, pt engaged in dynamic sitting balance activity involving 2 sets x 10 reps bolster taps anteriorly with subsequent return to midline to facilitate anterior weight shifting and core MS to ease functional transfers and EOB ADLs.
Seated unsupported in w/c, pt engaged in dynamic sitting balance activity involving 2 sets x 10 reps anterior and lateral bolster taps involving multi-directional weight shift and return to midline to improve weight shifting and core MS in prep for functional transfers and EOB ADLs.
Tabletop towel slides
Initiated tabletop activities via push/pull towel slides with bilateral UE, targeting deltoid muscle group, to increase bilateral UE ROM, sitting balance, and activity tolerance in prep for sit <-> stand transition.
Balloon toss
Initiated dynamic sitting balance activity via 2 sets x 10 reps balloon toss, initially within BOS and improving to outside BOS, to facilitate multi-directional weight shift and righting reactions in prep for functional transfers and EOB ADLs.
Reaching to // bars
Initiated dynamic seated balance activities (performed supported in w/c) involving reaching anteriorly for // bars in prep for functional transfers. Therapist positioned laterally to provide tactile cues at lumbar spine to facilitate increased anterior weight shifting.
Progression within POT
Initiated dynamic sitting balance activities performed at EOM from reaching contralaterally with alternating UE within BOS, progressing to bending and reaching in vertical/horizontal planes outside BOS (via retrieving items from the floor and placing them at varying heights/positions) to facilitate increased anterior/lateral weight shift in prep for increased participation in EOB ADLs.
Pt engaged in various standing activities to improve standing balance, ability to maintain upright posture, endurance, and weight shifting to improve safety/independence in standing ADLs (i.e., toileting tasks and sink-side grooming) and functional mobility/transfers. Activities include:
Balloon tap & Ball toss
Initiated dynamic standing balance activities via 2 sets x 5 reps unilateral UE balloon tap with each UE, while maintaining opposite UE support on RW, within BOS. Verbal/tactile cues provided to maintain trunk extension and scap retraction for upright posture.
Initiated dynamic stand balance activity reciprocal ball toss (without UE support) in various heights/positions outside BOS to facilitate weight shifting for improved safety and independence during functional mobility/transfers. Pt benefited from verbal cues to enhance BOS at task initiation.
Reaching for cones
Initiated dynamic standing balance activities via reaching for cones contralaterally to place ipsilaterally with alternating UEs in horizontal plane, while maintaining opposite UE support on RW, in prep for improved safety during performance of toileting tasks and sink side grooming in standing.
Initiated dynamic standing balance activities (i.e., reaching across midline for cones with following internal rotation behind back) involving reaching outside BOS with physical support provided PRN to improve independence and safety with self-care ADLs.
Initiated dynamic standing activity via bending to retrieve items from the floor with subsequent ipsilateral/contralateral reaching outside BOS to place items in a basket in prep for clothing retrieval to improve functional independence in all basic self-care ADLs.
Standing on uneven surface
Initiated dynamic standing balance activity via standing on blue foam airmat during engagement in a reciprocal ball toss with medium/large therapy balls outside BOS (without UE support) to facilitate increased weight shifting and standing balance for improved safety and independence during functional mobility and ADL/IADLs. Intermittent verbal cues required t/o for pacing and body alignment to maintain safety.
Obstacle course
Initiated use of obstacle course requiring patient to weave between cones to promote standing balance, endurance, safe walker management, and negotiation of environmental barriers to simulate small household spaces for improved safety and independence during functional mobility within the home.
Progression within POT
Initiated stand balance activities with unilateral UE support on RW, progressing to reciprocal ball toss with bilateral UE (and no UE support) via tossing/catching/bouncing a large therapy ball in various heights/positions to facilitate weight shifting for improved safety and independence during functional mobility/transfers.
Standing tolerance was targeted through engagement in various standing activities (i.e., functional reaching, static standing to grab bar, lateral weight shifting in place) to ease standing ADL performance (such as toileting) and functional transfers. Pt dem ability to stand for 1-3 minutes consistently t/o entirety of this POT.