Introduction of mat activity 국립재활원물리치료실장영민

Transcription

1 Introduction of mat activity 국립재활원물리치료실장영민

2 Content 1. Why do mat activity? 2. Supine progression 3. Prone progression 4. Theraputic mat activity

3 Why do mat activity? 1. Wide BOS & lower GOG: security and safety for patient. 2. Simple activities and bigger movements are possible( trunk mass flexion, extension, rolling, etc). 3. Incorporating both mobility and stability. 4. Combined and selective movements. 5. Balance and balance reaction. 6. Transfer and functional ADL. 7. Individual and group treatment.

4 Is it necessary to improve function? Rehab. environment & life boundary - mat, bed, wheelchair... Participation restriction - assist of family or care giver Activity limitation - position change, - transfer, - Functional ADL on mat

5 Is it necessary to improve function? Varied- Stimulation Practice Semisupervision

6 Hook lying 1 Bridging 2 Supine progression 3 Prone progression Supine Rolling Prone Supine on elbows Rolling Prone on hands Side lying Prone on elbow Amphibian Position Side lying on elbow Kneel and elbow Sitting on hand Quadruped Long sitting Sitting on heel Crawling Scooting Standing on heel Kneel walking Short sitting Half kneel standing Supine on hands Standing Walking

7 Supine progression Crawling Bear standing Standing Quadripedal Side-sitting Kneeling Half - kneeling Rolling Long-sitting Supine Scooting

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9 Prone progression Crawling Bear standing Standing Quadripedal Creeping Prone on hands Kneeling Half - kneeling Prone on elbow Side-sitting Prone Long-sitting Scooting

10 Theraputic mat activity - stages of motor control Mobility: Availability to assume a posture and to initiate a movement. Stability: Stabilize a new static position and control gravity, Co-contraction Controlled Mobility: Make movements in a stable position. Skill: Manipulating the environment with dynamic, proximal stability

11 Theraputic mat activity - stages of motor control Mobility Stability Controlled Mobility Skill

12 Theraputic mat activity hooklying & bridging General characteristics Hooklying 은일차적으로 lower trunk, hip, knee control 이요구된다. Hooklying 은안정적인자세에서양쪽 foot 의 sensory input 과체중지지를경험할수있다. Bridging 시 lower back & hip extensor m. 이 pelvic 을들어올린다. Bridging 시 hamstring m. 은 knee 와 feet 의위치를유지하도록한다. Treatment strategies & considerations Lower trunk 의 stability-mobility control. 양쪽하지의 weight bearing 과 shifting. Upper trunk 와양쪽상지의 stability. 안정적인자세에서보행준비.

13 Procedure and Patterns Hook Lying Lower trunk Rotation Objectives Bridging

14 Theraputic mat activity - rolling General characteristics Minimal antigravity postural control 이요구된다. Normal rolling 은전형적으로 segmental trunk pattern 으로성취된다. Head &neck motion 은 upper trunk rotation 과조합된다. Normal postural reaction 은 rolling 에도움을준다. Treatment strategies & considerations Rolling 에서 scapular 와 pelvis 는 handle 역할을한다. 첫시작은 side lying 에서시작하고적은범위에서넓은범위로진행한다. Limb movement 와 momentum 은 rolling 을더쉽게하도록도와준다.

15 Supine Procedure and Patterns Trunk flexion Trunk Extension Backward Rolling Rolling Objectives Side lying

16 Procedure and Patterns Supine Backward Rolling Rolling Objectives Prone

17 Theraputic mat activity prone on elbow position General characteristics head and upper trunk 는 elbow 와 forearm 에체중부하된상태이다. 이자세는일차적으로 head, upper trunk, shoulder control 이포함된다. 몸통에대한 scapular 와 shoulder 의 stability 가요구되어진다. 신체에대한 head 의정상적인 righting reaction 이요구되어진다. Treatment strategies & considerations Shoulder/scapular 주변근육의약화는이자세의성취와유지에제한을준다. - Assist 를위한도구, 자세변화고려. Upper extremity 의 spasticity 는이자세의유지를방해할수있다. - relaxation 을위한준비과정고려. 이자세유지를위한 lumbar spine 부분, hip flexor m. 의제한점을고려한다. - Assist 를위한도구, 자세변화고려.

18 Procedure and Patterns Prone Objectives Prone on elbow

19 Procedure and Patterns Prone on elbow Objectives Amphibian Position

20 Procedure and Patterns Amphibian Position Objectives Elbows and knees

21 Theraputic mat activity sidelying on elbow position General characteristics Side lying 자세에서몸통을들어올려한쪽 elbow 와 forearm 에체중지지가된자세이다. 신체의외측부분에감각자극을줄수있는자세이다. 아래쪽상지의 stability 가요구되고위쪽상지의 motion 이용이한자세이다. 몸통의 lateral part 의 elongation 과 upper trunk 의조절이필요한자세이다. Treatment strategies & considerations Affected side 의 sensory input 과초기 weight bearing. Trunk lateral part 의 elongation. Upper trunk 의 rotation control. 아래쪽상지의 shoulder jt. mobilization.

22 Supine Procedure and Patterns Side lying on elbow Objectives Side lying on hand Long Sitting (Lift, scooting)

23 Supine Procedure and Patterns Side lying on elbow Objectives Side lying on hand Quadruped Position

24 Theraputic mat activity Quadruped position General characteristics prone on elbow 보다높은자세이나비교적안정정인 four-limb position 이다. 상지는 shoulder flexion 약 90 도의자세로관절위치가 shoulder-elbow-wrist 로위치한다. 하지는 hip flexion 약 90 도의자세로 hip jt. 아래 knee jt. 가위치하며등은평평하게유지한다. 이자세를취하고유지하는데 head/neck, upper trunk, upper extremity 그리고 lower trunk, hip control 이요구된다. Treatment strategies & considerations 양쪽상, 하지의 stability 상태에서 weight bearing. 다양한방향으로의 weight shifting. 몸통의 lateral part 의 mobility 증가. 몸통의 balance tr.

25 Quadruped Position Procedure and Patterns Objectives Kneeling Position

26 Procedure and Patterns Kneeling Position Objectives Kneel standing

27 Procedure and Patterns Kneel standing Objectives Half kneeling

28 Procedure and Patterns Half kneeling Objectives Standing

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