STS scenario 1

• Difficulty getting out of a chair due to decreased forward movement during flexion momentum phase

  • Main Analysis Findings
  • decreased forward movement during flexion momentum phase - potential trunk flexor (iliopsoas) weakness - leads to less facilitation of lower limb extension
  • poor control of back extensors?
• Difficulty getting out of a chair due to decreased forward movement during flexion momentum phase

  • Further tests/investigations you would like to do
  • trunk flexor (iliopsoas) strength test/rom
  • assess strength of other muscles in flexion momentum - tibialis anterior (produces a concentric contraction to bring tibial shaft forward), back extensors (working isometrically to maintain spinal extension)
  • iliopsoas rom - potential tightness
  • fear?
• Difficulty getting out of a chair due to decreased forward movement during flexion momentum phase

  • A suitable outcome measure
  • timed up and go
  • iliopsoas strength
  • iliopsoas/flexion momentum ROM
• Difficulty getting out of a chair due to decreased forward movement during flexion momentum phase

  • Justification for selection of treatment
  • reaching forward to touch marker on a wall to increase forward movement
  • strengthen iliopsoas
  • increase rom of iliopsoas

  
• Difficulty getting out of a chair due to decreased forward movement during flexion momentum phase

  • progression
  • move marker further back, increase distance and increasing amount of forward movement
  • fade feedback
  • from blocked to random practice
  • from constant to random practice
• Difficulty getting out of a chair due to decreased forward movement during flexion momentum phase

  • Justification of approaches to facilitated learning
  • distributed better than massed - refer to gait scenario 1
  • part practice to build confidence and perfect technique of impaired component, then progress to whole practice
  • varied practice - vary height of seat/marker
  • stage of learning
  • cues - going from angle of square to angle of triangle to increase forward movement
  • demonstration
  • imagery
  • fade feedback
  • start with extrinsic feedback, progress to intrinsic
  • progress from KP to KF
• Difficulty getting out of a chair due to decreased forward movement during flexion momentum phase

  • Main Analysis Findings
  • decreased forward movement during flexion momentum phase - potential trunk flexor (iliopsoas) weakness - leads to less facilitation of lower limb extension during extension phase