Modified Plantigrade Characteristics and Control

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Questions and Answers

What are the general characteristics of modified plantigrade?

PT stands with elbows extended, hands open, weight bearing on plinth, wide base of support, symmetrical feet, high center of mass, more stable than standing due to 4-limb support, uses head, trunk, upper extremities, and lower extremities for upright postural control, hips flexed, knees extended, ankles dorsiflexed, normal righting reaction for upright head.

What types of postural control are involved in modified plantigrade?

Static postural control and dynamic postural control for movement control.

What are some treatment strategies for modified plantigrade?

Base of support can be modified; wider base of support is safer initially.

When is modified plantigrade a better choice than parallel bars?

When the patient has upper extremity flexor hypertonicity, as holding on the bars encourages flexor tone. Signup and view all the answers

What should be mastered before plantigrade?

Sitting with elbows extended. Signup and view all the answers

What is the natural step after plantigrade?

Quadruped. Signup and view all the answers

How can you increase range of motion in plantigrade?

Weight shifting. Signup and view all the answers

How do you increase shoulder flexion range of motion in plantigrade?

Lean backwards. Signup and view all the answers

How can you improve dorsiflexion in plantigrade?

Shift forwards. Signup and view all the answers

What can plantigrade with hands on corners of a wall do?

Improve trunk extensor range. Signup and view all the answers

What can weight shifting against a wall improve?

Elbow extension strength. Signup and view all the answers

When is a hip flexed position with knees extended indicated?

In stroke with abnormal lower extremity synergies. Signup and view all the answers

How do you perform medial/lateral weight shifting in plantigrade?

With lower extremities in symmetrical stance. Signup and view all the answers

How do you perform diagonally forward and backward weight shifting in plantigrade?

With lower extremities in a step position. Signup and view all the answers

What other activity encourages weight shifting in plantigrade?

Pointing and reaching. Signup and view all the answers

What is the motor control goal of plantigrade?

Controlled mobility through weight shifting and static dynamic control during stepping. Signup and view all the answers

When is plantigrade indicated?

When absent or diminished isolated pelvic control is needed for weight shifting or stepping, important lead-up skill to gait. Signup and view all the answers

What is the functional outcome of plantigrade?

Patient can weight shift and step forwards and backward in plantigrade. Signup and view all the answers

Study Notes

General Characteristics of Modified Plantigrade

Patient stands with elbows extended and hands open, weight bearing on a plinth.
Base of Support (BOS) is wide with hands on the plinth and feet positioned symmetrically.
Center of Mass (COM) is elevated, enhancing stability compared to standing.
Involves head, trunk, upper extremities (UE), and lower extremities (LE) for postural control.
Hips are flexed, knees extended, and ankles are dorsiflexed.
Normal righting reaction is present for keeping the head upright.

Types of Postural Control in Modified Plantigrade

Static postural control is essential for maintaining an upright posture.
Dynamic postural control facilitates movement activities such as weight shifting and reaching.

Treatment Strategies

The Base of Support can be customized to suit patient needs.
A wider Base of Support is recommended for safety in initial stages.

Comparison with Parallel Bars

Modified plantigrade is preferable when the patient exhibits UE flexor hypertonicity (e.g., from TBI), as holding bars may increase flexor tone.
This position encourages UE extension, counteracting hypertonicity.

Prerequisites for Modified Plantigrade

Mastery of sitting with elbows extended is necessary before progressing to plantigrade.

Progression After Plantigrade

The next step following plantigrade is moving to quadruped, particularly beneficial for patients with shoulder and elbow instability (e.g., post-surgical repair).

Increasing Range of Motion (ROM) in Plantigrade

Weight shifting (w/s) techniques can be utilized to enhance ROM.

Shoulder Flexion ROM in Plantigrade

To improve shoulder flexion, the patient should lean backward during the activity.

Improving Dorsiflexion in Plantigrade

Forward shifts of the body can help increase dorsiflexion range.

Trunk Extensor Range Improvement

Performing plantigrade with hands positioned on corners of a wall can enhance trunk extensor range.

Elbow Extension Strength Improvement

Engaging in weight shifting against a wall can strengthen elbow extension.

Indication for Hip Flexed Position with Knees Extended

This position is beneficial for stroke patients with abnormal lower extremity synergies, as it moves them out of synergy.

Performing M/L Weight Shifting in Plantigrade

LEs should be maintained in a symmetrical stance during medial/lateral shifting.

Diagonal Weight Shifting in Plantigrade

This involves positioning the lower extremities in a stepping formation for forward and backward movements.

Activities Encouraging Weight Shifting in Plantigrade

Engaging in pointing and reaching activities facilitates improved weight shifting.

Motor Control Goal of Plantigrade

Focus is on achieving controlled mobility during weight shifting and maintaining static-dynamic control while stepping.

Indications for Plantigrade

Recommended for patients with absent or diminished isolated pelvic control necessary for weight shifting or stepping.
Serves as a crucial preliminary skill leading to gait.

Functional Outcome of Plantigrade

Enables the patient to perform weight shifts and step movements forward and backward while in plantigrade.

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Description

Explore the characteristics and treatment strategies related to modified plantigrade standing. This quiz covers postural control types and compares it with parallel bars, emphasizing stability and safety. Test your knowledge on essential concepts for effective rehabilitation.