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?
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What should be mastered before plantigrade?
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What is the natural step after plantigrade?
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How can you increase range of motion in plantigrade?
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How do you increase shoulder flexion range of motion in plantigrade?
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How can you improve dorsiflexion in plantigrade?
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What can plantigrade with hands on corners of a wall do?
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What can weight shifting against a wall improve?
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When is a hip flexed position with knees extended indicated?
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How do you perform medial/lateral weight shifting in plantigrade?
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How do you perform diagonally forward and backward weight shifting in plantigrade?
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What other activity encourages weight shifting in plantigrade?
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What is the motor control goal of plantigrade?
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When is plantigrade indicated?
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What is the functional outcome of plantigrade?
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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.
