Functional Mobility Introduction Handout PDF

FUNCTIONAL MOBILITY INTRODUCTION J.J. Mowder-Tinney PT, PhD, NCS Identify the types of functional mobility this module will focus on bed mobility Learning Objectives Identify the components of task analysis – analyze a movement Demonstrate the progression of motor task requirements Bed mobility Roll...

FUNCTIONAL MOBILITY INTRODUCTION J.J. Mowder-Tinney PT, PhD, NCS Identify the types of functional mobility this module will focus on bed mobility Learning Objectives Identify the components of task analysis – analyze a movement Demonstrate the progression of motor task requirements Bed mobility Rolling (supinesidelyingprone) Bridging and scooting Basic Mobility Skills Supine or sidelyingsitting Basic transfers Level surface Unlevel surface Sitstand Basic w/c skills Propulsion Pressure relief THE KEY IS ANALYZING THE MOVEMENT!! To determine how to assist someone in moving requires understanding normal Why is this important? movement To determine the best inter vention requires analyzing the movement and finding the WHY Initial Conditions/ Termination What is initial/Terminal BOS? Starting position and alignment? Check all three planes Unable to sustain Preparation Alignment/Midline Descriptors Multiple attempts to initiate a movement Rocking, start/stop, hesitations, sway, poor adjustment Where is movement initiated Execution Difficult with transition Hesitation, Inaccurate speed Stopping movement, Extraneous movement Deterioration of performance Inaccurate direction or speed Observations Description Speed of Movement Time to complete the task Amount of Movement Amplitude (large, med, small), excursion, ROM of movement required to complete the task, direction Symmetry of Movement There may be natural symmetries in a task Control Smoothness, coordination, stability, sequencing, timing initiation Symptom Alteration Guarded, shortness of breath, pain alteration OVERALL ~Are you giving Max assist at the knee so it doesnʼ t buckle? ~Or mod assist at the trunk to maintain upright? Big Picture Considerations Amount of cueing /assist AND what kind? The more specific you are with this description the better. What is their breathing like? What elements of motor control are necessar y to per form the various components of the task? Hypothesize the WHY What musculoskeletal components (ROM, muscle length, strength) are needed to be able to per form the functional task? Search for the underlying cause of the movement issues: Neuromuscular /Biomechanical /Psychological Fell, Dennis W. LIFESPAN NEUROREHABILITATION. Available from: FADavis, F. A. Davis Company, 2018. Page 469 Adequate mechanical capacity Mobility of joint, sof t tissue, muscle and neurovascular Appropriate neuromuscular function Initiate contraction, adequate strength Efficient Movement and endurance Effective motor control (be specific here if you state this: correct muscle recruitment, correct timing of muscle recruitment, etc) Proper movement strategies while engaged in functional activity with changing task demands CONSTRAINTS AND FACILITATORS Movement Individual Constraints related to the body’s structure and/or behavioral function Task Environment Constraints related to a specific task or skill Constraint from outside the body Surrounding Environment Person Stability or Stationary or Considerations for adjusting challenge Mobility Motion Manipulation or None Objects Stationary Taxonomy of Tasks Closed Adapted from Gentile Task taxonomy Page 471 Motion Variable Consistent motionless motion Surrounding Environment Open How would Supine to sit we adjust the challenge for Earl?? Sit to stand Mobility Stability Controlled Mobility Skill MOTOR TASK REQUIREMENTS GREAT WORK!