Steps To Follow

1 The Problems We Cannot See.- 1.1 Perception and Perceptual Problems.- 1.2 Implications for Therapy.- 1.3 Application to Therapy.- 1.4 Guiding.- 1.5 Considerations.- 2 Normal Movement Sequences and Balance Reactions.- 2.1 Analysis of Certain Everyday Movements.- 2.2 Balance, Righting and Equilibrium Reactions.- 2.3 Considerations.- 3 Abnormal Movement Patterns in Hemiplegia.- 3.1 Persistence of Primitive Mass Synergies.- 3.2 The Synergies as They Appear in Association with Hemiplegia.- 3.3 Abnormal Muscle Tone.- 3.4 Placing.- 3.5 Relevant Tonic Reflexes.- 3.6 Associated Reactions and Associated Movements.- 3.7 Disturbed Sensation.- 3.8 Considerations.- 4 Practical Assessment — A Continuing Process.- 4.1 The Aims of Assessment.- 4.2 Immediate Observation.- 4.3 Subjective History.- 4.4 Appropriate Clothing for Assessment and Treatment.- 4.5 Muscle Tone.- 4.6 Joint Range.- 4.7 Muscle Charts.- 4.8 Recording the Assessment.- 5 The Acute Phase — Positioning and Moving in Bed and in the Chair.- 5.1 The Arrangement of the Patient’s Room.- 5.2 Positioning the Patient in Bed.- 5.3 Sitting in a Chair.- 5.4 Self-Assisted Arm Activity with Clasped Hands.- 5.5 Moving in Bed.- 5.6 Transferring from Bed to Chair and Back Again.- 5.7 Incontinence.- 5.8 Constipation.- 5.9 Considerations.- 6 Normalising Postural Tone and Teaching the Patient to Move Selectively and Without Excessive Effort.- 6.1 Activities in Lying.- 6.2 Activities in Sitting.- 6.3 Activities in Standing to Train Weight-Bearing on the Hemiplegic Leg.- 6.4 Activities in Standing to Train Selective Movement of the Hemiplegic Leg.- 6.5 Rolling Over.- 6.6 Considerations.- 7 Retraining Balance Reactions in Sitting and Standing.- 7.1 Activities in Sitting.- 7.2 Activities in Standing with the Weight on Both Legs.- 7.3Activities in Standing with the Weight on the Hemiplegic Leg.- 7.4 Activities Where the Weight Is on Alternate Legs.- 7.5 Activities in Standing with the Weight on the Sound Leg.- 7.6 Considerations.- 8 Encouraging the Return of Activity in the Arm and Hand and Minimising Associated Reactions.- 8.1 Activities in Supine Lying.- 8.2 Activities in Sitting.- 8.3 Activities in Standing.- 8.4 Stimulation of Active and Functional Movement.- 8.5 Considerations.- 9 The Re-education of Functional Walking.- 9.1 Important Considerations Before Facilitating Walking.- 9.2 Facilitation.- 9.3 Protective Steps to Regain Balance.- 9.4 Supporting the Hemiplegic Foot.- 9.5 Going up and down Stairs.- 9.6 Using a Stick.- 9.7 Considerations.- 10 Some Activities of Daily Living.- 10.1 Therapeutic Considerations.- 10.2 Personal Hygiene.- 10.3 Dressing.- 10.4 Undressing.- 10.5 Eating.- 10.6 Driving a Car.- 10.7 Considerations.- 11 Mat Activities.- 11.1 Going down on to the Mat.- 11.2 Moving to Side-Sitting.- 11.3 Activities in Long-Sitting.- 11.4 Rolling.- 11.5 Prone Lying.- 11.6 Moving to Prone Kneeling.- 11.7 Activities in Prone Kneeling.- 11.8 Activities in Kneel-Standing.- 11.9 Activities in Half-Kneel-Standing.- 11.10 Standing up from Half-Kneeling.- 11.11 Considerations.- 12 Shoulder Problems Associated with Hemiplegia.- 12.1 The Subluxed or Malaligned Shoulder.- 12.2 The Painful Shoulder.- 12.3 The “Shoulder-Hand” Syndrome.- 12.4 Considerations.- 13 The Neglected Face.- 13.1 Important Considerations for the Facilitation of the Movements of the Face and Mouth.- 13.2 Dentures.- 13.3 Appropriate Treatment for the Common Difficulties.- 13.4 Oral Hygiene.- 13.5 Considerations.- 14 Out of Line (The Pusher Syndrome).- 14.1 The Typical Signs.- 14.2 Specific Treatment.- 14.3 Considerations.-15 The Home Programme.- References.