Stabilizing Reversals

12.6.3 Standing

Stand in a diagonal in front of the leg that is to take the patient's weight initially. Guide the patient to that side and use approximation and stabilizing resistance at the pelvis to promote weight-bearing on that leg (O Fig. 12.17 b; O Fig. 12.16 c). If weight is to be borne equally on both legs stand directly in front of the patient.

Weight Acceptance

— Combine approximation through the pelvis on the strong side with stabilizing resistance at the pelvis.

— Combine approximation through the pelvis on the weaker side (knee blocked if necessary) with stabilizing resistance at the pelvis.

Stabilization

— Combine Approximation and Stabilizing Reversals at the pelvis for the lower trunk and legs (O Fig. 12.18 a).

— Combine Approximation and Stabilizing Reversals at the shoulders for the upper and lower trunk (O Fig. 12.18 b).

— Using Combination of Isotonics with small motions or Stabilizing Reversals, resist balance in all directions. Work at the head, the shoulders, the pelvis, and combination of these.

One-Leg Standing

Use this activity to promote weight bearing in stance and to facilitate pelvic and hip motion in swing. The patient stands on one leg with the other hip flexed. The flexed hip should be above 90° if possible, to facilitate hip extension on the other leg. If the patient is not able to hold up the flexed leg, assist by placing the patient's knee above your pelvis and giving a compressive force to hold the leg in place (O Fig. 12.19 d). Alternate the weightbearing leg frequently to avoid fatigue. The timed one-leg-standing measurement is a good functional balance test to evaluate the patient's progression.

Emphasis on Stance Leg

— Approximate through the pelvis to encourage weight bearing (O Fig. 12.19 c).

— Use Combination of Isotonics with small motions or Stabilizing Reversals at the pelvis to resist balance in all directions.

Stabilizing Reversals
Fig. 12.18a,b. Stabilization at the pelvis and on the shoulders

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