Therapeutic Goals

Give the therapist effective control of the patient's motion.

Facilitate control of the direction of the resistance.

Enable the therapist to give resistance without fatiguing.

Johnson and Saliba first developed the material on body position presented here. They observed that more effective control of the patient's motion came when the therapist was in the line of the desired motion. As the therapist shifted position, the direction of the resistance changed and the patient's movement changed with it. From this knowledge they developed the following guidelines for the therapist's body position (G. Johnson and V. Saliba, unpublished handout 1985): — The therapist's body should be in line with the desired motion or force. To line up properly, the therapist's shoulders and pelvis face the direction of the motion. The arms and hands al

O Fig. 2.6. Positioning of the therapist's body for the leg pattern flexion-abduction-internal rotation so line up with the motion. If the therapist cannot keep the proper body position, the hands and arms maintain alignment with the motion (O Fig. 2.6).

— The resistance comes from the therapist's body while the hands and arms stay comparatively relaxed. By using body weight the therapist can give prolonged resistance without fatiguing. The relaxed hands allow the therapist to feel the patient's responses.

Not only are the body position and body mechanics of the therapist important, but also the position in which the patient is treated. The treatment goal as well other factors influence this position. The functional activity that the patient needs, muscle tone, muscle strength, pain, and stability of the patient and therapist are some of the factors that need to be considered when choosing the appropriate position in which to treat patients.

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