C

s-«tha tal qe af ,.,;slcAtie:apf \SIMATSl

berdM Tiwrapf II

I. How an • physical therapist determine the approcwlate seat dePth for • whttl<:half S / 21 ?
••
••
2. What are some basic wheelchair handl"'I techniques. that should be taught to • ne-
3. How can a physical thefapist teach a wheekhait u - to p,Ol)ef1v !)C)Sltion tt,e;< boclv
••
Injuries?
4 How can a !Physical therapist use motor learnrn& p,;ncll)les to iml)<O¥e • patient's motoc control?
S. What are AOU and why are they lmpoctant? Mention~"' AOu.
6. What factors can Impact a person's ablloty to perform I.OU?
7. How can• physical therap,st 1ssess a pat,e nt' s ADI. ;ablht1es?
8. How can a physical ther1p1st use 11sk-spe<1f1C 1r;alri1n1 to 1mpr011e • p111ent' s Ml!.. ablhtll's?
9. What are wrne common rnethOds of ~ lance 1rain1r,g?
10. What are the benefits ol balance 1ra1n1nc for older adults?
11. What 1re s.ome commori exerclsrs or ac11v111es that may be 1ncO<'porated into uutch tralni na?
12. How can an Individual adJUSI crutches for optimal f11?
13. Whal art tlhe comporients of the ICF model?
14. What IS the Berg Bal.ince Selle ?
IS. What is th.: rnnc1rk ot' ,ix-.:1tic11) in coordination. cxcrc=, 1
16. What are the pnr equlSltes for the appliution of lower hmb bri<e?
\ 1 . ~•'nn, nrr 1hr key pnnc,pl~ of m:unm\ lymphatic dnurq~·•
18. A 40-ye.ir•old woman who wants t o sta n a new e•erc1!>t routine. She is interested 1n jogi... but s11e is
concerned about over uer11ng h er!>ttt . Her r e stin g heart rate 1s 70 ~au per minute . 5M wo,,ld l1Ulo.,_
what her target heart rate ione should ~ tor moderate-inte nsity exer •
19. Whai 15 the principle of graded actMty 1n t ~ t e d tllefc.ise?
10. What is Scroth exercise?
t •

-
 A.<a< eacn group to:
• measure ea& penor and record the measuremerts;
• every member of the gro1.p should measure every other pern>n - so
that the measl.rements car be compared at the erd of the exercise:
• record tt-e measl.rements in the space provided in tt-e wOl"'<book.

MC>ft around the gro1.ps ard morvtor closely. Use the guide below to
check that the participants use the correct tecl,niques.
Check measuremerts to assess row accurately pMtldpants are taking
the measurements.
Trainer may record measurements or a wt-iteboard so that any
d ifferences are t-ighlighted

Allow 15 min1.tes (5 minutes per pern>n) for practice and IS minutes

for feedback.

• Ask: Were all me=rements of tt-e same person the same?

• Ask: What may ca1.se differerces? (Answer: not Lsirg the correct
tedmiqi.e - for example not askirg the wheelchair user to sit upright
not placing the upe measure ir the correct position. not reading the
tape measure correctly).
• Ask: What problems might be caLsed if the wrong measurement is
taken? (Answer: tt-e wheelchair may rot fit the user).

Trainers - use this guide to check that participants are using co rrect techniques

f or all measurements, make sure the tape measure ts held straight and the
wheelch air user ts sitting upnght. T he feet should be supported on the floor
o r on foot blocks 1f h e /she cannot reach the floor comfortably.

A Check there is noth,rg in wheelchair 1.se.-'s podcets before

measunng. Measure hips o r widest part of thighs. Holding two
clipboards/books against each side o f the wheelchair user can help

0w
to get an acc1.rate measurement

8 Place a chpboard/book at the back of the wheelchair 1.ser to help

get an accurate measuremert Measure from the back of the pehns
to the back of the kree ,n a straight l,r e .
Always measure bot/, legs. If there ,s a difference betweer the two
legs. creek ti- at tl-e wheelchair LSl!f" 1s Sitting up wrth the,r pelvis
level. If there JS stJII a d1ffetence. make the wheelchair prescription
for the shorter sade.

13t

WHEELCHAIR
SERVICETRAINING PACILJI.GE
148 / 260

C Measl.re from tt-e back of the knee to the base of

tl-e heel. Make sure the wheelchair user's ankles are
bent at 90 degrees (1f possible). Always measure both
legs. If the wl-eelcliair user wears shoes. measure with
tl-e sroes trey wear most days (if any).

D Measl.re the seat to the bottom of the rib cage.To

help fird the bottom of the ri> cage. place hands
on both sides o f the pelvis. Gently sq1,eeze hands
inwards ard slide I-ands upv,ards. Tl-e bottom of the
rib cage is just abol,e tt-e waist

E Measl.re from tt-e seat to tt,e bottom of the shoulder

blade in a vertical line.To 1-elp find tt-e bottom of the
sl-01.lder blade. ask tt-e wheelchair 1,serto sl-rug his/
her shoulders.

6. How to take body measurements (20 minutes)

Explain: We have now practised taking measurements from the wheelchair user.
Now we will see how these measurements relate to the wheelchair.

Ask participants to look at their copy of the

wheelchair assessment form.
Point out the third column on the
measurement table.
Expwn: This explains how the body
measurement relates to the wheelchair. We
will look at each one now.
 bent at 90 degrees (if possible).Always measure both
legs. If the wreelcrair user wears shoes. meas,.re wrth
tre sr oes trey wear most days (if any).

D Meas,.re the seat to the bottom of the rib cage.To

help fird the bottom of the rib cage, place r ands
on both sides of the pelvis. Gently squeeze hands
inwards ard slide rands upwards. Tt,e bottom o f tre
rib cage is just ab011e tt-e waist

E Meas,.re from tre seat t o tt-e bottom of t t,e shoulder

blade in a vertical line.To r elp find tt-e bottom of tt-e
sroLlder blade, ask tt-e wheelchair 1.ser to shrug his/
her shoulders.

6. How to take body measurements (20 minutes)

Explain: We have now practised taking measuremenu from the wheelchair user.
Now we will see how these measurements relate to the wheelchair.

Ask participants to look at their copy of the

wheelchair assessment form.
Point out the third column on the
measurement table.
Explaln: This explains how the body
measurement relates to the wheelchair. We
will look at each one now.

Explaln:
• Measurement A: Hip width equals the
width of the wheelchair seat.
• The wheelchair seat width should be as
dose to the user's hip width as possible,
but should newr be smaller.
• If a wheelchair user has no sensation, it
is important to make sure that the sides
of the wheelchair are no< pressing on the
pelvis or thighs.

140

149 / 260 ••
••
••

Explain:
• Measurement B: Seat depth less
approximately 30-SS mm is the ideal
wheelchair seat depth.
Correct tit gives the thigh good support.
This will reduce pressure under the seat
bones and help to stop pressure sores.
For wheelchair users with long legs. there
may be a bigger gap. Up to 60 mm is
:acceptable.
If the - 1~ is too long, the user wil not
be able to sit upti#tt. The bad< "the alf may
also rub on the mit edge cl the seat. ausing
disc:cmiort and/or a premre sore.
If there is a diffwenc::e between right and
left sides. use the shorter leg measurement
to make presc:ription choices.

_
Explain:
. ...__c~ - Measurement C equals either:
.!':.:."'
lloo. _ _&:- _
- _ _ -_-
.., ...
_

the measurement from the top of the

;:::~~---
. " ' - " ' , . . ,...It. .. . ." ( -
seat cushion to the footrests: or
the measurement from the top of
--- •
the cushion to the floor (for foot
11 :1 O 'fJ @ IMI ~ W *~i H ~I ~,~ •□
9789241503471 tr... t\ ••
•

Explain:
• Measurement 8: Seat depth less
approximately 30-SS mm is the ideal
wheelchair seat depth.
Correct fit giws the thigh good support.
This will reduce pressure under the seat
bones and help co stop pressure sores.
For wheelchair users with long lep, there
may be a biger 1ap. Up to 60 mm is
acceptable.
Wthe seat lercth is too I~ the user wil not
be able IX) sit upr\tlt. The back cl the calf may
also rub on the rent ed&'I d the seat. ausir,i
discx)mb-t and/or a presare sore.
If there is a difference ~ n ,;,ht and
left sides, use the shorter lee measurement
to make p r e ~ choices.

Explain:
• Measurement C equals either:
the measurement from the top of the
seat cushion to the footresu; or
the measurement from the top of
the cushion to the floor (for foot
propellini).
• The correct footresu hei,t,t is imp<>l"tant
u this ensures that the thi,tls are
-11 supp<>l"ted and the feet are fully
supp<>l"ted by the footrests.
The footresu hei&ht almost always needs
final adjustment at fittln1, u it is hard
to estimate how much the cushion will
compress when the user sits on it.
The correct seat hei,t,t for someone
propellin, with their feet Is Important
to ensure they are -11 supported in
the whHlchair and can reach the floor
comfortably to propel efficiently.

141

Explain:
• Measurement D or E equals the distance

1he tap oldie badnst.

. !!l.~ fit should pe ~
allow
support he/Ille needs
~
.. acdwe whNlchail . . . die frNdom co
 the cushion to the ftoor (for foot
propelling).
The correct footrests height is important
as this ensures that the thighs are
well supported and the feet are fully
supported by the footrests.
The footrests height almon always needs
final adjustment at fitti11&, as it is hard
to estimate how much the cushion will
compress when the user sits on it.
The correct seat heicht for some011e
propellins with their feet is important
to ensure they are well supported in
the wheelchair and can reach the ftoor
comfortably to propel efficiently.

141

WHEELCHAIR
,.-_. _ ,, SERVICETRAININGPACltAGE

.. ....._
Explain:

.,.,_,_ 0 or I•._-.•• Measurement D or E equals the distance

, between the top of the seat cushion and

M. . .
v. ... ~ - -- - - -
•C.,,« t tlt the top of the backrest.
C•"""-• ••N---fl.. ..:
.si.1•re•___.._-
, 11• ..,,..,...., ..c
.-.. • The correct fit should I'"" the wheelchair
user the support he/she needs and allow

.._.i4
. Slle,i!. . . . . . . . . . ... ~

......,,, ..,..
... , ..t ..... _ .. _ . . , .
an active wheelchair user the freedom to
move the shoulders to push.

Explain:
• Measurement D - will p a backrest
hei&flt which comes level with the bottom
of the wheelchair user's rib caie-
This is a good height if the wheelchair user:
is fit and active:
can sit upright easily with good balance.

• Measurement E - will ctve a backrest

height level with the bottom of the

--
wheelchair usef"'s shoulder blades.
•n. 1, . .... ...,.lf. • This is a J00d helcht if the wheelchair
· • ·~ ,. . . . ,....-11y. user:
·----""7..-.~JIII. • is likely to pt tired quickly:
• has difficulty sittin& upright.
• Explain: Always take both back height
measurements, as sometimes it is not
clear durinc the assessment which height
backrest will be most comfortable for the
user.

142
 233

WHEELCHAIR
SERVICE TRAINING PACKAGE

Annex 4: Wheelchair prescription (selection) form

This presrnpt,on form ,s for record,ng the cho,ce of wheelcha,r, wheelcha,r components
and cush,on for a wheelcha,r user who ,s able to s,t upnght comfortably

I . Wheelchair user information

Wheelchair user"s name:
Date of assessment: -----------Number:
Date of fitting: _ _ __
Assessor's name:
-----------------------
2. Type of wheelchair and size selected
To select the type of wheelchair:
• Discuss with the wheelchair user.
Think about the most important needs of the wheelchair user.
Check: wheelchair frame. castor and rear wheels. footrests. armrests, backrest
height (or adjustability). rear wheels position. support and comfort.

Type of wheelchair Size

□
□
□
□
□

3. Type of cushion selected

Type o f cushion Size
E.g. Foam pressure relief cushion □
E.g. Flat foam cushion □
□

4. Agreed
Signature of the user:
Signature of the assessor:
Signature of the manager:

134

242 I 260

A nnex 5: Wheelchair summary form

Notes for traiMrs - ,ejrrfora these points cbWlf proctia.

• Pushing con-ect!y means less effort.

• Push from 10 o·dock to 2 o·dod< position.
• Use a long smooth action to push.

• Hold one push rim towards the front and the other towards
the back.
• Pull the forward hand bad<wards and push the backward
hanc forwards at the same tme.

• Lean forwan! - this helps stop the wheekha.r llpping.

• When prarus,ng, ~ an assistant stand behind for safety.
• To stop or rest - park the wheelchar s.idew¥,

• Lean baclcwarcs. 51 / 260 ••

••
• Let the push nm slide slowly through the ha, ••
• E,cperienceo wheelchair = who are able to do a
..wheetoe·· (1.e. balance the wheelchair on the rear wheels
only) may rol dOIMl a slope on their back wheels.This ,s
very efficient

• Go up backwat'ds.
• Tilt wheelchair on to the back wheels. posrt,oned aga,nst
the first step.
• Ass,stant puls backwards and upwards - roU,ng the
wheekhair14>-
• WheekhJJr use- can ass.st by pul~ng the push rms
backwards.
• A second ass.st.ant can aSSISt by holding on to the wheelchair
frame from the front (not footrests).

41

ii • Go COM> forwards.
'i Q; • Tilt the wheelcha,r on to the back wheels.
s. ~
GI ..
• AsSlst.w'lt lets the back ~ s sow+, rol dOIM\ one step at a t me.
~ .~ • Wheelchair u= can .lS.S4st by controlling the wheelchair wrth
C ., the push nms.
3 ..
0 • A second = n t an help by steady,ng the wheekhar from
0 the front. hole.re on to the wheelchair fr.wne (not footrests).

• Being able to co a partial wheelie is very useful fo.- a

wheelchair user.
• The wheelchair u= can lift the front wheels to clear small
kerbs. stones and bumps.
• Roll the wheelchair backwards un!JI han<!s are at IO o·clod,.
then push forwards quickly.
• The castor wheels should come up.
• With practice. rt ,s possible to lift the castor v.heels at the
nght tJme to clear small obstacles.
• Always make sure there is a peoon stan<!r,g behind the
'hheelchalr user when he/she t:>eg,n to practise this sloll.
 around the room are sitting.
Explain:
when providing a wheelchair, it is

- important to encourage wheekhair

users to "sit upright";
"sitting upright" is sometimes called
"neutral sitting posture".

Ask a YOlunteer from the group to sit in a chair at the front of the group. Ask him/
her to "sit upri,t,t". (Ensure that he/she sits with an upri&f,t/neutral poswre).
Ask the croup to describe the YOlunteer's posture. Encourap responses.

45

IIAlJC LEVll

54 / 260 ••
••
WHEELCHAIR ••
SERVICE TRAINING PACKAGE - -

Most important answers:

• pelvis uprighl and level; • legs slightly open (abducted);

• shoulde~ level.arms free to tn<111e: • knees and ar-kles flexed near 90
• trunk upright deg<tts;
• back following the three natural c~rve1,; • heels directly below the knees or
sloghl ly faward or back;
• head upright and balanced aver the body;
• feet flat on the floor.
• hips flexed near 90 degree1;

H ow to tell 11 a pen;on is sitting upright

Look from the side and check:

✓ pelvis upright
✓ trunk upr,ghl back following the three natural CUrve1.:
✓ hips flexed near 90 deg=
✓ knees and arJdes flexed near 90 deg<tts;
✓ heels directli, below the knees or s~ghtly forward or back:
✓ feet flat on the floor or footrests.

Look from the front and check:

✓ pelvis level;
✓ shoulde~ le-.el. relaxed and arms free to move:
✓ legs shgh tly open (abducted):
✓ head upright and balanced aver the body.

Explain:
• Upright sitting is not exactly the same for f!'lery person.
The following slides wil show the key things to look for - however. these are
only a guide.
• The most important thing about upright sitting is that the person is relaxed.
comfortable and well balanced.
-- Factors Affecting ADL +
Default (GPT-3.5)

ADLs, including:

1. Physical Health: Physical conditions

or disabilities can significantly affect
a person's ability to perform ADLs.
This includes mobility issues,
chronic pain, sensory impairments,
and conditions like arthritis or
neurological disorders.
2. Cognitive Function: Cognitive
impairments, such as dementia or
Alzheimer's disease, can affect a
person's ability to remember and
carry out tasks related to ADLs.
3. Emotional and Mental Health:
Mental health conditions like -.v
depression. anxietv. or other mood
-- Fa ct or s A ffe ct in g A O L +
De fa ul t (GPT-3.5)
fll ~J JI U~ f df lU
fJ~ f:S UI I:: ; c:1UflfLY LU f~

.
ca rr y ou t ta sk s re la te d to A D Ls
3. Emotional an d M en ta l H ea lt h:
M en ta l he al th co nd iti on s lik e
oo d
de pr es si on , anxiety, or ot he r m
n an d
di so rd er s ca n im pa ct m ot iv at io
en er gy levels, w hi ch ca n in tu rn
pl et e
af fe ct a pe rs on 's ab ili ty to co m
ADLs.
liv in g
4. Environmental Factors: Th e
nt
en vi ro nm en t can be a si gn ifi ca
te d
factor. A ho m e th at is no t ad ap
an d
fo r ac ce ss ib ili ty or is cl ut te re d
es
di so rg an iz ed can po se ch al le ng
fo r pe rf or m in g ADLs.
lit y of ~
5. Social Su pp or t: Th e av ai la bi
fa m ily m em be rs , ca re gi ve rs , or
-- Factors Aff ec tin g AO L +
vc-1a u1L \ UI , - v,.J /

s. Social Support: Th e av ail ab ilit y of

fam ily members, ca reg ive rs, or
su pp ort ne two rks can gre atl y
influence a pe rso n's ab ilit y to
co mp let e ADLs. Ha vin g as sis tan ce
or en co ura ge me nt can ma ke a
sig nif ica nt dif fer en ce .
6. Financial Resources: Ad eq ua te
financial res ou rce s are ne ed ed to
aff ord necessary as sis tive de vic es ,
ho me mo dif ica tio ns , or pro fes sio na l
ca reg ivin g se rvi ce s tha t ca n su pp ort
ADLs.
7. Education an d Training: Kn ow led ge
ab ou t pro pe r tec hn iqu es an d too ls
for pe rfo rm ing ADLs, as we ll as
access to tra ini ng an d ed uc ati on J
-- Factors Affecting ADL +
Default (GPT-3.5)

ADLs.
7. Education and Training: Knowledge
about proper techniques and tools
for performing ADLs, as well as
access to training and education,
can enhance a person's
independence.
8. Age: Older individuals may face
natural age-related declines in
physical and cognitive abilities,
which can impact their ability to
perform ADLs.
9. Cultural and Personal Preferences:
Cultural beliefs and personal
preferences may influence how
..J,,
ADLs are approached and what is
-- Factors Affecting ADL +
Default (GPT-3.5)

which can impact their ability to

perform ADLs.
9. Cultural and Personal Preferences:
Cultural beliefs and personal
preferences may influence how
ADLs are approached and what is
considered essential for daily living.
10. Medical Treatments and
Interventions: Medical treatments,
therapies, and interventions can
have an impact on a person's ability
to perform ADLs. For example,
physical therapy can improve
mobility and functioning.

It's important to, note that the impa<'t

of these factors can vary widely frort
 Factors Affecting ADL +
Default (GPT-3.5) t!J

m How can a physical therapist use task

specific training to improve patient
adl

Ill Task-specific training is a therapeutic

approach used by physical therapists
to help patients improve their ability
to perform specific activities of daily
living (ADLs). Here's how a physical
therapist can utilize task-specific
training to enhance a patient's ADL
performance:

1. Assessment and Goal Setting:

• The physical therapist starts b·. -.v
conducting a thorough

Send a message
-- Factors Affe ctin g ADL +
Defa ult (GPT-3.5)

1. Assessment and Goa l Set ting :

• The phy sica l the rap ist star ts by
con duc ting a tho rou gh
ass ess men t of the pat ient 's
cur ren t abilities, incl udin g
stre ngth s, weaknesses, ran ge of
mot ion, balance, and
coo rdin atio n.
• Spe cific ADL s tha t the pat ient
stru ggle s with are iden tifie d.
2. Task Selection and Prioritization:
• Based on the ass ess men t, the
ther apis t sele cts spe cific ADL s
tha t are rele van t and mea ning ful
to the pati ent' s dail y life.
• Prio ritiz atio n is imp orta nt,
-- Factors Aff ec tin g AO L +
~
De fau lt (GPT-3.5)
- -- · - ···- -·- ··-
• Sp ec ific AOLs tha t the pa tie nt
str ug gle s wit h are ide nti fie d.
2. Task Selection an d Prioritization:
• Based on the as se ssm en t, the
the rap ist se lec ts sp ec ific AO Ls
tha t are relevant an d me an ing ful
to the pa tie nt' s da ily life.
• Pri ori tiza tio n is im po rta nt,
foc us ing on tas ks tha t have the
gre ate st im pa ct on the pa tie nt' s
ind ep en de nc e an d qu ali ty of life.
3. Breaking Down Tasks:
• Th e the rap ist bre ak s do wn ea ch
chosen AO L int o its co mp on en t
parts. For example, if the go al i' .,J,,
to im pro ve dre ssi ng , thi s mi gh t
- Factors Affecting AOL +
that are relevant and meaningful
to the patient's daily life.
• Prioritization is important,
focusing on tasks that have the
greatest impact on the patient's
independence and qual ity of life.
3. Breaking Down Tasks:
• The therapist breaks down each
chosen AOL into its component
parts. For example, if the goal is
to improve dressing, this might
involve breaking it down into
steps like reaching, gripping, and
coordinating movements.
4. Repetitive Practice:
• The patient engages in repetitive
practice of these specific task! ~

This helps reinforce neural

- Factors Affecting ADL +
Default (GPT-3.5)

parts. For example, if the goal is

to improve dressing, this might
involve breaking it down into
steps like reaching, gripping, and
coordinating movements.
4 . Repetitive Practice:
• The patient engages in repetitive
practice of these specific tasks.
This helps reinforce neural
pathways and muscle memory
associated with the targeted
movements.
5. Feedback and Guidance:
• The therapist provides
continuous feedback on
technique, posture, and

movement patterns to ensure\-~--

-- Factors Affe ctin g AOL +
Defa ult (GPT-3.5)

• The pat ien t engages in rep etit ive

pra ctic e of these spe cific tasks.
This helps reinforce neural
pathways and muscle me mo ry
associated with the targ ete d
movements.
5. Fee dba ck and Guidance:
• The the rap ist provides
continuous fee dba ck on
technique, posture, and
movement pat tern s to ensure the
patient is per form ing the tas k
cor rec tly and efficiently.
6. Progressive Challenge:
• As the pat ien t gains proficiency,
the the rap ist progre ssively ~

inr.n:~~~P.~ thP.rfiffir.11ltv nf th P.

Send a mes sag e

 +
-- Fa ct or s A ffe ct in g A D L

De fa ul t (GPT-3.5)
!:>K
µa ue r IL 1!::> µt ::r , ur rr 11 r1y u ,e La

co rr ec tly an d ef fic ie nt ly .
6. Progressive Ch al le ng e:
nc y,
• As th e pa tie nt ga in s pr of ic ie
th e th er ap is t pr og re ss iv el y
in cr ea se s th e di ffi cu lty of th e
ta sk . Th is co ul d in vo lv e ad di ng
resistance, in cr ea si ng th e
t, or
co m pl ex ity of th e en vi ro nm en
al te rin g th e ta sk in a w ay th at
en co ur ag es fu rt he r sk ill
de ve lo pm en t.
7. Contextual Training:
• Th e th er ap is t co ns id er s th e
d
pa tie nt 's ho m e en vi ro nm en t an
'V
in te gr at es as pe ct s of it in to th€
tra in in g. Th is he lp s en su re th at

Send a m es sa ge
 +
-- Factors Af fe ct in g AD L

Defau lt (GPT-3.5)
C CI I VII VI II II C II '-, VI
v V l l I fJI CI\ I 1.y VI 1.II

altering th e ta sk in a wa y th at
encourages fu rth er sk ill
development.
7. Contextual Training:
• The th er ap is t co ns id er s th e
patient's ho m e en vi ro nm en t an d
integrates as pe ct s of it in to th e
training. Th is he lp s en su re th at
th e skills learned in th e th er ap y
se tti ng tra ns fe r ef fe ct iv el y to th e
patient's da ily life.
8. Use of Adaptive Aids and
Equipment:
• The th er ap is t m ay in tro du ce or
re co m m en d th e use of ad ap tiv e
'd . gr au'V
a, s or eq ui pm en t (s uc h as

Send a m es sa ge
 Factors Affecting ADL +
Default (GPT-3.5)

ll It:: ::.t\111::; lt::dl I lt::U 111 ll It:: ll lt::I d!JY

setting transfer effectively to the

patient's daily life.
8. Use of Adaptive Aids and
Equipment:
• The therapist may introduce or
recommend the use of adaptive
aids or equipment (such as grab
bars, dressing aids, or mobility
devices) to support the patient in
performing ADLs more
independently.
9. Functional Integration:
• The therapist encourages the
patient to apply the learned ski 11s
in real-life situations, gradually ~

incorporating them into their

- Factors A ff ec tin g AOL +
D ef au lt (GPT-3.5)

9. Functional Integration:
e
• The th er ap is t encourages th
ill s
pa tie nt to ap pl y th e learned sk
in real-life situations, gradually
in co rp or at in g th em in to th ei r
da ily routine.
1 0. Monitoring an d Adjusting:

rs th e
• The th er ap is t closely m on ito
pa tie nt 's progress, m ak in g
an as
ad ju st m en ts to th e tr ai ni ng pl
needed. This could involve
g new
m od ify in g th e tasks, in tr od uc in
cus
challenges, o r ch an gi ng th e fo
based on evolving goals an d
abilities.
 Factors Affecting ADL +
incorporating them into their
daily routine.
10. Monitoring and Adjusting:

• The therapist closely monitors the

patient's progress, making
adjustments to the training plan as
needed. This could involve
modifying the tasks, introducing new
challenges, or changing the focus
based on evolving goals and
abilities.

1. Home Exercise Program:

• The therapist may provide the

patient with a personalized exercise
program that complements the ta--~ ·
 Factors Affecting ADL +
1. Home Exercise Program:

• The therapist may provide the

patient with a personalized exercise
program that complements the task-
specific training, allowing for
continued practice and
improvement outside of therapy
.
sessions.

By utilizing task-specific training,

physical therapists can effectively
target the specific functional
challenges faced by their patients,
ultimately enhancing their
independence in performing ADLs
and improving their overall quality ..,i,

life.
Examples of balance exercises include:

• Standing with your weight on one leg

and raising the other leg to the side or
behind you

• Putting your heel right in front of your

toe, like walking a tightrope

• Standing up and sitting down from a

chair without using your hands

• Walking while alternating knee lifts with

each step

• Doing ta i chi or yoga

• Using equipment, like a Bosu, which

has an inflatable dome on top of a
circular platform, which challenges
vour balance
ADVERTISEME NT
 chair without using your hands

• Walking while alternating knee lifts with

each step

• Doing tai chi or yoga

• Using equipment, like a Bosu, which

has an inflatable dome on top of a
circular platform, which challenges
your balance

Over time, you can improve your balance

with these exercises by:

• Holding the position for a longer

amount of time

• Adding movement to a pose

• Closing your eyes

• Letting go of your chair or other support

You can do balance exercises as often as

you'd like, even every day. Add in two days a
\MPPk of strPnPth trr1ininP. which r1lso hPlns
ADVERTISEMENT
 0

MIine·e>Cerctse
1

, 1'{ PrOgresston

GRADED REACHING ◄
NSTANDltG
◄

SID.ANGN ◄
DIFFERENT OIIIEC110NS
◄

◄
WALICING PRACTICE
◄

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 Baseline e>cercise Priogression

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ANDLATERAL

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HALFSQUAlS ◄
SLIDING DOWN A WALL
◄

o:u;1'1ied by
e-ni::~cup e-t !';IO"h:!.ro~~·
Why balance training is important for
older adults?

Recent research shows that a

well-designed balance
exercise program for older
adults can assist in
preventing falls and may
improve independence and overall quality
of life. These exercises work by helping you
to maintain your centre of gravity, and
improve posture, muscle reaction time and
mobility, Leeson explains. 6 6JU., 2021

■ https://www.mater.org.au • news > f. ..

Five balance-boosting exercises for older

adults - Mater
- Exercising with Crutches +
L..J

possible. Here are a few exercises you

can incorporate with crutches:

1. Seated Upper Body Exercises: You

can perform exercises like seated
shoulder presses, bicep curls, and
tricep dips while using your crutches
for stability.
2. Leg Raises: While seated or lying
down, lift one leg at a time, engaging
your core and leg muscles.
3. Seated Leg Extensions: Sit on a
chair or bench and extend your legs
straight out in front of you, then
lower them back down.
4. Seated Marching: While seated, lift
'V
your knees one at a time in a
----a....=-- --"-=-- ... _ ..._.... ,. ·-· ·- ·--
- Exercising with Crutches +
Ut::laUll \Ur 1-v .v/ L.:.J

tricep dips while using your crutches

for stability.
2. Leg Raises: While seated or lying
down, lift one leg at a time, engaging
your core and leg muscles.
3. Seated Leg Extensions: Sit on a
chair or bench and extend your legs
straight out in front of you, then
lower them back down.
4. Seated Marching: While seated, lift
your knees one at a time in a
marching motion to work your leg
muscles.
5. Crutch-assisted Standing Exercises:
Use your crutches for support while
performing standing exercises lik~
'V
squats, lunges, or calf raises.
 Health
Cond,itlon

Body Structures
and Functrions •
(Impairments)
Lllllli--►
•· . ActiiVities •Clll-------11t•
(Limitations) =
··. Particip~tion
(Restrictions)
Motor, 5e·lf-care, Socia I Roles,
Cognlt~on. MobHlty, Educatlon,
Affective ADL Employment

IEn1v lronment Personal

(Ba 11rlers) Factors
Physkat, Attitud ina I, Soc~ a I Sex,,Age,
!Health behavi,ours
Interpretation

Cut-off scores for the elderly were

reported by Berg et al 1992 l6 1as follows :

• A score of 56 indicates functional

balance.
• A score of< 45 indicates individuals
may be at greater risk offal ling.
• A score of <49 indicates a risk of
falls in individuals with stroke l7 ] .

It has been reported more recently that in

the elderly population a change of 4
points is needed to be 95% confident that
true change has occurred i~ ~'tt<t!k±Rtt0 P
scores within 45-56 initially, 5 points if

D 0 <J
Berg Balance Scale (with instructions)
SITrlNG TO STANDING
INSTRUCTIONS: Please s1and up. Try not to use your hand for support.
( ) 4 able to stand without using hands and stabilize independently
( ) 3 able to stand independently using hands
( ) 2 able to stand using hands after several tries
( ) I nttds minimal aid to stand or s1abilize
( ) 0 needs moderate or maximal assist 10 stand

STANDING UNSUPPORTED
INSTRUCTIONS: Please sland for two minutes without holding on.
( ) 4 able to stand safely for 2 minutes
( ) 3 able 10 stand 2 minutes wilh supervision
( ) 2 able to stand 30 =onds unsupported
( ) I needs several tries to stand 30 seconds unsupported
( ) 0 unable to Stand 30 seconds unsupported

If a subject is able to stand 2 minutes unsupported. score full points for sitting unsupponed. Proceed to item #4.

SITTING WITH BACK UNSUPPORTED BUT FEET SUPPORTED ON FLOOR OR ON A STOOL

INSTRUCTIONS: rlcase sit with llrmS folded for 2 minute< .
( ) 4 able to sit safely and securely for 2 minulcs
( ) 3 able to sit 2 minutcS under supervision
( ) 2 able 10 able to sit 30 seconds
( ) I able to sit IO seconds
( ) 0 unable 10 sit without support IO seconds

STANDING TO SITTING
INSTRUCTIONS: Please sit down.
( ) 4 sits safely with minimal use of hands
( ) 3 controls descent by using hands
( ) 2 uses back of legs against chair to control dcSCCnl
( ) I sits independcndy but has uncontrolled dcsc,enl
( ) 0 needs assisl 10 sit

TRANSFERS
INSTRUCTIONS: Arrange chair(s) for pivot transfer. Ask subject to transfer one way toward a scat w1th armrests
and one way toward a seat wilhoul armrests. You may use 1wo chairs (one with and one without armrcsu) or a bed
and a chair.
( l 4 able 10 transfer iafely with minor use of hands
( ) 3 able to transfer iatety definite need of hands
( ) 2 able to transfer with verbal cuing and/or supervision
( ) I needs one person to a.,sist
( ) 0 needs two people to assist or supervise to be safe

STANDING UNSUPPORTED WITH EYES CLOSED

INSTRUCTIONS: Please close your eyes and s1and still for 10 seconds.
( ) 4 able to stand IO seconds safely
( ) 3 able to stand IO seconds with supervision
( ) 2 able to stand 3 seconds
( ) I unable to keep eyes closod 3 seconds but Slays safely
( ) 0 need~ help to keep from falling

STANDING UNSUPPORTED WITH FEET TOGETHER

INSTRUCTIONS: Place your feel together and stand without holding on.
( ) 4 able to place fo:t togcthcr indcpcndcntly and •tand I minute ..,_fcly . .
( ) 3 able to place feet iogethcr independently and sland I minute w1th supcrv1swn
( ) 2 able to place feet together independently but unable 10 holcl for 30 seconds
( )I n«ds help to attain posi1ion bul able to sund IS seconds fec, tog<1h,,r
( )0 n«ds help to a1tain posi1ion and unable to hold few IS s«ands

REACHING FORWARD wrrn OUTSTRETCHED ARM WHILE STANDING

INSTRUCrtONS: Lift arm 10 90 degtta. Sm,u:h OUI )'OW' f1ng,n and reach forward as far .. you can. (Examiner
pla.:es a ruler at !he end of fingertips whm atm" a, 90 dtgre,,s. Fillgers shouid no110Ud1 ,he n,J,r whik reaching
forward. The recorded measure is die d,sw,ce fo,ward lhat lht fing,rs reach while lhe subjM is in die moSI
forward lean position. When possible, ..k subject"' uJ< bolh arms whtft re:>ch1ng ,o avoid rotation ofdle lt\ll\k.)
( ) 4 can reach forward confldendy 2S cm (IO l'.l<hes)
( ) J can reach forward 12 cm (S inches)
( ) 2 can reach forward S cm (2 1DChes)
( ) I rea.:hes forward but needs supervision
( ) 0 loses balance while uy1ng/r<quires """'"'"' supp>.n

PICK UP OBJECT FROM THE FLOOR FROM A STANDING POSlllON

INSTRUCTIONS: Pick up lhe shoe/slil'l"'f, ,.,Juch 1$ place in front ofynur fec,,
( ) 4 a'ble ,o pick up shppor safely and easily
( ) J able "' pick up shppor but needs supervision
( ) 2 unable to pick up bu1 rea<:hes 2-S cm( 1-2 inches) f'rom tbl'l"'f and kttps balanct indq,endaltly
( ) I unable to pick up and needs supervision ,.,h,le uymg
( ) O unable ,o uy/needs assist to kttp from losmg balan<t or falling

T URNING TO LOOK BEHIND OVER LEFT AND RJGlfl SHOULDERS WHILE STANDING
INSTRUCTIONS: Tum 10 look directly bdllnd you over ,oward die left shoulder. Rtpeat 10 lhe righL Examiner
may pick an object to look at directly bthmd die subject to <neounge a betttt "'ut wm.
( ) 4 loob bthind from both sides and " 'tight shills ,.,.,11
( ) J loob bthind one side only odler sldt shows less ..,.1g1u shift
( l 2 1ums sideways only but ma,niaiM bal.1nct
( ) I n«ds suporvision when wming
( ) 0 n«ds assist to kttp from losing balanC't o, falling

TURN 360 DEGREES

INSTRUCTIONS: Tum complt"'IY arourul in a full etrcle. Pause. Then wm a full circle in die olher direction.
( ) 4 a'ble ,o turn 360 degrttS safely ,n 4 seconds or less
( ) J a'ble ,o turn 360 degrttS safely one side only 4 s«:tlllds o, less
( ) 2 able "'turn 360 degrttS saftly bul stM.•I>•
( ) I needs close supervision or verbal cuing
( ) 0 n«ds assisiance while ,urning

PLACE ALTERNA:Jli FOOT ON STEP OR STOOL WHIU STANDING UNSUPPORTED

INSTRUCTIONS: Ploce each fooc altema.,ly on the sttpls,ool. Continue until each foot has IOUCh lhe stepis,ool
four times.
(
(
) 4 a'ble to stand independently and safely and comp~ 8 si,ps in 20 S<COnds
) 3 a'bl< ,o stand independently and compl"" 8 s1<ps in > 20 seccmds 2/ 3 ••
••
(
(
) 2 a'bl< 10 co,nple"' 4 '"'J>S wilhout aid wilh supervwon
) I a'ble to compl•"' > 2 , .,ps needs minimal asslSI
••
( ) 0 n«ds assistance ,o kttp from falling/unable to uy

STANDING UNSUPPORTED ONE FOOT IN FRO!'IT

INSTRUCTIONS: (DEMONSTRATE TO SURJEC'l) Plact one foot directly in from oftht olher. If you feel lhat
you cannot place )'OU( root or
directly in rroni. uy to •"'P far """""" ahead dlat ,he httl your rorward root is
ahead oft.he toes of the other foot. (To seo,e J poi"", die lcnglh of the ""P should =ted the lenglh oflhe olher
foot and die width oflhe sunce should apprMima"' die subj<et's normal Sll'idt " ·idlh.)
( ) 4 a'ble to pla.:e foot Wld<m indq><ndently and hold JO seconds
( ) J a'ble ,o pla.:e foot ahtod independently and hold JO stcoads
( ) 2 a'ble to take small •"'P 1ndq)<ndently and bold JO ...:onds
( ) I n«ds help 10 step but can hold IS s«ands
( ) 0 loses balance while sicpping or standing

STANDING ON ONE LEG

INSTRUCTIONS: Stand on,- leg as long as you can •itbc>ul holding on.
( ) 4 Ible to till l<g independenlly and hold > 10 s«onds
( ) 3 Ible to till leg independently utd hold S-10 seconds
( ) 2 Ible lo lift leg independently and hold ? 3 KCOnds
( ) I tries ,o Iii\ leg unable., hold J 5«0Dds but remains Slanding indepmdcntly.
( ) 0 llnable to uy of needs '""'ist to pm'ffll fall

( ) TOTAL SCORE (Maximum • 56)

( ) I needs h<lp k> ottain position bu1 able k> stand IS seconds feet 1ogeth,r
( ) 0 need, help k> oltain posi1ion and unable to hold for IS sec:oods

REACHING FORWARD wrrn OUTSTRETCHED ARM WHILE STANDING

INSTRUCTIONS: L,n arm 10 90 degre<s. Stre<ch ou1 your fingers and reach forward as far as you can. (Exominer
plac•• a ruler•• 1he en<! of fingcnips when arm is a, 90 degrees. fingers should nOI ioocb !be ruler while reaching
focw>rd. The recorded m<asure is 1he disunce forward lhal !he fingers reoch while !he subjm as an !he mo.i
fotWa.rd lean position. Wbtn poilible. ask subject to use both arms when reaching to avoid rouuon oflhc uunk.)
( ) 4 can reach foNo•3fd oonfidendy 25 cm ( 10 inches)
( ) 3 can reach fon:.•3fd 12 cm (5 inches)
( ) 2 can reach fon:.•ard 5 cm (2 inches)
( ) I reaches forward bu1 needs supervision
( ) 0 loses balance while uyinglrequires exlemal suppon

PICK UP OBJECT FROM nm FLOOR l' ROM A STANDING POSITION

INSTRUCTIONS: Pick up !he shoe/slipper, which is place m fronl of your t'<ct.
( ) 4 abl< 10 pic.k up slipper ,.fely and easily
( ) 3 ablt 10 pick up slipper bul nt<ds supervision
( ) 2 unable 10 picl: up bul reachn 2-5 cm(l-2 inchts) from shpp,r and keeps balance and,pendelllly
( ) I unable 10 pick up and needs sup,rvlllion while irying
( ) 0 unable 10 try/n.,,ds assiSI k> keq, from losing bolanco or falhng

TURNING TO LOOK BEHIND OVER I.EFr AND RIGIIT SIIOUI.DERS WHILE STANDING
INSTRUCTIONS: Tum 10 look dirc.:lly behind you over tow1rd !he lefl SMulder. Repeal 10 !he righL Examintt
may pick an objecl k> look .i dirccdy behind lhe subj,:,:110 encourage a beutt 11••is1 tum.
( ) 4 lool:s behind (rom ho1h sides and "'eight shills w<II
( ) 3 lool:s behind one side only 01her side si-s i.... weigh• ,hift
( ) 2 turns s,deways only bul muinwin, b,alancc
( ) I nL'Cds supervia1100 when cumins
( ) 0 nax..ts assist 10 k«p from 108ing balanco or rallang

l URN 360 DEGREES

INS'rRUCTIONS: Turn completely around in• full carcle. .......,, Th<n 1um • full circle in the Olher darc,:lion.
( ) 4 obi• 10 tum )60 dcgrets sar.ly in 4 "'-"OndJ or le$$
( ) 3 obi• 10 tum )60 degr,cs sartly one side only 4 seconds or le$$
( ) 2 abl• to tum )60 dcgrets sartly bul ,lowly
( ) I na'<ls close supervi,.on or n-rbol cuins
( ) 0 needs assistance whilt turrung

Pl.ACE ALTERNATE t'OOT ON STEP OR STOOL WHILE STANDING UNSUPPORTED

INSTRUCTIONS: Place each fool allemalely on lhe st<p/Slool. Conlinut unlll c:xh r001 has IOU<h 1he Slq>/Slool
four times.
( ) 4 ablt 10 sW\d independently and ..fdy and complele 8 Slt•p• in 20 seoonds
( ) 3 ablt 10 sW\d indepcndcnlly and compl,u, 8 sk:ps m > 20 ,oconcb
( ) 2 able 10 complew 4 step, wi1hoo1oid with sup,rvmon
( ) I able 10 C001pte1e > 2 <lep, need< minimal IIM"1
( ) 0 needs ossistance 10 keep from falling/unable 10 try

STANDING UNSUPl?ORTED ONE FOOT IN FRONT

INSTRUCTIONS: (DEMONSTRATE TO SUBJ EC-I) Plxt one foot directly in fron1 oflbe olhe 2/ 3
you eanno1 place your foor directly in fron1. 1ry 10 s1ep rar enoogJ, ahead thal the heel of your for»
ahead of the toes oflht olher font (To ,icore 3 poinlS, 1he l,ngth orlhe Sttp should exceed !he lengb,
foo1 and the widlh oflhe Slane< ,houkl approximate !he subject's normal said< "idth.)
( ) 4 •hie 10 pt..,, fooi Wldern ,ndep<ndenlly ond hold 30 second$
( ) J able 10 pl0<:e roo, ahe:id ,nd<pendently and hold JO seconds
( ) 2 •hie 10 lake small 11,p andepenai<ntly and hold 30 5<.:ond•
( ) I nc'Cds help 10 Slcp bu1 can hold I Ss«-onds
( ) 0 lo,.,. IMlluncc while ,1epp1ns o, sl&ndms

STANDING ON ON E LEG

INSTRUCTIONS: S1and on one les as long as you can wi1hout holding on.
( l 4 able 10 lift leg indtpmdenlly and hold > 10 ,econds
( ) 3 able k> lift leg independently and hold S-10 seconds
( ) 2 able lo lift leg independently and hold ? 3 seconds
( ) I 1ries k> lift leg unable k> hold 3 seconds bu1 remains ""nding independenlly.
( ) 0 unable 10 try of needs as,isl k> prevent fall

( ) TOTAi.SCORE (Maximum • 56)

 1/ 3
Berg Balance Scale (with instructions)
srmNG TO STANDING
INSTRUCTIONS: Please stand up. Try no< to use your hand for support.
( ) 4 able to stand witlwut using hands and st>bilize indq>endently
( ) 3 able to stand independmtly using hands
( )2 3.ble to s.tand using bands afwr iwveral tricn
( ) I needs minimal aid to scand or smbil11.c
( ) 0 needs modcralc or maxim.ii as.sis1 10 stand

s·rANDING UNSUPl'OR:TED
INSTRUCTIONS: Please sUlnd for two minutes witl,oot holding on.
( ) 4 able to SWld ,afely for 2 minutes
( ) 3 able to stand 2 mi,utes with supervision
( ) 2 able to stand 30 sa:onds unsupported
( ) I needs several tries to sl>nd 30 seconds unsuworted
( ) 0 unable to stand 30seeonds unsupported

If a subject is able to stand 2 minutes unsupported. s.corc full poinlS for s111ing unsupported. Proceed to Uffll #4.

srmNG Willi BACK lJNSUPPORTf:.D BUT FEET SUPPORTED ON FLOOR OR ON A STOOL

INSTRlJC'l"ION.S: Plcn!i< 111 ,..,th ann, folded ror 2 oninutes.
t ) 4 able to su sofoly ••d s«urely for 2 nunUl<s
( ) J able to siL2 minut~ under supervision
( ) 2 able 10 able 10 sit JO seeonds
( ) I able 10 sit IOseoood.s
( ) 0 unable to <it wiooutsupport 10 S«:onds

STANDING TO SITTlNG
fNSiRUCTlONS: Pie~ iit down.
)4 sits safely with minimal use of hands
)3 controls descent by using hand.<
)2 uses back of legs against chair to control de,cent
)I sits independently but has uncootrolled de><ent
) 0 needs assist to sit

TRANSl'ERS
INSTRUCTIONS: Arrange chair(!) for pivot tronsfer. Ask subject 10 transf<r ooe way toward , seat with armresu
and one WI)' toward a seat "'ilhout annrcsu. You may use l"'O ch.atrs (one wuh and one withoul armrests) or a bed
and II cluur.
( ·, 4 able 10 uun.ilCr safely v.•11.h minor u~ of h:mds
( ) 3 able to trunSler safely definote need or hands
( ) 2 able to transftr with vcrl>al cuing and/or sup:rvis.ion
( ) I needs one penon to assist
( ) O needs two poop.le 10 as..Jst or supervise to be safe

STANDING UNSUPPORTED WITH EYES CLOSED

INSTRUCTIONS: Please dose your eyes and stand still for 10 seconds.
( )4 ableto stond IO seconds safely
( ) 3 able 10 SWld IO seconds with supenision
( l 2 able to sWld 3 seconds
t ) I unable to keep e)"S closed 3 seconds but stays safely
( ) 0 ne«ls help to keep from falhng

STANDING UNSUPPORTED Wl11l FEETTOGElllER

INSTRUCTIONS: Placc rour feet togethrr and st>nd without holding on.
( ) 4 •hie to place feet together independ<ntly and stand I minute safely
( ) l able 10 place-feet 10gcther independrntly :and stand I minute wi1h Wpt"r.·1sJon
t ) 2 able 10 place fcct ~thrr independently bw unable to hold ror 30 seconds

Screenshot has been saved to Pictures/

RE
INS
Screenshot
p1ooe.s ::
forward. 'nte recorded measure is the distance. forw-ard that the fingers reach while llte subject lS in m.! mo
forward lean position. WIien possible , ask subject to use both arms when reaching. to avoid rotation of the
( ) 4 can reach forwad confidently 25 cm ( 10 inches)
l ) 3 can reach forwad 12 cm (5 inches)
t J 2 can reach forwanl 5 em (2 inches)
t ) I reaches forward but needs supen•ision
( ) 0 loses balance .,.,lile trying/requires ex1"mal suppon

PICK UP OBJECT FROM THE FLOOR FROM ASTANDfNG POSITION

IN..::TIU lf"T lf'I N..::• J>i,-- l• , n ,h.,,. .d,,,,..,,,.:;:1;nn,~, w k i,•h. ;.., 11\h,•~ i l'I fr,, 1"11 t1f, ,,.,r r_...,.
-- Specificity in Exercise +
Default (GPT-3.5) t!J

II The principle of specificity in

exercise, also known as the specificity
principle, states that the type of
exercise or training you do should be
specific to the goals you want to
achieve. In other words, if you have a
particular fitness goal, you should
tailor your training to target the
specific aspects of fitness related to
that goal. For example, if you want to
improve your strength, you should
focus on resistance training exercises
rather than solely doing cardio
workouts. This principle helps ensure
that your training regimen is efficiE. -.v
~nrl AffArti\/A in ~rhiA\/inn \/1"\I 1r
II The principle of specificity in
exercise, also known as the specificity
principle, states that the type of
exercise or training you do should be
specific to the goals you want to
achieve. In other words, if you have a
particular fitness goal, you should
tailor your training to target the
specific aspects of fitness related to
that goal. For example, if you want to
improve your strengthr, you should
focus on resistance training exercises
rather than solely doing cardio
workouts. This principle helps ensure
that your training regimen is efficient
and effective in achieving your
desired outcomes.
-- Specificity in Exercise +
Iii The principle of specificity in
exercise, also known as the specificity
principle, states that the type of
exercise or training you do should be
specific to the goals you want to
achieve. In other words, if you have a
particular fitness goal, you should
tailor your training to target the
specific aspects of fitness related to
that goal. For example, if you want to
improve your strength, you should
focus on resistance training exercises
rather than solely doing cardio
workouts. This principle helps ensure
that your training regimen is efficient
and effective in achieving your
desired outcomes.

□ rb CJJ
Default (GPT-3.5)

Specificity in coordination exercise

II In the context of coordination

exercise, the principle of specificity
emphasizes that the training should
closely mimic the specific
movements and skills required for a
particular activity or sport. This
means that if you want to improve
your coordination for a specific sport
or activity, you should incorporate
drills and exercises that closely
resemble the movements and
demands of that sport.
or activity, you should incorporate
drills and exercises that closely
resemble the movements and
demands of that sport.

For example, if you're training for a

sport like tennis, your coordination
exercises might involve drills that
focus on hand-eye coordination,
footwork, and agility specific to the
movements required in tennis. This
targeted approach helps enhance the
neural pathways and muscle memory
needed for the specific coordination
demands of the activity you're
training for.
II Prerequisites for application of lower
limb brace

II Before applying a lower limb brace,

it's important to consider several key
factors:

1. Assessment by a Healthcare
Professional: A qualified healthcare
professional, such as an orthopedic
doctor, physiotherapist, or orthotist,
should evaluate the individual's
condition and recommend the
appropriate type of brace based on
the specific needs and diagnosis.
2. Correct Diagnosis: It's crucial to '1,

h~\lo ~ l"'lo~r 11nrlorct~nrlinn nf tho

 - -- - - - - --- ---- --,, -

Professional: A qualified healthcare

professional, such as an orthopedic
doctor, physiotherapist, or orthotist,
should evaluate the individual's
condition and recommend the
appropriate type of brace based on
the specific needs and diagnosis.
2. Correct Diagnosis: It's crucial to
have a clear understanding of the
underlying condition or injury that
necessitates the use of a lower limb
brace. Different conditions may
require different types of braces, and
using the wrong type could
potentially worsen the situation.
3. Proper Sizing and Fitting: The brar~
~
should be properly sized to ensured
 require different types of braces, and
using the wrong type could
potentially worsen the situation.
3. Proper Sizing and Fitting: The brace
should be properly sized to ensure a
snug, yet comfortable fit. This helps
provide the necessary support
without causing discomfort or
impeding blood circulation.
4. Instructions and Training: The
person applying the brace (whether
it's the individual themselves or a
caregiver) should receive thorough
instructions on how to properly
apply, adjust, and remove the brace.
This may include specific techniques
for strapping and securing the br~ -.v.
- ...... -- . ... ' -· . . - .- ,

apply, adjust, and remove the brace.

This may include specific techniques
for strapping and securing the brace.
5. Skin Inspection and Care: Before
applying the brace, it's important to
inspect the skin for any signs of
irritation, redness, or wounds.
Keeping the skin clean and dry, and
using protective padding or liners
when necessary, can help prevent
skin issues.
6. Clearance of Obstructions: Make
sure there are no obstructions, like
clothing or other materials, that
might interfere with the proper
application of the brace.
7. CheckinQ for DamaQe or Wear:
 application of the brace.
7. Checking for Damage or Wear:
Regularly inspect the brace for any
signs of damage, such as fraying
straps or broken components. A
damaged brace may not provide the
necessary support and should be
repaired or replaced.
8. Monitoring Comfort and
Functionality: The person wearing
the brace should regularly check for
any discomfort, pressure points, or
signs that the brace is not
functioning as intended. If any issues
arise, they should consult their
healthcare professional.
9. Follow-Up with Healthcare Provic' ~
Periodic follow-up appointments
-- Specificity in Exercise +
Default (GPT-3.5)

any discomfort, pressure points, or

signs that the brace is not
functioning as intended. If any issues
arise, they should consult their
healthcare professional.
9. Follow-Up with Healthcare Provider:
Periodic follow-up appointments
with a healthcare provider are
important to ensure that the brace is
still appropriate for the individual's
needs and that adjustments are
made as necessary.

Remember, the application and use of

a lower limb brace should always bP
.Jt
guided by a qualified healthcare
 Google
Q. moderate intensity exerc i . ,!,

LI LIT,J ffi 6IT 6ll Ly.~ W ITffi ffi 6IT

◄D In English

At least 150 minutes a week of

moderate intensity activity such as
brisk walking. At least 2 days a week
of activities that strengthen
muscles. Activities to improve
balance such as standing on one
foot. Aim for the recommended
activity level but be as active as one
is able.

Physical Activity Recommendations

for Different Age Groups - CDC
-- Graded Activity in Exercise +
LIC'IQUll \U r 1-v.v / L.:.J

IJ The principle of graded activity in

task-oriented ex,ercise involves
gradually increasing the difficulty or
complexity of a specific activity or
task to improve a person's functional
abilities. This approach is commonly
used in rehabilitation settings to help
individuals regain strength,
coordination, and confidence in
performing everyday activities after
an injury or surgery. By starting with
easier tasks and progressively
advancing to more challenging ones,
individuals can build their capabilities
over time. This principle is tailored to
each person's specific needs and
-J,,
~hilitio llr. ,.,· n r.r c::tr 1t"'t11ro ~n
-- Graded Activity in Exercise +
complexity of a specific activity or
task to improve a person's functional
abilities. This approach is commonly
used in rehabilitation settings to help
individuals regain strength,
coordination, and confidence in
performing everyday activities after
an injury or surgery. By starting with
easier tasks and progressively
advancing to more challenging ones,
individuals can build their capabililties
over time. This principle is tailored to
each person's specific needs and
abilities, allowing for a structured and
effective approach to rehabilitatio1n.

□ rb [JJ
-- Graded Activity in Exercise
T
+
~
Default (GPT-3.5)
:::,• - - - - __ .... ••J •••• - · · - - - - - · ,.,._, , __ _

1. Post-Surgery Rehabilitation:
• After knee surgery, starting with
simple exercises like leg raises
and progressing to more complex
movements like squats or stair
climbing.
• Following shoulder surgery,
beginning with gentle range of
motion exercises and advancing
to resistance exercises with
gradually increasing weights.
2. Cardiovascular Conditioning:
• For someone recovering from a
heart condition, starting with light
activities like walking and
'1.-
gradually increasing the intensity
 motion exercises and advancing
to resistance exercises with
gradually increasing weights.
2. Cardiovascular Conditioning:
• For someone recovering from a
heart condition, starting with light
activities like walking and
gradually increasing the intensity
or duration over time.
• Progressing from low-impact
exercises like stationary biking to
higher-impact activities like
• • • •
Jogging or sw1mm1ng.
3. Occupational Therapy:
• For individuals with hand injuries,
starting with basic activities lik'-~
 Graded Activity in Exercise +
t:)U::J (.;l:St::S 111\t: :SldllUI ldf y Ult\lf ty LU

higher-impact activities like

jogging or swimming.
3. Occupational Therapy:
• For individuals with hand injuries,
starting with basic activities like
gripping a sponge and
progressing to more intricate
tasks like buttoning a shirt or
using small tools.
4. Neurological Rehabilitation:
• For stroke survivors, starting with
basic balance exercises and
moving on to more complex
activities like walking on uneven
surfaces or performing dual tasks
(e.g., walking while talking).
-- Graded Activity in Exercise +
I '-'•'-'/

moving on to more complex

activities like walking on uneven
surfaces or performing dual tasks
(e.g., walking while talking).
5. Pain Management:
• In cases of chronic pain, starting
with gentle stretches and
gradually incorporating strength-
building exercises to improve
overall function and reduce pain.
6. Sports Training:
• In sports tra.ining, gradually
increasing the intensity and
complexity of drills to improve
skills, strength, and endurance.
For example, starting with basic
ball-handling drills in basketba ""
 complexity of drills to improve
skills, strength, and endurance.
For example, starting with basic
ball-handling drills in basketball
and progressing to more
advanced moves.
7. Cognitive Rehabilitation:
• For individuals recovering from
brain injuries or cognitive
impairments, starting with simple
tasks like basic memory exercises
and progressing to more
challenging activities like
problem-solving or multitasking.

Remember, the key to graded activity

is to tailor the progression to the
individual's specific abilities and
 0.. benefits of schroth exerci ,!,

61"6U 6\J If ID LI L ffiJ a; 6TT 6fl LI/-~ W ITffiffi 6TT 6l!p ITU

'4~ In English

The goal of Schroth exercises is to

de-rotate, elongate and stabilize the
spine in a three-dimensional plane.
This is achieved through physical
therapy that focuses on: Restoring
muscular symmetry and alignment
of posture. Breathing into the
concave side of the body.
~ https://www.hopkinsmedicine.org > ...

Schroth Method for Scoliosis I Johns

Hopkins Medicine
3D approach: Exercises take into account the
spiraling effect of scoliosis on your vertebrae
(spinal bones) and muscles. Your therapist will
use a three-dimensional method to treat your
whole spine and the muscles around it. Ages:
Schroth therapy can be used to treat adults
and children, starting at about age 10 .

El http s://www.ohsu.edu > schroth-met. ..

Schroth Method for Scoliosis I Rehabilitation

Services - OHSU

cgLDgl.!JLD

What are the benefits of exercising

with scoliosis?

Exercise does not prevent scoliosis but it

does help with pain, posture, strength,
stamina and wellbeing. Many children and
adults who have mild scoliosis through to
more severe can feel some level of pain at
any point during their lives. 14 !]i6U., 2022

1:1 http s://s auk.org.uk > exercises-to-av...

Exercises to avoid and their alternatives -

Scoliosis Association