GENERAL GUIDELINES - 9 Tips for Exercise: Body Mechanics for Helper - To protect back, stay as upright as possible and keep head in line with trunk. - Always position yourself as close as possible to the body part to be exercised. - To keep back straight, you may need to place one knee on patient's bed. - Keep abdominal muscles taut. Use your legs and arms to lift and move. - Stand with feet apart so you can shift your weight from one leg to the other as you move. - Take steps when turning. Avoid twisting your back. - Always use a gait belt when moving or transferring patient. - Take stretch breaks: Place hands on lower back, stand tall and lean back slightly. GENERAL GUIDELINES - 10 Tips for Exercise: Positioning of Patient - Wear clothing that does not restrict movements. - Select a firm surface for sitting or lying. - Use folded towel or cushion under elbows when resting arms on hard surface. - Keep head in line with trunk, chin tucked. - Lying (Supine) Use pillow under head as needed for comfort. May support arms on pillows. May bend knees unless instructed otherwise. - Side-lying Make sure trunk and legs are not twisted. May use pillows between legs and to support top arm. - Lying on stomach (Prone) Use pillows under stomach and ankles as needed for comfort. - Sitting Both feet supported on floor, stool or other firm, level surface. Page 1 of 4
GENERAL GUIDELINES - 11 Tips for Exercise: General Guidelines - Allow sufficient time for each session so exercises can be carried out thoroughly. - Do not move too fast. Adjust pace so patient can participate fully. - Both patient and helper must remember to breathe normally while performing exercises. - Helper uses one hand to stabilize per instructions, to insure that patient is not substituting different movements to accomplish exercise. - Helper's hand hold needs to be supportive to promote patient comfort. To protect patient's skin, avoid pinching or grasping too tightly. - Observe patient for signs of discomfort. - Take short breaks as needed. GENERAL GUIDELINES - 12 Tips for Exercise: ROM / AAROM Range of Motion (ROM) - Use hand positions as instructed on card to insure that motion occurs at desired joint. - Whenever possible use contact of whole hand on patient. - Use slow, steady, smooth motions. - Never force a joint or muscle when you feel resistance. - If motion is painful, follow guidelines from patient's occupational or physical therapist. Active Assistive Range of Motion (AAROM) - Patient is primary mover in these exercises. - Helper provides support and assistance only as needed to control movement. Page 2 of 4
GENERAL GUIDELINES - 13 Tips for Exercise: Stretching - At point of muscle tension, hold position as instructed. - Use steady pressure. Never bounce. - Ensure that patient feels stretch in intended location. - Cue patient to exhale slowly during stretch. - Warm muscles stretch more effectively than cold ones. Apply heat for minutes before stretching. (see card G.G.-2) GENERAL GUIDELINES - 16 Tips for Tone Management Use slow movements to avoid triggering spasticity. Prolonged, gradual stretch of the muscles is most effective. If sitting, shift weight onto affected buttock to reduce tightness of limbs. Stretch thumb out to side and spread the fingers apart to open up a tight fist. Bend large toe downward to reduce rigidity in leg. Use ice to reduce muscle tone. (see card G.G.-3) Page 3 of 4
GENERAL GUIDELINES - 17 Tone Management: UE Flexors Position Patient: Sit on firm surface. Helper: Support left arm at elbow. Position hand flat with fingers as straight as possible. Motion - Patient leans on arm, putting weight on hand. - Helper may gently hold in place. Hold seconds. Repeat times. Do sessions per day: before exercises after exercises Variation: Perform with helper holding fingers and thumb apart. Page 4 of 4
CHART COPY Routine For: GENERAL GUIDELINES - 9 Tips for Exercise: Body Mechanics for Helper - To protect back, stay as upright as possible and keep head in line with trunk. - Always position yourself as close as possible to the body part to be exercised. - To keep back straight, you may need to place one knee on patient's bed. - Keep abdominal muscles taut. Use your legs and arms to lift and move. - Stand with feet apart so you can shift your weight from one leg to the other as you move. - Take steps when turning. Avoid twisting your back. - Always use a gait belt when moving or transferring patient. - Take stretch breaks: Place hands on lower back, stand tall and lean back slightly. GENERAL GUIDELINES - 10 Tips for Exercise: Positioning of Patient - Wear clothing that does not restrict movements. - Select a firm surface for sitting or lying. - Use folded towel or cushion under elbows when resting arms on hard surface. - Keep head in line with trunk, chin tucked. - Lying (Supine) Use pillow under head as needed for comfort. May support arms on pillows. May bend knees unless instructed otherwise. - Side-lying Make sure trunk and legs are not twisted. May use pillows between legs and to support top arm. - Lying on stomach (Prone) Use pillows under stomach and ankles as needed for comfort. - Sitting Both feet supported on floor, stool or other firm, level surface. GENERAL GUIDELINES - 11 Tips for Exercise: General Guidelines - Allow sufficient time for each session so exercises can be carried out thoroughly. - Do not move too fast. Adjust pace so patient can participate fully. - Both patient and helper must remember to breathe normally while performing exercises. - Helper uses one hand to stabilize per instructions, to insure that patient is not substituting different movements to accomplish exercise. - Helper's hand hold needs to be supportive to promote patient comfort. To protect patient's skin, avoid pinching or grasping too tightly. - Observe patient for signs of discomfort. - Take short breaks as needed. GENERAL GUIDELINES - 12 Tips for Exercise: ROM / AAROM Range of Motion (ROM) - Use hand positions as instructed on card to insure that motion occurs at desired joint. - Whenever possible use contact of whole hand on patient. - Use slow, steady, smooth motions. - Never force a joint or muscle when you feel resistance. - If motion is painful, follow guidelines from patient's occupational or physical therapist. Active Assistive Range of Motion (AAROM) - Patient is primary mover in these exercises. - Helper provides support and assistance only as needed to control movement. GENERAL GUIDELINES - 13 Tips for Exercise: Stretching - At point of muscle tension, hold position as instructed. - Use steady pressure. Never bounce. - Ensure that patient feels stretch in intended location. - Cue patient to exhale slowly during stretch. - Warm muscles stretch more effectively than cold ones. Apply heat for minutes before stretching. (see card G.G.-2) GENERAL GUIDELINES - 16 Tips for Tone Management Use slow movements to avoid triggering spasticity. Prolonged, gradual stretch of the muscles is most effective. If sitting, shift weight onto affected buttock to reduce tightness of limbs. Stretch thumb out to side and spread the fingers apart to open up a tight fist. Bend large toe downward to reduce rigidity in leg. Use ice to reduce muscle tone. (see card G.G.-3) GENERAL GUIDELINES - 17 Tone Management: UE Flexors Position Patient: Sit on firm surface. Helper: Support left arm at elbow. Position hand flat with fingers as straight as possible. Motion - Patient leans on arm, putting weight on hand. - Helper may gently hold in place. Hold seconds. Repeat times. Do sessions per day: before exercises after exercises Variation: Perform with helper holding fingers and thumb apart. COMMENTS: Patient Name/Number: Clinician Name/Signature: Date: Page 1 of 1