DEVELOPMENTAL MILESTONES TRAINING (QUADRUPED ON ELBOWS AND KNEES)
Time and time again, especially with neuro cases with postural instability, coordination, muscle tone issues, etc. Reliance to compensation to elicit function is very common, e.g. circumduction movement of the affected extremity during ambulation, lateral trunk flexion for limited shoulder movements, etc. Gratification is immediate with the false functional outcome, but as time goes, all the excitement passes when progress starts to decline or falter. Patients are unable to improve any further considering the domino effect of the current-sub par movement compensations they are already adapted to. The abnormal patterns they acquired causes more issues not limited to further increase in muscle tone, weakness, muscular incoordination, contractures, pain, etc. As far as the cases I am handling are concerned, especially the ones in the acute phase (days to weeks following the condition), though somehow tedious and taxing to do, I find it helpful, stable and long lasting to work on the developmental milestones depending on the level they are at than cutting it short promoting compensatory functional movements. We developed the same patterns growing up, I do not know about you but I never heard of any bipedal who from womb, immediately was up and running the same day they came out. Promoting stability and mobility to the patients paying attention to the quality of movements and positions in strict accordance to the developmental milestones promotes more stable functional recovery for me. Here is one example of training I do to improve general body stability and mobility. First exercise challenge, patient on his elbows and knees with cues to bring his shoulder blades from being retracted to go forward applying as much pressure on both elbows as possible. Next routine, I asked him to tuck and tighten his belly in and assume a cat’s back (kyphotic posture) as he keeps his shoulder blades into protraction. Lastly, I made him put some torque (rotational pressure) on both knees squeezing the the gluteal muscles all together. After finishing the segmented exercise routine, we finished up combining all the movement patterns learned/acquired earlier as structured and controlled as possible with as much grace.
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