SKILLED THERAPY: DEVELOPMENTAL MILESTONE

Half Kneeling:
I am a great believer and practitioner of development milestones training and it’s reliability if utilized properly on adult patients. It is a common practice for therapists, myself included to skip levels because it make things easier. The transition routine has always been: supine-sitting-standing-ambulation. It was because of this that I coined the term half-baked progress. It is the perception that most patients and therapists have, that because the patient seemed functional looking, especially for patients who are itching to be discharged out of the hospital or from any program, he/she is cured and deemed independent. The reality is, the same patient also comes home with a lot of deviations, compensations and coordination/balance issues. The problem as I have observed , cutting it short may improve on major muscles, but it skips the progress of others areas needed to keep the movements fluid. It prevents the healing brain from relearning old skills that were forgotten/missing post onset of the condition.
I am working on postural stability of a patient in half kneeling posture several months post CVA. Muscle imbalances affects his general mobility as I found out. To therapists, we are all familiar and aware of the golden period post CVA ( 90 days), when progress halts and is expected to be slower afterwards. It is okay to be aggressive given the right situation. If we just spend a little bit more effort not skipping important stages of development especially at the early stage post onset, long term effects would be more beneficial to our patients and us.

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