Movement Task Modifications and Facilitation

Flashcards covering movement task modifications, environmental adjustments, and the ORDER framework for facilitating patient mobility.

Patient cannot bridge because they cannot get their feet into position. How could you modify the task?

Place their feet for them or start with hips and knees already flexed.

Patient cannot generate enough lift during bridging due to weak glutes. How could you modify the task?

Perform a partial bridge.

Patient's feet slide during bridging. How could you modify the environment?

Place feet against a firm surface.

Patient loses alignment during bridging. How could you facilitate movement?

Tactile cueing at pelvis and knees.

Patient cannot feel where their legs are during bridging. How could you enhance performance?

Provide proprioceptive input through knees or feet.

Patient cannot move sideways during bridge and shift. How could you modify the task?

Practice moving pelvis first before moving the whole body.

Patient cannot move their trunk laterally during bridge and shift. What cue could you use?

Visual target to move towards.

Patient fatigues during bridge and shift. What modification could help?

Break the task into smaller movements.

Patient cannot initiate rolling. What visual cue could help?

Reach for an object or roll towards a wall.

Patient cannot generate trunk rotation during rolling. What movement could be emphasised?

Reach arm across body.

Patient has difficulty rolling because of weakness. What environmental modification could help?

Use a bed rail.

Patient cannot complete a full roll. What task modification could help?

Practice partial rolling.

Patient cannot push up from side-lying. What individual factor may be limiting them?

Upper limb strength.

Patient cannot swing their legs off the bed. What individual factor may be limiting them?

Hip strength or ROM.

Patient becomes unsafe when moving from side-lying to sitting. What environmental modification could help?

Lower bed height.

Patient does not understand side-lying to sit. What ORDER step should be tried first?

Direct/Demonstrate.

Patient cannot stand from a chair due to weak quadriceps. What environmental modification could help?

Raise chair height.

Why does increasing chair height make sit-to-stand easier?

Less hip and knee force required.

Patient cannot generate enough forward momentum during sit-to-stand. What movement component may be missing?

Trunk flexion.

Patient struggles to stand. What external support may help?

Armrests or a rail.

Patient has difficulty standing because they cannot feel their feet. What enhancement could help?

Proprioceptive input through lower limbs.

Patient drops into the chair during stand to sit. What muscle group may be weak?

Quadriceps.

Patient cannot control descent into sitting. What movement is lacking?

Eccentric control.

How could you make stand-to-sit easier?

Use a higher chair.

Patient struggles with walking because they trip their toes. What movement component may be missing?

Dorsiflexion.

Patient has difficulty walking because of poor balance. What environmental modification could help?

Walking aid.

Patient has difficulty with gait because of reduced confidence. What modification could help?

Shorter walking distance.

Patient struggles with gait because of poor strength. What individual factor is limiting performance?

Strength.

Patient cannot clear the foot during swing phase. What cue could help?

Visual target or stepping over an obstacle.

Patient cannot reach an object because it is too far away. How could the task be modified?

Move object closer.

Patient cannot reach overhead. How could the environment be modified?

Lower the object.

Patient has poor awareness of arm position during reaching. What enhancement could help?

Proprioceptive cueing.

Patient compensates with shoulder hitching during reaching. What cue could help?

Auditory cueing: "Keep your shoulder down."

Patient cannot grasp a small object. How could the task be modified?

Use a larger object.

Patient cannot grasp because of weak grip. How could the environment be modified?

Use larger handles.

Patient cannot position the hand correctly before grasping. What movement component may be missing?

Pre-shaping.

Patient cannot orient their hand to the object. What movement component may be impaired?

Forearm pronation/supination.

Patient cannot manipulate a pen. How could the task be modified?

Use a larger pen.

Patient cannot manipulate a button. How could the task be modified?

Practice with larger objects first.

Patient cannot manipulate an object because of poor sensation. What individual factor is limiting performance?

Proprioception/sensation.

For any movement task, what three categories of modification should always be considered?

Individual, Task, Environment.

For any movement task, what framework should be used to facilitate movement?

ORDER.

If a patient cannot perform a movement, what should be tried before physically assisting them?

Observe → Request → Direct/Demonstrate.

If verbal and visual cueing fail, what should be tried next?

Enhance (tactile/proprioceptive cueing).

If tactile and proprioceptive cueing fail, what should be tried next?

Replace (stabilisation/facilitation).