Steps to Follow

1 Problems That Cannot Be Seen Directly.- Problems Related to Disturbed Perception.- Some Common Problems Associated with Disturbed Perception.- Reciprocity of Perception and Learning.- Disturbed Perception and Learning.- Implications for Therapy.- Guided Movement Therapy (Guiding).- Therapeutic or Intensive Guiding.- Guiding When Giving Assistance.- Guiding the Patient in a Standing Position.- Considerations.- 2 Normal Movement Sequences and Balance Reactions.- Analysis of Certain Everyday Movements.- Balance, Righting and Equilibrium Reactions.- Task-orientated Arm and Hand Movements.- Considerations.- 3 Abnormal Movement Patterns in Hemiplegia.- Persistence of Primitive Mass Synergies.- The Synergies as They Appear in Association with Hemiplegia.- Abnormal Muscle Tone.- Typical Patterns of Spasticity or Hypertonicity.- Placing.- Reappearance of Tonic Reflex Activity.- Associated Reactions and Associated Movements.- Abnormal Tension in the Nervous System.- Disturbed Sensation.- Considerations.- 4 Practical Assessment — a Continuing Process.- The Aims of Assessment.- Recommendations for Accurate Assessment.- Specific Aspects of Assessment.- Recording the Assessment.- The Comprehensive Evaluation.- Considerations.- 5 The Acute Phase — Positioning and Moving in Bed and in the Chair.- The Arrangement of the Patient’s Room.- Positioning the Patient in Bed.- Sitting in a Chair.- Self-assisted Arm Activity with Clasped Hands.- Moving in Bed.- Transferring from Bed to Chair and Back Again.- Incontinence.- Constipation.- Considerations.- 6 Normalising Postural Tone and Teaching the Patient to Move Selectively and Without Excessive Effort.- Important Activities for the Trunk and Lower Limbs in Lying.- Activities in Sitting.- Placing the Hemiplegic Leg and Facilitating Crossing It Over the Other Leg.- Coming From Sitting to Standing.- Activities in Standing with Weight on the Hemiplegic Leg.- Pelvic Tilting with Selective Flexion/Extension of the Lumbar Spine.- Activities inStanding with Weight on the Sound Leg.- Considerations.- 7 Retraining Balance Reactions in Sitting and Standing.- Activities in Sitting.- Activities in Standing with the Weight on Both Legs.- Activities in Standing with the Weight on the Hemiplegic Leg.- Activities During Which the Weight Is on Alternate Legs.- Activities in Standing with the Weight on the Sound Leg.- Considerations.- 8 Encouraging the Return of Activity in the Arm and Hand and Minimising Associated Reactions.- Activities in Supine Lying.- Activities in Sitting.- Activities in Standing.- Stimulation of Active and Functional Movements.- Retraining Selective Flexion of the Arm and Hand.- Considerations.- 9 Re-educating Functional Walking.- Considerations for Treatment.- When to Start Walking.- The Facilitation of Walking.- Practical Ways to Facilitate Walking.- Self-inhibition of Associated Reactions.- Protective Steps to Regain Balance.- Supporting the Hemiplegic Foot.- Going Up and Down Stairs.- Using a Walking-stickor Cane.- Considerations.- 10 Some Activities of Daily Living.- Therapeutic Considerations.- Personal Hygiene.- Dressing.- Undressing.- Eating.- Driving a Car.- Considerations.- 11 Mat Activities.- Going Down Onto the Mat.- Moving to Side-Sitting.- Activities in Long-Sitting.- Rolling.- Prone Lying.- Moving to Prone Kneeling.- Activities in Prone Kneeling.- Activities in Kneel-Standing.- Activities in Half-Kneel-Standing.- Standing up from Half-Kneeling.- Considerations.- 12 Shoulder Problems Associated with Hemiplegia.- The Subluxed or Malaligned Shoulder.- The Painful Shoulder.- The “Shoulder-Hand” Syndrome.- Considerations.- 13 The Neglected Face.- Important Considerations for Facilitation of the Movements of the Face and Mouth.- Dentures.- Appropriate Treatment for the Common Difficulties.- Oral Hygiene.- Considerations.- 14 Out of Line (the Pusher Syndrome).- The Typical Signs.- Predisposing Factors.- Specific Treatment.- Considerations.- 15 Including Nervous System Mobilisation in the Treatment.- Adaptation of the Nervous System to Movement.- Loss of Nervous System Mobility Following a Lesion.- Problems Associated with Abnormal Tension and Loss of Mobility.- The Tension Tests for Assessment and Treatment.- Conclusion.- 16 Maintaining and Improving Mobility at Home.- Maintaining Mobility Without the Help of a Therapist.- Common Sites of Increased Hypertonicity and/or Loss of Range of Motion.- Ensuring the Patient’s Participation.- Specific Exercises for Muscles and Joints.- Automobilisation of the Nervous System.- Some Additional Active Exercises.- Leisure Activities and Hobbies.- Conclusion.- 17 References.- 18 Subject Index.