PROPER POSTURES TherapyProtocols

PROPERPOSTURESSagar Naik, PT, Dr. Saravanan, Dr. Prerana, Dr. Bhargav Desai

SITTING

NEVERALLOWSLOUCHPOSTUREWHILESITTING

ENCOURAGETOUSELUMBARROLLTOMAINTAINLUMBARLORDOSIS

ADVICEFIRMSTRAIGHTBACKCHAIRS

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PROPER POSTURES TherapyProtocols

AVOIDBACKLESSCHAIR(REQUIREDTHENUSENADACHAIR)

ENCOURAGE FREQUENT MOVEMENT BREAKS. INSTRUCT PATIENT TOAVOID SITTING LONGER THAN20MINUTESATA TIME FOR THE FIRST2WEEKSANDTHENGRADUALLY INCREASEDEPENDINGONTOLERANCETOPAINALLOW PATIENT TO RETURN TO DRIVING FOR SHORT PERIODS AFTERABOUT1TO2WEEKS.REMINDTHEPATIENTTHATSAFETY ISAPRIORITYFROMTHEMNOTACONVENIENCE.

STANDING&WALKING

1) ADVICE PATIENTS TO LIMIT STANDINGAT THE KITCHEN SINKOR BATHROOMCOUNTERTOSHORTPERIODS.

2) AVOIDBENDINGATTHEWAIST.3) ENCOURAGE PATIENT TO MAINTAIN LUMBAR LORDOSIS DURING STANDING

ANDWALKINGWHILEPERFORMINGABDOMINALBRACE.

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PROPER POSTURES TherapyProtocols

SLEEPING

LYINGONSOFTMATRESSESORSOFAS

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PROPER POSTURES TherapyProtocols

BODYMECHANICS

TRANSFERS

1) TEACHPATIENTTOMOVECORRECTLYFROMSUPINETOSITTING

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PROPER POSTURES TherapyProtocols

2) TEACH PATIENT TO MOVE CORRECTLY FROM STANDING TO LYING ON THEFLOOR

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PROPER POSTURES TherapyProtocols

3) TEACHPATIENTTOMOVECORRECTLYFROMSITTINGTOSTANDING

4) ROLLING IN BEDASAUNITAND RISING FROM BED SHOULD BE PERFORMEDCORRECTLY.

5) ALLTWISTINGMOVEMENTS SHOULDBEAVOIDED. INSTRUCTTOMOVETHEIRFEETTOTURNINSTEAD.

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PROPER POSTURES TherapyProtocols

DRESSING

1) INSTRUCTTHEPATIENT INTHECORRECTWAYTOPUTONPANTS,SOCKS,ANDSHOESINTHESUPINEPOSITION.

2) SLIPONSHOESARETHEEASIESTTOHANDLEINTHEFIRST2WEEKS.3) TYINGSHOESCANLATERBEPERFORMEDSAFELYBYPUTTINGTHEFOOTONA

STOOLORCHAIR.

HYGIENE

1) SHOWERINGCANBEGINAFTERTHESECONDWEEK.2) PATIENTCANSHOWERLEGS INSTANDINGPOSITION,WITHFOOTONTHETUB

ORSHOWERSEAT,AVOIDINGLUMBARFLEXION.

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PROPER POSTURES TherapyProtocols

LIFTING

1) AVOIDALLLIFTINGINPHASEI.2) SWOOP LIFTING IS USUALLY A SAFE AND WELLTOLERATED TECHNIQUE FOR

LIFTINGINPHASEII.It isperformedbymakinga long stride forward to thekneelingposition (lunge)andthenreachingtoliftalightobject.

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PROPER POSTURES TherapyProtocols

BENDING

1) AVOIDALLBENDINGMOVEMENTSATWAIST.2) LUMBARFLEXIONWITHLOADINGISTHEMOSTHAZARDOUSMOVEMENTINTHE

FIRST2PHASES.3) OCCASIONALLYLIMITEDBENDINGISNECESSARY.

Patientcansafelybendbysimultaneouslyflexingatthekneesandhips(HINGEATTHEHIPS)whilemaintaininganeutralspineandanabdominalbrace.

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KINESTHETICPROPRIOCEPTIVECOORDINATION

1) Patients with low back pain may possess poor kinestheticproprioceptivecoordination.

2) Thiscanbeimprovedbyusinglumbartape.3) Therapist places the patient on all fours and asks to maintain neutral spine

position.4) Thentherapistplacesa12to18cmlongtapeontheparaspinalsparalleltothe

spine,avoidingincisionsite.5) Then patient is asked to make small movements into flexion and extension,

alwaysreturningtoneutral.6) Additional feedback from tape puling or wrinkling will assist the patient in

learningspinalproprioception.7) Various postures can be tried, including kneeling, sidelying, sitting, standing,

withsmallmotionsofthelumbarspine.8) Patientcanprogresstofunctionalmovementslikewalking,transfers.

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