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El. knyga: Locomotor Training: Principles and Practice [Oxford Scholarship Online E-books]

, (Associate Professor, Department of Physical), (Associate Professor & Rehabilitation Research Director, Owsley B. Frazier Chair in Neurological Rehabilitation, Department of Neurological Surgery, University of Louisville, Louisville, KY.)
  • Formatas: 200 pages, 160 illustrations
  • Išleidimo metai: 26-Aug-2011
  • Leidėjas: Oxford University Press Inc
  • ISBN-13: 9780195342086
Kitos knygos pagal šią temą:
  • Oxford Scholarship Online E-books
  • Kaina nežinoma
Locomotor Training: Principles and PracticeDidesnis paveikslėlis
  • Formatas: 200 pages, 160 illustrations
  • Išleidimo metai: 26-Aug-2011
  • Leidėjas: Oxford University Press Inc
  • ISBN-13: 9780195342086
Kitos knygos pagal šią temą:
Wiley OnlineMore info about Oxford Scholarship Online e-books
Partnerių interneto svetainė: http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780195342086.001.0001/acprof-9780195342086
Physical rehabilitation for walking recovery after spinal cord injury is undergoing a paradigm shift. Therapy historically has focused on compensation for sensorimotor deficits after SCI using wheelchairs and bracing to achieve mobility. With locomotor training, the aim is to promote recovery via activation of the neuromuscular system below the level of the lesion. What basic scientists have shown us as the potential of the nervous system for plasticity, to learn, even after injury is being translated into a rehabilitation strategy by taking advantage of the intrinsic biology of the central nervous system. While spinal cord injury from basic and clinical perspectives was the gateway for developing locomotor training, its application has been extended to other populations with neurologic dysfunction resulting in loss of walking or walking disability.
Chapter 1 Evidence-Based Practice and Activity-Based Therapy for Recovery of Posture, Standing, and Walking 3(18)
I Rehabilitation of Walking After Neurologic Injury or Disease: A Historical Perspective
4(1)
II Recovery of Posture and Walking After Spinal Cord Injury
5(5)
A Functional Deficits After Spinal Cord Injury
6(2)
B Physical Rehabilitation After Spinal Cord Injury
8(2)
III Recovery of Posture and Walking After Stroke
10(2)
A Functional Deficits After Stroke
10(2)
B Physical Rehabilitation After Stroke
12(1)
IV Evidence-Based Practice
12(9)
A Evidence-Based, Restorative Strategies for Rehabilitation After Neurologic Insult: Locomotor Training
13(8)
Chapter 2 Evidence for Locomotor Training 21(19)
I Neural Control of Locomotion
22(2)
A Central Pattern Generation
22(1)
B Interaction of Sensory Input with Spinal Cord Interneuronal Networks
23(1)
C Activity-Dependent Plasticity and Task-Specific Training
24(1)
II Evidence of Sensory Processing by Human Spinal Networks
24(2)
III Translation of Scientific Evidence into a Rehabilitation Intervention
26(14)
A Activity-Based Therapy (Locomotor Training)
26(3)
i Maximize Weight-Bearing on the Legs (Principle 1)
27(1)
ii Optimize Sensory Cues (Principle 2)
28(1)
iii Optimize the Kinematics (i.e., Trunk, Pelvis, and Lower Extremities) for Each Motor Task (Principle 3)
28(1)
iv Maximize Recovery Strategies; Minimize Compensation Strategies (Principle 4)
29(1)
B Clinical Evidence for Functional Recovery in Spinal Cord Injury
29(2)
C Clinical Evidence for Functional Recovery in Stroke
31(9)
Chapter 3 Locomotor Training as an Activity-Based Therapy for Posture, Standing, and Walking 40(14)
I Compensation-Based Rehabilitation to Activity-Based Therapy
41(2)
A Compensation Approaches
42(1)
B Activity-Based Therapy
43(1)
II Locomotor Training Principles
43(2)
A Maximize Weight-Bearing on the Legs (Principle 1)
44(1)
B Optimize Sensory Cues Appropriate for Specific Motor Task (Principle 2)
44(1)
C Optimize Kinematics for Each Motor Task (Principle 3)
44(1)
D Maximize Recovery Strategies; Minimize Compensation Strategies (Principle 4)
45(1)
III Locomotor Training Therapeutic Components
45(2)
A Step Training
46(1)
B Overground Assessment
47(1)
C Community Integration
47(1)
IV Phases of Recovery
47(3)
A Phase 1
48(1)
B Phase 2
48(1)
C Phase 3
48(1)
D Phase 4
48(2)
V Areas of Progression
50(1)
A Endurance
50(1)
B Speed
50(1)
C Weight-Bearing (Load)
50(1)
D Independence
50(1)
VI Clinical Model
51(3)
A Equipment
51(1)
B Staffing
51(1)
C Clinical Guidelines
52(2)
Chapter 4 Basic Skills for Implementation of Locomotor Training 54(31)
I Proper Attire, Harness Application, and Support Apparatus
55(9)
A Proper Client Attire
55(1)
B Applying the Harness
56(4)
i Pelvic Belt Placement
57(1)
ii Harness Vest Placement
58(1)
iii Leg Strap Placement
58(1)
iv Final Adjustments and Troubleshooting Harness Fit
59(1)
C System Requirements
60(2)
D Positioning Client on Treadmill with Body Weight Support
62(2)
II Client and Trainer Positions During Standing
64(6)
A Client Position
66(1)
B Hip Trainer
66(2)
C Leg Trainers
68(2)
III Client and Trainer Positions During Stepping
70(15)
A Client Position
71(1)
B Hip Trainer
72(1)
C Leg Trainers
72(4)
D Alternate Hand Placements
76(11)
i Reverse Hand Placement
76(2)
ii Modified Standard Hand Placement
78(7)
Chapter 5 Basic Skills for Retraining the Nervous System 85(13)
I Locomotor Training: The Step Training Component
86(1)
II Step Retraining
87(3)
A Initiation
87(1)
B Stance
88(1)
C Stance-to-Swing Transition
89(1)
D Swing
89(1)
E Swing-to-Stance Transition
90(1)
F Body Weight Support on the Treadmill Operator
90(1)
III Step Adaptability
90(1)
IV Stand Retraining
91(1)
V Stand Adaptability
92(1)
VI Team Roles
93(5)
A Client
93(1)
B Team Leader
94(1)
C Hip Trainer
94(1)
D Leg Trainers
94(3)
E Body Weight Support on the Treadmill Operator
97(1)
Chapter 6 Introduction to Overground Assessment and Community Integration 98(16)
I Overground Assessment
100(4)
A Trunk Stability
100(1)
B Sit to Stand
100(1)
C Stand
101(2)
D Initiating Walking
103(1)
II Community Integration
104(10)
A Functional Goals for Mobility
104(2)
B Sit to Stand
106(1)
C Stand
106(3)
D Walking
109(1)
E Introducing Assistive Devices
110(4)
Chapter 7 Phases of Recovery 114(46)
I Introduction to Four Phases of Recovery
116(1)
II Abilities During Step Training
117(16)
A Stand Retraining
117(2)
i Optimal Client Position
117(1)
ii Trainer Instructions
118(1)
a BWST Operator
118(1)
b Hip Trainer
118(1)
c Leg Trainers
118(1)
d Assessment
118(1)
iii Scoring
119(1)
B Stand Adaptability
119(4)
i Optimal Client Position
119(1)
ii Trainer Instructions
119(2)
a BWST Operator
120(1)
b Hip Trainer
120(1)
c Leg Trainers
120(1)
d Assessment
120(1)
iii Scoring
121(2)
C Step Retraining
123(4)
i Optimal Client Position
123(1)
ii Trainer Instructions
124(1)
a BWST Operator
124(1)
b Hip Trainer
124(1)
c Leg Trainers
125(1)
d Assessment
125(1)
iii Scoring
125(2)
D Step Adaptability
127(6)
i Optimal Client Position
127(1)
ii Trainer Instructions
128(2)
a BWST Operator
128(1)
b Hip Trainer
129(1)
c Leg Trainers
129(1)
d Assessment
129(1)
iii Scoring
130(3)
III Abilities During Overground Assessment
133(21)
A Sit
133(3)
i Optimal Client Position
133(1)
ii Trainer Instructions
133(1)
iii Scoring
133(3)
B Reverse Sit-Up
136(3)
i Optimal Client Position
136(1)
ii Trainer Instructions
136(1)
iii Scoring
137(2)
C Sit-Up
139(2)
i Optimal Client Position
139(1)
ii Trainer Instructions
139(1)
iii Scoring
139(2)
D Trunk Extension in Sitting
141(3)
i Optimal Client Position
141(2)
ii Trainer Instructions
143(1)
iii Scoring
143(1)
E Sit to Stand
144(3)
i Optimal Client Position
144(2)
ii Trainer Instructions
146(1)
iii Scoring
146(1)
F Stand
147(3)
i Optimal Client Position
147(1)
ii Trainer Instructions
147(1)
iii Scoring
148(2)
G Walking
150(4)
i Optimal Client Position
150(1)
ii Trainer Instructions
150(1)
iii Scoring
151(3)
IV Overview of Utilization of Phases of Recovery for Progression
154(1)
V Appendix A
154(1)
A Phase Scoring Sheet
154(1)
VI Appendix B
155(5)
A Phase Sheet Cards
155(5)
Chapter 8 Progression to Recovery 160(23)
I Four Areas of Progress
161(2)
A Endurance
162(1)
B Speed
162(1)
C Load
162(1)
D Independence
163(1)
II Progression by Phase of Recovery and Locomotor Training Component
163(16)
A Phase 1 Progression
163(3)
i Step Training
164(1)
ii Overground Assessment
164(2)
iii Community Integration
166(1)
B Phase 2 Progression
166(5)
i Step Training
167(1)
ii Overground Assessment
167(3)
iii Community Integration
170(1)
C Phase 3 Progression
171(6)
i Step Training
173(1)
ii Overground Assessment
173(1)
iii Community Integration
173(4)
D Phase 4 Progression
177(2)
i Step Training
178(1)
ii Overground Assessment
178(1)
iii Community Integration
178(1)
III Overall Summary
179(4)
Index 183
Dr. Susan J. Harkema PhD, Associate Professor holds the Owsley B. Frazier Rehabilitation Chair in Neurological Surgery and is the Rehabilitation Research Director of the Kentucky Spinal Cord Injury Research Center at the University of Louisville. She is the Director of Research at Frazier Rehab Institute and is Director of the NeuroRecovery Network that provides standardized activity-based therapies for individuals with spinal cord injury at seven national rehabilitation centers in the United States. Her research focuses on neural plasticity of spinal networks and recovery of function after spinal cord injury.





Dr. Behrman is an Associate Professor in the Dept of Physical Therapy, College of Public Health and Health Professions at the University of Florida and a Research Health Scientist at the VA Brain Rehabilitation Research Center, Malcom Randall VA Medical Center. She also is a co-Director of the Christopher and Dana Reeve Foundation NeuroRecovery Network translating evidence for activity-based therapies into clinical practice. Her research targets developing "best practice" for walking recovery after neurologic injury using principles of activity-dependent plasticity and an understanding of the neurobiology of walking.

Dr. Barbeau was part of the first group that developed the locomotor training in SCI and stroke subjects in the early 80s. He has had a significant contribution to the development of functional electrical stimulation and the drugs on the locomotor pattern in the SCI subjects.
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