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Balance

Impairments and Functional Limitations:
Muscle weakness (specifically quadriceps, ankle dorsiflexors, ankle plantar flexors)
Limited range of motion in the lower extremities
Slowed reaction time
Reduced processing of sensory information (proprioceptive/somatosensory, visual and vestibular)
Disequilibrium
Cognitive impairment


Assessments and Rating Scales:
Berg Balance Scale (Berg 1995)
Gait Speed Test (Guralnik 1994)
Modified Clinical Test of Sensory Integration on Balance (Shumway-Cook 1986)
Multi-Directional Reach Test (Newton 1997)
Sitting Balance Scale (Medley, Thompson 2011)
Tinetti Balance and Gait Evaluation (Tinetti 1986)
Trunk Impairment Scale (Verheyden, Nieuwboer 2004)


Physical Therapy Intervention:
Provide a multi-component balance-training program.

  • Ensure patient safety during training to prevent falls and injuries.
  • Incorporate balance exercises into everyday activities.
  • Incorporate balance exercises during regular strength training, stretching, and endurance routines.
  • Perform balance training first (when combined with resistance and flexibility activities). Recommend 10-15 minutes, three days a week.


Provide progressive challenges to balance.

  • Static balance control in sitting, half kneeling, tall kneeling, standing, tandem standing, single leg standing, lunging and squatting
  • Dynamic balance control while on a moving surface (therapy ball, wobble board, mini trampoline)
  • Challenge postural reactions
    • Ankle strategy
    • Hip strategy
    • Stepping strategy
    • Weight shift strategy
    • Suspension strategy


Progress balance activities and exercises by challenging the visual system (low lighting, wear sunglasses indoors, eyes closed), the proprioceptive/somatosensory system (unstable surfaces such as foam pads, therapy ball, mini trampoline, balance disc, wobble board, Biomechanical Ankle Platform System (BAPS), Bosu ball trainer, ambulation on an uneven surface), and the vestibular systems (gaze stability exercises).


Provide dual-tasking balance challenges by combining a balance exercise with another form of physical activity (ball kick, ball toss, arm or leg exercises), a cognitive task (count backward from 100 by 3’s, recite the alphabet backwards or name the presidents) or by adding external distractions (noise, people, music).


Utilize interactive video games (Wii-Fit, Wii Sport, and Kinect) and brain fitness programs (Mindfit) to challenge balance..


Patient and Caregiver Handouts:
Balance Exercise Guidelines
Balance Exercises - Sitting
Balance Exercises - Standing
Core Exercise Guidelines
Core Exercises - Back Muscles
Core Exercises - Pelvic Muscles
Core Exercises - Stomach Muscles
Exercise Ball Guidelines
Exercise Ball - Back Muscles
Exercise Ball - Pelvic Muscles
Exercise Ball - Stomach Muscles


Additional Treatment Guides:
Dizziness
Therapeutic Exercise

© 2018 Cheryl Hall│www.pttoolkit.com
Treatment Guides - Section 1

Interventions
Balance Training
Fall Risk Assessment and Prevention
Functional Mobility
Gait
Therapeutic Exercise
Conditions and Diseases
Adhesive Capsulitis
Alzheimer’s Disease and Related Disorders – Mid Stage
Alzheimer’s Disease and Related Disorders – Late Stage
Amputation of the Lower Limb
Amyotrophic Lateral Sclerosis
Ankle Sprain
Ankylosing Spondylitis
Biceps Tendinitis
Breast Cancer-Pre and Postoperative Management
Burn Injury
Cancer
Cardiac Disease
Cardiac Surgery
Carpal Tunnel Syndrome - Conservative Management
Carpal Tunnel Syndrome - Postoperative Management
Cervical Stenosis, Myelopathy and Radiculopathy
Cervical Spine Surgery
Chronic Obstructive Pulmonary Disease
Chronic/Persistent Pain Syndrome
Complex Regional Pain Syndrome Type I
Congestive Heart Failure (see Cardiac Disease)
Cubital Tunnel Syndrome - Conservative Management
Cubital Tunnel Syndrome - Postoperative Management
De Quervain's Syndrome - Conservative Management
De Quervain's Syndrome - Surgical Management
Diabetes – Type 2
Dizziness
Emphysema (see Chronic Obstructive Pulmonary Disease)
Epicondylitis - Conservative Management
Fracture of the Ankle (Lateral/Medial/Posterior Malleolus)
Fracture of the Elbow (Radial Head/Olecranon/Distal Humerus)
Fracture of the Hip (Proximal Femur)
Fracture of the Knee (Tibial Plateau/Patella)
Fracture of the Shoulder (Proximal Humerus)
Fracture of the Wrist (Distal Radius)
Frailty and Delility
Greater Trochanteric Pain Syndrome
Guillain-Barré Syndrome
Huntington's Disease
Joint Contractures
Kidney Disease
Low Back Pain - Acute
Low Back Pain - Chronic (see Chronic/Persistent Pain Syndrome)
Low Back Pain - Sacroiliac Joint
Lumbar Stenosis
Lumbar Spine Surgery
Morbid Obesity - Person of Size
Multiple Sclerosis
Myasthenia Gravis - Generalized
Myocardial Infarction
Osteoarthritis - Conservative Management
Osteoporosis
Palliative Care and Hospice
Parkinson's Disease - Early Stage
Parkinson's Disease - Mid Stage
Parkinson's Disease - Late Stage
Peripheral Neuropathy
Peripheral Vascular Disease
Piriformis Syndrome
Plantar Fasciitis
Post-Poliomyelitis Syndrome
Pressure Ulcers
RRheumatoid Arthritis - Conservative Management
Rotator Cuff Pathology - Conservative Management
Rotator Cuff Pathology - Postoperative Management
Scleroderma/Systemic Sclerosis
Spinal Cord Injury - Paraplegia T1-S5
Spinal Cord Injury - Tetraplegia/Quadriplegia C1-8
Stroke
Total Ankle Replacement (Arthroplasty)
Total Hip Replacement (Arthroplasty)
Total Knee Replacement (Arthroplasty)
Total Shoulder Replacement (Arthroplasty)
Urinary Incontinence
Vertebral Compression Fracture

Functional Mobility - Section 2

Adaptive Equipment
Adaptive Equipment for Bathing
Adaptive Equipment for Mobility
Adaptive Equipment for Moving in Bed
Adaptive Equipment for Transfers
Adaptive Equipment for Using the Bathroom
Adaptive Equipment for Walking
Ambulation
Walk with a Cane on the Stronger, Left Side
Walk with a Cane on the Stronger, Right Side
Walk with a Standard Walker - Full Weight Bearing
Walk with a Standard Walker - Non-Weight Bearing
Walk with a Standard Walker - Partial Weight Bearing
Walk with a Standard Walker - Toe-Touch Weight Bearing
Walk with a Standard Walker - Weight Bearing as Tolerated
Walk with a Wheeled Walker - Full Weight Bearing
Walk with a Wheeled Walker - Weight Bearing as Tolerated
Bath Transfers
Transfer to Shower Chair (back up, turn left)
Transfer to Shower Chair (back up, turn right)
Transfer to Shower Chair (left leg, right leg, sit)
Transfer to Shower Chair (right leg, left leg, sit)
Transfer to Shower Chair (left leg, sit, right leg)
Transfer to Shower Chair (right leg, sit, left leg)
Transfer to Tub Bench - After Hip Surgery (back up, turn left)
Transfer to Tub Bench - After Hip Surgery (back up, turn right)
Transfer to Tub Bench (back up, turn left)
Transfer to Tub Bench (back up, turn right)
Transfer Wheelchair to Tub Bench - Move to the Left
Transfer Wheelchair to Tub Bench - Move to the Right
Bed Mobility
Bridging
In and Out of Bed - Toward Your Left Side
In and Out of Bed - Toward Your Left Side After Hip Surgery
In and Out of Bed - Toward Your Left Side Log Rolling
In and Out of Bed - Toward Your Right Side
In and Out of Bed - Toward Your Right Side After Hip Surgery
In and Out of Bed - Toward Your Right Side Log Rolling
In and Out of Bed - Toward Your Weaker Left Side
In and Out of Bed - Toward Your Weaker Right Side
In and Out of Bed with Help - Toward Their Left Side
In and Out of Bed with Help - Toward Their Right Side
Move From One Side 0f the Bed to the Other
Move Up in Bed
Roll onto Your Left Side
Roll onto Your Right Side
Stairs
Down a Curb or Single Step Using a Walker
Down Steps with a Rail Using a Cane
Down Steps with a Rail Using a Closed Walker
Down Steps with a Rail Using an Open Walker
Down Steps without a Rail Using a Cane
Up a Curb or Single Step Using a Walker
Up Steps with a Rail Using a Cane
Up Steps with a Rail Using a Closed Walker
Up Steps with a Rail Using an Open Walker
Up Steps without a Rail Using a Cane
Transfers
Car Transfer
Get Down On the Floor
Get Up From the Floor
Sit-Pivot Transfer - Move to the Left
Sit-Pivot Transfer - Move to the Right
Sit-Pivot Transfer with Help - Move to Their Left
Sit-Pivot Transfer with Help - Move to Their Right
Sitting Down
Sitting Down - After Hip Surgery
Standing Up
Standing Up - After Hip Surgery
Standing Up with Help
Stand-Pivot Transfer with Help - Move to Their Left
Stand-Pivot Transfer with Help - Move to Their Right
Transfer Board - Move to the Left
Transfer Board - Move to the Right
Wheelchair Mobility
Wheelchair Mobility

Educational Handouts - Section 3

Amputation of the Lower Limb
Care of the Prosthesis and Lower Limb Coverings
Care of Your Residual Limb
Phantom Limb Pain
Position Your Residual Limb - AKA
Position Your Residual Limb - BKA
Cardiopulmonary
Breathing Distress - Causes and Tips to Prevent
Breathing Distress Control
Cardiac Precautions for Exercise - Therapist Resource
Controlled Cough
Daily Tasks after Open Heart Surgery
Deep (Diaphragmatic) Breathing
How to Check Your Heart Rate
Postural Drainage - Chest Percussion
Postural Drainage Positions
Pursed Lip Breathing
Sternal (Breastbone) Precautions
Tips to Conserve Energy
Other
Arm Measurement
Check Your Skin
Leg Measurement
Pain Journal
Position in Bed to Reduce Pressure
Pressure Relief
Stress Management
Stress Management - Relaxation Tools
Tips to Prevent Lower Body Lymphedema
Tips to Prevent Upper Body Lymphedema
Neurological
Cognitive Strategies to Improve Movement
Position in Bed - Left Side Weakness
Position in Bed - Right Side Weakness
Position Your Arm - Left Side Weakness
Position Your Arm - Right Side Weakness
Protect the Arm - Left Side Weakness
Protect the Arm - Right Side Weakness
Orthopedic
Body Mechanics
Daily Tasks after Back (Lumbar) Surgery
Daily Tasks after Neck (Cervical) Surgery
Daily Tasks after Shoulder Surgery
Desensitization
Edema (Swelling) Control of the Arm(s)
Edema (Swelling) Control of the Leg(s)
Good Posture
Hip Dislocation Precautions - Posterior Approach
Joint Protection and Energy Conservation for Wheelchair Users
Scar Massage
Self Traction (Unloading)
Spinal Surgery Precautions
Splint/Brace Instructions
Superficial Cold
Superficial Heat
Safety
Don’t Let a Fall Get You Down - Booklet
Don’t Let a Fall Get You Down Post - Fall Survey
Fall Triggers and Tips to Prevent Falls - Therapist Resource
Foot Care and Foot Safety
Home Safety Assessment - Therapist Resource
Using a Front Wheel Walker (2 wheels)
Using a Rollator (3 or 4 wheels)
Using a Standard Walker (no wheels)
Using a Wheelchair

Therapeutic Exercise Handouts - Section 4

Back/Core Exercises
Core Exercise Guidelines
Core Exercises - Back Muscles
Core Exercises - Pelvic Muscles
Core Exercises - Stomach Muscles
Exercise Ball Guidelines
Exercise Ball - Back Muscles
Exercise Ball - Pelvic Muscles
Exercise Ball - Stomach Muscles
Low Back Stretches
Trunk Active Range of Motion
Balance Exercises
Balance Exercise Guidelines
Balance Exercises - Sitting
Balance Exercises - Standing
Condition Specific Exercise Programs
Above Knee Amputation Exercises
Below Knee Amputation Exercises
Burn Injury Stretches
Femur Fracture Exercises
Greater Trochanteric Pain Syndrome Exercises
Hip Replacement Exercises
Knee Replacement Exercises
Lumbar Stenosis Exercises
Lumbar Surgery Exercises
Mastectomy Exercises
Osteoporosis Extension Exercises
Parkinson’s Disease Exercises
Piriformis Syndrome Exercises
Plantar Fasciitis Exercises
Pulmonary Exercises
Tibial Plateau Fracture Exercises
Exercise Guidelines
Exercise Tips for Amyotrophic Lateral Sclerosis
Exercise Tips for Ankylosing Spondylitis
Exercise Tips for Arthritis
Exercise Tips for Diabetes
Exercise Tips for Guillain-Barré Syndrome
Exercise Tips for Multiple Sclerosis
Exercise Tips for Myasthenia Gravis
Exercise Tips for Orthopedic Conditions
Exercise Tips for Post-Poliomyelitis Syndrome
Exercise Tips for Renal Conditions
Lower Extremity Exercises
Ankle and Foot Active Range of Motion
Ankle and Foot Isometric Exercises
Ankle and Foot Strength Exercises
Ankle and Foot Stretches
Calf Stretches
Hip and Knee Exercises - Lying
Hip and Knee Exercises - Seated
Hip and Knee Exercises - Standing
Hip Stretches
Stretch Band Exercises - Legs
Thigh Stretches
Neck Exercises
Neck Active Range of Motion
Neck Isometric Exercises
Neck Strengthening Exercises
Neck Stretches
Other
Arm Cycle
Cool-Down Stretches
Exercise Log
General Exercise Tips
Passive Range of Motion
Passive Range of Motion - Left Side Weakness
Passive Range of Motion - Right Side Weakness
Pelvic Floor (Kegel) Exercise
Physical Activity Plan
Total Body Exercise Program
Walking Guidelines
Warm-Up Exercises
Pre-Gait Exercises
Pre-Gait Exercise Tips
Pre-Gait Arm Strength Exercises
Pre-Gait Hip and Knee Strength Exercises
Pre-Gait Mat/Bed Exercises
Pre-Gait Standing Exercises
Upper Extremity Exercises
Arm Strength Exercises
Dowel Exercises - Supine
Dowel Exercises - Upright
Elbow, Forearm and Wrist Active Range of Motion
Elbow, Forearm and Wrist Strength Exercises
Elbow, Forearm and Wrist Stretches
Elbow, Wrist and Hand Active Exercises
Finger and Thumb Strength Exercises - Left
Finger and Thumb Strength Exercises - Right
Finger and Thumb Stretches and Active Range of Motion - Left
Finger and Thumb Stretches and Active Range of Motion - Right
Flexor Tendon Glides
Forearm and Wrist Active Range of Motion
Forearm and Wrist Strength Exercises
Forearm and Wrist Stretches
Median Nerve Glides
Nerve Flossing - Median
Nerve Flossing - Radial
Nerve Flossing - Ulnar
Pendulum Exercises - Left
Pendulum Exercises - Right
Posture Exercises
Putty Exercises
Scapular Mobility and Strength Exercises - Left Side Weakness
Scapular Mobility and Strength Exercises - Right Side Weakness
Shoulder Active Range of Motion
Shoulder and Hand Active Exercises
Shoulder and Rotator Cuff Active Exercises - Left
Shoulder and Rotator Cuff Active Exercises - Right
Shoulder and Rotator Cuff Exercises Free Weight - Left
Shoulder and Rotator Cuff Exercises Free Weight - Right
Shoulder and Rotator Cuff Exercises Stretch Band - Left
Shoulder and Rotator Cuff Exercises Stretch Band - Right
Shoulder Blade Exercises
Shoulder, Elbow, and Hand Active Exercises
Shoulder Isometric Left - Seated
Shoulder Isometric Left - Standing
Shoulder Isometric Right - Seated
Shoulder Isometric Right - Standing
© 2018 Cheryl Hall│www.pttoolkit.com
Balance

Impairments and Functional Limitations:
Muscle weakness (specifically quadriceps, ankle dorsiflexors, ankle plantar flexors)
Limited range of motion in the lower extremities
Slowed reaction time
Reduced processing of sensory information (proprioceptive/somatosensory, visual and vestibular)
Disequilibrium
Cognitive impairment


Assessments and Rating Scales:
Berg Balance Scale (Berg 1995)
Gait Speed Test (Guralnik 1994)
Modified Clinical Test of Sensory Integration on Balance (Shumway-Cook 1986)
Multi-Directional Reach Test (Newton 1997)
Sitting Balance Scale (Medley, Thompson 2011)
Tinetti Balance and Gait Evaluation (Tinetti 1986)
Trunk Impairment Scale (Verheyden, Nieuwboer 2004)


Physical Therapy Intervention:
Provide a multi-component balance-training program.

  • Ensure patient safety during training to prevent falls and injuries.
  • Incorporate balance exercises into everyday activities.
  • Incorporate balance exercises during regular strength training, stretching, and endurance routines.
  • Perform balance training first (when combined with resistance and flexibility activities). Recommend 10-15 minutes, three days a week.


Provide progressive challenges to balance.

  • Static balance control in sitting, half kneeling, tall kneeling, standing, tandem standing, single leg standing, lunging and squatting
  • Dynamic balance control while on a moving surface (therapy ball, wobble board, mini trampoline)
  • Challenge postural reactions
    • Ankle strategy
    • Hip strategy
    • Stepping strategy
    • Weight shift strategy
    • Suspension strategy


Progress balance activities and exercises by challenging the visual system (low lighting, wear sunglasses indoors, eyes closed), the proprioceptive/somatosensory system (unstable surfaces such as foam pads, therapy ball, mini trampoline, balance disc, wobble board, Biomechanical Ankle Platform System (BAPS), Bosu ball trainer, ambulation on an uneven surface), and the vestibular systems (gaze stability exercises).


Provide dual-tasking balance challenges by combining a balance exercise with another form of physical activity (ball kick, ball toss, arm or leg exercises), a cognitive task (count backward from 100 by 3’s, recite the alphabet backwards or name the presidents) or by adding external distractions (noise, people, music).


Utilize interactive video games (Wii-Fit, Wii Sport, and Kinect) and brain fitness programs (Mindfit) to challenge balance..


Patient and Caregiver Handouts:
Balance Exercise Guidelines
Balance Exercises - Sitting
Balance Exercises - Standing
Core Exercise Guidelines
Core Exercises - Back Muscles
Core Exercises - Pelvic Muscles
Core Exercises - Stomach Muscles
Exercise Ball Guidelines
Exercise Ball - Back Muscles
Exercise Ball - Pelvic Muscles
Exercise Ball - Stomach Muscles


Additional Treatment Guides:
Dizziness
Therapeutic Exercise

© 2018 Cheryl Hall│www.pttoolkit.com
Chronic Obstructive Pulmonary Disease

Conditions include emphysema, chronic bronchitis, asthma and bronchiectasis


Impairments and Functional Limitations:
Impaired transfers and bed mobility
Impaired gait
Limited range of motion (chest and shoulders)
Muscle weakness
Impaired aerobic capacity/endurance
Impaired balance
Dyspnea at rest or with exertion
Difficulty controlling airway secretions
Memory impairment
Co-occurring conditions - stress incontinence, cubital tunnel syndrome, depression and anxiety, heart disease, hypertension, lung cancer.


Stages of COPD:
Mild - FEV1 is equal or greater than 80 percent.
Moderate - FEV1 is between 50 and 79 percent.
Severe - FEV1 is between 30 to 49 percent.
Very Severe - FEV1 is less than 30 percent.


Physical Therapy Intervention:
Train in safe and efficient functional mobility (sit to stand, bed mobility skills, transfers, wheelchair mobility, ambulation and stairs).

  • Treat underlying impairments that limit safety and independence.
  • Train in the safe and correct use of assistive devices and adaptive equipment (walkers, canes, sliding boards, bed transfer handles, leg lifters, wheelchairs) as appropriate.


Teach patient and caregiver safe use of oxygen during mobility including fire safety, managing O2 lines, care and use of oxygen equipment, carrying portable O2.


Provide an individualized exercise and walking program that includes endurance, strengthening and flexibility activities that incorporate breathing techniques.


Assess and monitor blood pressure, heart rate, respiratory rate and oxygen saturations and perceived rate of exertion in response to functional activities and exercise.


Instruct in energy conservation, pursed lip breathing, heart rate and dyspnea self-monitoring with application to functional tasks.


Instruct in respiratory panic identification causes and alleviation techniques.


Provide respiratory management.

  • Secretion removal (percussion, vibration, and postural drainage).
  • Inspiratory muscle training (pursed lip breathing exercises, and inspiratory muscle trainers).
  • Cough training.


Reinforce education to reduce exacerbations (cover face with mask, avoid close contact with people who have a cold or flu, through and frequent hand washing, take medications, know the early symptoms).


Educate patient and caregivers about COPD, community resources. Encourage participation in support groups. Refer to outpatient Pulmonary Rehab as appropriate.


Provide education regarding fall risk and prevention strategies. Evaluate home environment, provide environmental modifications and adaptations as appropriate.


Patient and Caregiver Handouts:
Breathing Distress - Causes and Tips to Prevent
Breathing Distress Control
Cool-Down Stretches
Controlled Cough
Edema (Swelling) Control of the Leg(s)
How to Check Your Heart Rate
Posture Exercises
Postural Drainage - Chest Percussion
Postural Drainage Positions
Pulmonary Exercises
Pursed Lip Breathing
Tips to Conserve Energy
Walking Guidelines
Warm-Up Exercises


Additional Treatment Guides:
Fall Risk Assessment and Prevention
Urinary Incontinence

© 2018 Cheryl Hall│www.pttoolkit.com
Fracture of the Ankle
(Lateral, Medial, Posterior Malleolus)

Impairments and Functional Limitations:
Impaired transfers and bed mobility
Impaired gait
Muscle weakness
Limited ankle ROM
Impaired balance/proprioception
Pain and edema
Weight bearing restrictions


Physical Therapy Intervention:
Train in safe and efficient functional mobility (sit to stand, bed mobility skills, transfers, and wheelchair mobility) while adhering to weight bearing restrictions.

  • Treat underlying impairments that limit safety and independence.
  • Train in the safe and correct use of assistive devices and adaptive equipment (walkers, canes, sliding boards, bed transfer handles, leg lifters, wheelchairs) as appropriate.


Gait training with assistive device and/or ankle cast/boot as appropriate.

  • Progress weight bearing. Follow the referring surgeon’s specific guidelines for progression.
  • Monitor cardiac status during ambulation. The amount of energy required to perform limited weight bearing is 30 to 50% greater than that required for normal ambulation.


Pain and edema control

  • Moist heat, warm whirlpool, and/or pulsed ultrasound
  • Ice, TENS, compression, and elevation
  • Cold for 20 minutes following exercises


Provide exercises for all uninvolved joints to prevent loss of ROM and strength.


Provide a progressive ankle exercise program that includes endurance, strengthening and stretching activities. Progression depends on co-morbidities, type of injury, stage of healing, surgical intervention, and complications. Follow the referring surgeon’s specific guidelines for progression.


Provide a fall prevention program that includes balance, coordination and agility training and education about fall risk and prevention strategies.


Patient and Caregiver Handouts:
Ankle and Foot Active Range of Motion
Ankle and Foot Isometric Exercises
Ankle and Foot Strength Exercises
Ankle and Foot Stretches
Arm Strength Exercises
Edema (Swelling) Control of the Leg(s)
Exercise Tips for Orthopedic Conditions
Superficial Cold
Superficial Heat

© 2018 Cheryl Hall│www.pttoolkit.com
Ankle and Foot Active Range of Motion

Do the checked exercises _____ times per day, _____ days a week

Pull Foot Back
Sit in a chair. Pull your foot toward your knee.

Do _____ sets of _____.
Repeat with other foot.
Point Foot
Sit in a chair. Point your toes.

Do _____ sets of _____.
Repeat with other foot.
Turn Foot In
Sit in a chair. Point your toes up. Turn your foot inward.

Do _____ sets of _____.
Repeat with other foot.
Turn Foot Out
Sit in a chair. Point your toes up. Turn your foot outward.

Do _____ sets of _____.
Repeat with other foot.
Ankle Circles
Sit in a chair. Make circles with your foot. Move one way and then the other.

Do _____ sets of _____.
Repeat with other foot.
Toe Curls
Sit in a chair. Keep your ankle in neutral. Curl your toes down.

Do _____ sets of _____.
Repeat with other foot.
Pull Toe Back
Sit in a chair. Keep your ankle in neutral. Pull your toes back.

Do _____ sets of _____.
Repeat with other foot.
ABC's
Sit in a chair. Point your toes. Trace the letters of the ABC’s in the air.

Do _____ sets of _____.
Repeat with other foot.
© 2018 Cheryl Hall│www.pttoolkit.com
Edema (Swelling) Control of the Leg(s)

Keep your leg(s) up, as much as you can. Support your leg(s) with a pillow under your calf.

Apply a cold pack to your hip-knee-ankle-foot (circle). It should not be colder than 590F (150C).


Apply cold pack for _____ minutes, _____ times a day.

Lightly massage your foot and leg with lotion. Start at your foot and move up toward your hip.


Massage for _____ minutes, _____ times a day.

Wear a compression stocking.
Wear the stocking _____________________________________.

Apply elastic therapeutic tape to ___________________________.


Pump your ankles ______ times a day.

© 2018 Cheryl Hall│www.pttoolkit.com
Postural Drainage Positions

Use postures alone or with chest percussion. Do not do postural drainage soon after a meal.


Lie on your back with your knees bent, Put 2-3 pillows under your hips. Your chest should be lower than your hips. Breathe using deep (diaphragmatic) breathing.


Stay in this position for _____ minutes.

Lie on your side. Put 2-3 pillows under your hips. Your chest should be lower than your hips. Use a small pillow under your head. Breathe using deep (diaphragmatic) breathing.


Stay in this position for _____ minutes on each side.

Lie on your stomach. Place 2-3 pillows under your hips. Your chest should be lower than your hips. Use a small pillow under your head. Breathe using deep (diaphragmatic) breathing.


Stay in this position for _____ minutes.

© 2018 Cheryl Hall│www.pttoolkit.com
Up Steps With a Rail Using a Cane

Do not rush. Make sure you have your balance before using the stairs.


Step 1
Hold on to the rail. Hold the cane in you other hand. This may be your weaker side or your stronger side.

Step 2
Step up with your stronger leg to the first step.

Step 3
Step up with the cane and your weaker leg to the same step. Balance yourself.

Step 4
Repeat: stronger leg, weaker leg with cane, one step at a time.

Up with the “good” and down with the “bad”. This is an easy way to recall which leg to use first.

© 2018 Cheryl Hall│www.pttoolkit.com
Ejercicios Activos de Tobillo y Pie

Realice los ejercicios _____ veces al día, _____ veces a la semana.

Flexión del Dorso del Pie
Tire de los dedos del pie hacia la nariz. Mantenga la rodilla estirada. Mantenga la posición durante el recuento de _____.

Complete _____ serie(s) de _____
Flexión de la Panta de Pie
Punto los dedos del pie. Mantenga la rodilla estirada. Mantenga la posición durante el recuento de _____.

Complete _____ serie(s) de _____
Inversión del Pie
Mueva sólo el tobillo. Mantener los dedos señalados. Convertir el pie hacia adentro, para que la suela se enfrenta a la otra pierna. Mantenga la posición durante el recuento de _____.

Complete _____ serie(s) de _____
Eversión del Pie
Mueva sólo el tobillo. Mantener los dedos señalados. Gire el pie hacia fuera, lejos de la otra pierna. Mantenga la posición durante el recuento de _____.

Complete _____ serie(s) de _____
Círculos por el Tobillo
Haga el movimento de un círculo con el pie. Ir agujas del reloj y repita las agujas del reloj.

Complete _____ serie(s) de _____
Flexión del Dedo del Pie
Mantenga el tobillo en posición neutra. Doblar sus dedos de los pies hacia abajo.

Complete _____ serie(s) de _____
Extensión del Dedo del Pie
Mantenga el tobillo en posición neutra. Tire los dedos hacia usted.

Complete _____ serie(s) de _____
Alfabeto
Con los dedos del pie señale las letras del alfabeto en el aire.

Complete _____ serie(s) de _____
© 2018 Cheryl Hall│www.pttoolkit.com
Controlar el Edema de la Pierna(s)

Mantenga la pierna (s) elevado por encima del nivel del corazón tanto como sea posible cuando se está sentado en una silla o un sofá y al acostarse. Apoye a la pierna (s) con una almohada debajo de la pantorrilla, pero no bajo el talón o la rodilla.

Aplique una compresa fría en su cadera / rodilla / tobillo / pie (elija uno).
La temperatura no debe ser más fría que 590 F (150 C).


Aplique una compresa fría por _____ minutos, _____ veces al día.

Masajee de la pierna con una loción. Progrese desde el pie hasta la rodilla a la cadera.


Dé masaje por _____ minutos, _____ veces al día.

Use sus medias TED o medias de compresión.


Use las medias de ______________________________________

Bombee de sus tobillos ______ veces al día.


© 2018 Cheryl Hall│www.pttoolkit.com
Posiciones para Drenaje Postural

Acuéstese boca arriba con las rodillas dobladas. Ponga 2-3 almohadas debajo de sus caderas. Asegúrese de que su pecho es más baja que las caderas. Mantenga los brazos a los lados. Respira profundamente con la respiración diafragmática.


Permanezca en esta posición durante unos minutos _____.

Acuéstese sobre su lado. Ponga 2-3 almohadas debajo de sus caderas. Asegúrese de que su pecho es más baja que las caderas. Use una pequeña almohada bajo la cabeza. Coloque sus brazos por su cabeza. Respira profundamente con la respiración diafragmática.


Permanezca en esta posición durante unos minutos _____.


Rote en el otro lado.

Acuéstese sobre su lado. Ponga 2-3 almohadas debajo de sus caderas. Asegúrese de que su pecho es más baja que las caderas. Use una pequeña almohada bajo la cabeza. Descanse los brazos donde se sientan cómodos. Respira profundamente con la respiración diafragmática.


Permanezca en esta posición durante unos minutos _____.

© 2018 Cheryl Hall│www.pttoolkit.com
Utilizando Una Caña – Subir Escaleras

Paso 1
Mantenga su bastón en el lado opuesto de la barandilla, ésta puede ser su lado más débil y/o afectado o su lado fuerte.

Paso 2
Aferrarse a la barandilla con la mano libre. Levante la pierna más fuerte hasta el primer paso.

Paso 3
Llevar la pierna más débil/afectado y/o caña juntos hasta el mismo paso.

Paso 4
Mantenga su pierna más débil y/o afectados y la caña de paralelos entre sí.

Recuerde: "arriba con el bien." y "abajo con el mala".

© 2018 Cheryl Hall│www.pttoolkit.com

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