PANat Urias Johnstone Скачать руководство пользователя страница 13

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PANat

 

 

2009, 

revised 02/2015, version 2017 

13

 

 

Johnstone  air  splints  were  primarily  designed  for  the  stroke  patient  with 
moderate  to  severely  impaired  motor  control  of  movement.  They  provide  an 

effective and efficient method for training. 

 
The  user  guide 

only 

includes  general  information  and  instructions  for  application  and 

handling of the air splints. Sample exercises are given to help develop your own exercise 
programmes. Responsibility of treatment is guided by the skilled therapists. The overall 

aim  is  to  encourage  and  motivate  active  training  as  part  of  a  task  activity  with  the 

underused  hemiplegic  side  and  to  discourage  learned  disuse  with  its  negative 
consequences.  Air  splints  can  be  used  in  combination  with  other  low  cost  easy  to  use 

tools thus allowing a greater intensity and variety of training. 
 

The air splints were developed by physiotherapists Margaret Johnstone and Ann Thorp as 

a  rehabilitation  aid  for  those  with  stroke  and  multiple  sclerosis.  Their  ideas  have  been 
updated  and  PANat  was  launched  in  January  2007  to  reflect  the  development  of  the 

underlying theoretical assumptions and therapeutic uses of these air splints. 
 

To be effective it is essential that the air splints are applied and used as directed by this 

user guide. 
A number of research articles have used the air splints as passive resting tools applied in 

positions  and  postures  that  may  have  a  negative  outcome  on  training  and  potential 
recovery  (e.g.  Poole,  1990;  Kwakkel,  1999,  Platz,  2009).  This  is  contrary  to  the  aims 

and use of the air splints as practiced by the PANat group. 

With  correct  application  and  use  of  the  air  splints,  the  following  advantages  can  be 
observed: 

 

Advantages of use

 

 

1. Biomechanical 

 

To  prevent  secondary  impairments  of  muscle  shortening  and  loss  of  elasticity  in 

muscles (e.g. myofascia) and connective tissue (e.g. capsule joints). 

 

To  minimise  undesirable  muscle  activity  by  maintaining  joint  alignment  and 
limiting  the  degree  of  freedom  of  movement  in  multi-joint  movements.  This  is 

especially important in the early stages of skill acquisition. 

 

To  strengthen  muscle  groups  in  functional  activities/tasks,  by  allowing  safe  pain 

free early static or dynamic weight bearing. 

 

To encourage general fitness and strength, enabling the client to increase the time 
spent in training. 

 

To promote self-directed exercises in a safe and controlled environment, allowing 
the client to progress more quickly, from independent hands-on training to active 

problem solving hands-off situations. 

 
2.

 

Sensory

 

 

To  promote  proprioceptive  stimulation  by  weight  bearing  or  limb  loading  on  the 
extremities in various activities and postural sets. 

 

To  have  added  sensory  input  with  intermittent  pneumatic  compression  in 

combination with the air splints (tactile and proprioceptive). 

 

 
 

 
 

For  further  information  on  theoretical  background  and  courses  please  contact  the 
following address:  

www.panat.info

 

 

 

Содержание Urias Johnstone

Страница 1: ...habilitation integrating air splints and other therapy tools Urias Johnstone air splints PANat Theoretical framework clinical management and application of the Urias Johnstone air splints 1 Theoretica...

Страница 2: ...TS USED IN PANat 11 ADVANTAGES OF USE 13 GENERAL INFORMATION 14 LONG ARM AIR SPLINT 70 CM AND 80 CM 17 HALF ARM AIR SPLINT 53 CM 20 HAND AIR SPLINT DOUBLE CHAMBER 20 CM 24 HAND WRIST AIR SPLINT DOUBLE...

Страница 3: ...integrating air splints and other therapy tools Urias Johnstone air splints 1 Theoretical framework and clinical management of PANat G Cox Steck dipl Physiotherapist FH accredited Teacher of PANat Ma...

Страница 4: ...ctivity As a consequence they may develop learned non use muscle stiffness contractures and pain Studies have shown that using the air splint for repetitive and early stimulation in training the upper...

Страница 5: ...vement sequence with feedback in hands off situations Self directed practice is therefore on going in both supervised and unsupervised therapy sessions and at home Clinical Management Clinical managem...

Страница 6: ...ng the lever effect with air splints or other therapy tools and introducing cognitive elements e g dual tasking The appropriate choice and use of air splints and therapy tools may be used to reduce th...

Страница 7: ...etitive practice using external focus instructions and feedback during hands on off training This can be practiced when severe sensory motor cognitive and perceptual problems are present In addition t...

Страница 8: ...c carers An integral part of PANat is the education of carers family members and friends in understanding and managing the disease process Through training they develop skills to continue long term r...

Страница 9: ...tivities of the hemiparetic limbs in uni bi lateral and bimanual movements whilst preventing detrimental compensatory strategies The choice of activity in the session is based on the impairments that...

Страница 10: ...tion Movement and Neuromotor Processes In Carr J Shepherd R Movement Science Foundations for Physical Therapy in Rehabilitation 2nd ed 2000 16 Shumway Cook A Woollacott MH Motor Control Translating Re...

Страница 11: ...9 revised 02 2015 version 2017 11 PRO Active approach to Neurorehabilitation integrating air splints and other therapy tools Urias Johnstone air splints 2 Application of the Urias Johnstone air splint...

Страница 12: ...STING SPECIALLY DESIGNED FOR PATIENTS WITH MULTIPLE SCLEROSIS 41 LEG FOOT AIR SPLINT FOR STANDING SPECIALLY DESIGNED FOR PATIENTS WITH MULTIPLE SCLEROSIS 43 This user guide is developed by Gail Cox St...

Страница 13: ...ng tools applied in positions and postures that may have a negative outcome on training and potential recovery e g Poole 1990 Kwakkel 1999 Platz 2009 This is contrary to the aims and use of the air sp...

Страница 14: ...uble chamber 70 cm Ref 70 102 0 80 cm Ref 70 101 0 Foot air splint double chamber Ref 70 108 0 Half Arm air splint 53 cm Ref 70 003 0 Leg air splint double chamber 60 cm Ref 70 007 0 70 cm Ref 70 006...

Страница 15: ...and reapplied Inflation pressure should be checked by a manometer and must not exceed 40 mm Hg at rest use a 10 cm connection between splint valve and manometer Electric mechanical pumps to blow up ai...

Страница 16: ...chable mouth piece is easily fitted and carried in the user s pocket This can be washed as necessary 2 Disposable filter bottle contains crystals which absorb excess moisture This is fitted to the inf...

Страница 17: ...Passively mobilise realign and support the scapula to permit accurate positioning of the shoulder and arm Carefully bring the extended arm into outward rotation flexion and abduction Encourage the cli...

Страница 18: ...he hemiplegic hand The air splint is drawn up the arm to leave a space of 3 fingers width from the axilla 3 4 Place the inflation tube in your mouth This leaves both hands free to maintain the positio...

Страница 19: ...active movement is present encourage the client to move his limb 2 Passively mobilise all joints see preparation for application Ask the client if he is aware of changes in feeling or in movement of...

Страница 20: ...refully bring the extended arm into outward rotation flexion and abduction Encourage the client to turn his head to the affected side to watch and follow the movements of the arm and hand 3 4 Support...

Страница 21: ...ase of 1st metacarpal Hold it in this position during inflation The fingers are straight and held together not apart The wrist is supported in approx 10 dorsal extension Both of your hands are needed...

Страница 22: ...ls into prone and accepts weight through the forearm The yellow band is used as an external focus so that the client knows where to place the elbow The client drops his head to look at the yellow band...

Страница 23: ...r splint thus avoiding any potential trauma to the shoulder Do not leave the air splint on for more than 30 45 minutes Within the course of a treatment session it may be removed and reapplied if it is...

Страница 24: ...istributed through the buttocks and feet The feet must be flat on the floor Prior to application passive movements of the shoulder girdle and arm are carried out at the same time muscle pliability and...

Страница 25: ...oft tissues and to encourage extension of the toes during functional activities Removal of the air splint Inform the client that the air splint is to be removed Deflate the air splint If active moveme...

Страница 26: ...r splint for the larger hand Preparation Ensure the client is sitting with weight evenly distributed through the buttocks and feet The feet must be flat on the floor Prior to application passive movem...

Страница 27: ...toes during functional activities Removal of the air splint Inform the client that the air splint is to be removed Deflate the air splint If active movement is present encourage the client to move his...

Страница 28: ...the elbow Selective soft tissue mobilisation of the elbow Can be slipped on or off over the hand air splint when required Preparation 1 2 Prior to application ensure the following movements are comple...

Страница 29: ...the elbow air splint with the zip placed on the front anterior aspect of the elbow joint The arm is outwardly rotated externally rotated and positioned for weight bearing through the heel of the hand...

Страница 30: ...ovement is present encourage the client to move his limb Passively mobilise all joints see preparation for application Ask the client if he is aware of changes in feeling or in movement of the limb Pr...

Страница 31: ...ocks and feet The feet must be flat on the floor Prior to application passive movements of the shoulder girdle and arm are carried out at the same time muscle pliability and joint ranges are assessed...

Страница 32: ...training of the open hand with different materials and textures Removal of the air splint Inform the client that the air splint is to be removed Deflate the air splint If active movement is present en...

Страница 33: ...nsfers to minimise injury to the foot and maintain alignment of the heel forefoot and toes Preparation 1 2 Mobilise the ankle joint by sliding the foot backwards and forwards Ensure the heel and sole...

Страница 34: ...foot and toes allowing heel strike Removal of the air splint Inform the client that the air splint is to be removed Deflate the air splint If active movement is present encourage the client to feel t...

Страница 35: ...ike in gait To maintain foot ankle position thus limiting the likelihood of injury during gait Preparation 1 2 Place the foot in a functional position Ensure the heel and sole of the foot are flat on...

Страница 36: ...in the corner of the air splint Gather the excess fabric into your hands and direct the pressure backwards towards the heel Maintain the foot in a neutral position with pressure on the heel and infla...

Страница 37: ...rush a rag or ice Precautions Do not apply to the bare foot This air splint was made to be applied over the shoe Do not apply over shoes with sharp edges as this may damage the air splint Never allow...

Страница 38: ...ing To enable the following activities squats weight transfer from side to side single leg stance and side stepping To stretch Soleus and Gastrocnemius Preparation 1 2 Mobilise the trunk prior to stan...

Страница 39: ...Ensure the air splint is comfortable in between the legs and that the catheter if present is attached to the non plegic leg Adjust the zip so that it runs down the centre of the outside of the leg in...

Страница 40: ...t that the air splint is to be removed Deflate the air splint If active movement is present encourage the client to actively stabilise the leg whilst the air splint is deflating Passively mobilise all...

Страница 41: ...ssure with your hands to mobilise the joints and soft tissues of the leg The movements are slow and rhythmical Passively mobilise the leg ensuring all movements are pain free Application 1 2 Put the o...

Страница 42: ...the limb Remove the air splint Passively mobilise all joints see preparation for application and re evaluate the response to stretch reflex sensitivity Precautions Not to do with the Leg and Foot air...

Страница 43: ...in sitting with a back support for the client if necessary In sitting Ensure symmetrical postural alignment Apply a comfortable pressure with your hands to mobilise the joints and soft tissues of the...

Страница 44: ...autions Never walk in the leg and foot air splint for standing side stepping is allowed as it produces an abnormal gait pattern Ensure no air is under the heel when it is in the air splint Never use a...

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