__Progressive_Exercise_Therapy_in_Rehabilitation_and_Physical_Education

92 PROGRESSIVE EXERCISE THERAPY 2. Beam a little under Hip Height The subject stands close to the beam, and grasps it with the fingers behind and the thumbs in front, so that the hands touch the thighs. He then leans over the beam as far as possible, simultaneously bringing the chin on to the chest and looking at the knees; he then bends the knees and brings the heels up to the seat, which allows the weight of the upper part of the body to carry the legs over the beam. The body should be kept in this curled-up position until the feet touch the floor. 3. Using Two Beams: Lower Beam placed at Chest Level, and Upper Beam about 60 cm above ~'t The subject takes up the under grasp walk forwards standing position at the lower beam. He throws the legs up and gets the heels behind the upper beam; he then presses with the heels and bends the arms and circles up on the lower beam to the balance hanging position (Fig. 243, p. 271), In circling forwards­ downwards he bends the hip and knee joints as much as possible, Use of S~pporters Until the subject has acquired a good circling technique two supporters should stand on either side of him to give him confidence. Support is most often required when the subject changes his grasp before extending the body, and the assistants' hands should be placed under the shoulders and legs. It is also a wise precaution to put an agility mattress or mat under the beam in case the subject should accidentally lose his grasp. LATERAL FLEXORS OF THE SPINE Types of Static Exercises 1. Trunk (Spine Straight) on Leg Trunk lowering and raising sideways from standing or thigh support side towards standing by abducting and adducting the hip joint of one leg, the other leg being raised and lowered sideways with the trunk. Throughout the exercise the lateral flexors of the spine on the upper side act statically to keep the spine straight and to prevent gravity from side flexing it. Example: Side toward standing (wall bar stool),' Trunk lowering sideways to place the hand on the stool with single Leg raising sideways (Fig. 110). 2. Lateral Movemems of the Arm and/or Leg from Side Falling Position or its Modifications During the exercises the lateral flexors of the thoracolumbar spine on the

TRUNK EXERCISES 93 lower side act statically to keep the trunk straight and to prevent it from sagging. Example: Side falling; single Leg raising sideways (Fig. III). Fig. 110. Fig. Ill. Fig. 112. 3. Fallout Outward Exercises The exercises are performed with or without arm movements. The lateral flexors of the thoracolumbar spine of the upper side act statically to keep the spine straight and to prevent it from bending towards the side of the forward leg. Unless the exercises are performed with perfect control the lateral flexors will be used dynamically. Example: Wing standing; fallout outwards, left and right (Fig. 112). Strengthening Exercises Elementary GRADE 1 1. Side toward standing (wall bar stool); Trunk lowering sideways to place the hand on the stool with single Leg raising sideways. (See Fig. llO.) 2. Inclined side falling (hand on wall bar stool); single Leg raising sideways . GRADE 2 1. Half stretch side toward standing (wall bar stool); Trunk lowering sideways to place the free hand on the stool with single Leg raising sideways. 2. Side faIling; single Leg raising sideways (Fig. 111). Intermediate GRADE 1 1. Wing thigh support side toward standing (beam); Trunk lowering sideways with single Leg raising sideways (Fig. 113). 2. Half fist bend side falling; single Leg raising sideways with single Arm stretching sideways-upwards.

94 PROGRESSIVE EXERCISE THERAPY 3. Wing standing; fallout outwards, left and right. (See Fig. 112, p. 93.) 4. Stretch grasp high toward toe standing (wall bars); assuming Star position (Fig. 114). ab 4 ..- - ­ .... ­ Fig. 113. '-¥,\"­\\ \\·\"'l)·~~ I i r-I . ____I . .­/t •\\ .... ., \\ i~-~~....~~:: Fig. 114. GRADE 2 1. Half stretch half wing thigh support side towards standing (beam); Trunk lowering sideways with single Leg raising sideways. 2. Horizontal side falling; single Leg raising sideways (Fig. 115). ~.,.~ ,. ~ .!, Fig. 115. 3. Fist bend standing; fallout outwards, left and right, with Arm stretching upwards. 4. No progression. Advanced GRADE 1 1. Stretch side toward standing (wall bars); Trunk lowering sideways to grasp the bars with single Leg raising sideways. 2. Half fist bend horizontal side falling; single Leg raising sideways with single Arm stretching sideways-upwards. 3-4. No progressions. GRADE 2 No progressions.

TRUNK EXERCISES 95 Types of Dynamic Exercises 1. Spine on Pelvis Lateral flexion of the spine from a starting position which fixes the pelvis, such as ride sitting, stride sitting, and foot support side toward standing (see Fixation of Pelvis, p. 99). Examples: (i) Stride sitting; Trunk bending sideways. (ii) Ridesitting (chair: thighs gripping chair back),- Trunk bending from side to side (Fig. 116). (iii) Half neck rest foot support side toward standing (wall bars); Trunk bending sideways towards the bars with rhythmical pressing to 3 counts (Fig. 117). Fig. 116. Fig. 117. Fig. 118. 2. Spine on Pelvis: Pelvis on Legs Lateral flexion of the trunk from a starting position which allows lateral pelvic tilting to occur, such as stride standing, stride lying, and fixed side lying. The lateral flexors of the thoracolumbar spine act with the hip abductors and adductors. Examples: (i) Stride standing; Trunk bending from side to side. (ii) Stride lying; Trunk bending sideways. (iii) Fixed side-lying (one leg slightly in front of other); Trunk bending sideways (Fig. 118). 3. Legs on Pelvis: Pelvis and Lumbar Spine on Upper Trunk Leg raising sideways or leg swinging from side to side from hanging; this group of exercises includes leg lowering sideways from reverse hanging. The lateral flexors of the thoracolumbar spine act with the hip abductors and adductors. Examples: (i) Hanging (wall bars); Leg raising sideways (Fig. 119). (ii) Over grasp hanging (beam); Arm walking sideways with Leg swinging from side to side (Fig. 120).