FUNCTIONAL REHABILITATION: AMBULATION:
Learning to remain upright in a standing position is
the first step in ambulating. If the lower extremities are not innervated
as a result of the injury, posture and KAFOs (knee-ankle-foot-orthoses which
stabilize the feet, ankles, and knees) are the keys to balanced standing.
Stabilizes the hands on parallel bars (or crutches)
Retracts the scapulae and throws the head back to thrust the pelvis forward.
In this position, the weight line falls posterior to the hips and the hips
are momentarily extended (and therefore stable). If the hips momentarily
flex, the weight line will fall anterior to the hips, and the patient will
lose stability and "jacknife" as a result.
Frees at least one hand while standing balanced; this is necessary if functional
ambulation is to be achieved
The PoinTIS SCI Physical Therapy site
of the SCI Manual for Providers is based on information in Spinal Cord Injury:
Functional Rehabilitation, by M.F. Somers, Norwalk, CT, Appleton & Lange,
1992, and information in "Respiratory Rehabilitation of the Patient with
a Spinal Cord Injury", by J.L. Wetzel, B.R. Lunsford, M.J. Peterson, and
S.E. Alvarez, Chapter 28 in Cardiopulmonary Physical Therapy, S. Irwin and
J.S. Tecklin, eds., St. Louis, Mosby, 1995, unless otherwise