Please enable JavaScript in your browser to see this interactive content.
Patient engagement and participation is required at all levels. During the patient’s treatment there may be more than one of the approaches used depending on the patient’s need. For example to facilitate movement in a shoulder, tone management strategies may be done first (stage 1) then the patient and therapist/nurse could work on global positioning (stage 2)
| 1: Direct hands-on approach | 2: Direct hands-on approach | 3: Supervised instruction | 4: Functional activity |
|---|---|---|---|
| specific body areas.
Initially localising to specific anatomical structures – muscle, tendon, joints. Specific inhibitory or excitatory mobilisation of soft tissues to achieve local tone modification in order to change alignment. |
Globally thought the body.
Dynamic patterns associated with righting reactions – handling through “key points” which may change alignment. Lengthening or shortening through modifying tone. |
As the patient improves.
Practising tasks. Specific activities or movements under therapist or nurse control, but with your hands off, supervising only. Specific exercise or realignment strategy. Patient is actively participating and cognitively involved. |
Practising tasks independently.
Walking on ward or outside, exercise regimes, transfers, hands off, supervision only. Highly cognitive patient generated activity or minimal staff involvement. |
Page last reviewed: 05 May 2020
