Fit Ball Presentation 1

8/3/2019 Fit Ball Presentation 1

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Get On The BallSummary

Sharon Brogden 2011


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Benefits of using the Ball

Versatile and adaptable accommodates all stages ofrehab

Facilitates compliance different and fun

Can assist in unloading thetherapist

Integrated exercise i.e.addresses the patient as afunctional whole

Offers a variety of treatmentpositions

Can be used to elicit automaticpostural responses

Increases focus on the task

Introduces multiplanar forces

Can be used for variety ofpurposes;ROM,balance,co-

ordination,proprioception,stability,strength,cardio

Increases awareness of centreof gravity

Can alter tone

Allows scope for progression

to high levels Inexpensive and portable

Excellent for group work


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Intrinsic therapeutic qualities

Lability Responsiveness

Supportiveness Elasticity

Pliability Colour / Sensory


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The Supportive Role

Passive mobilisations in

supine

Active / active assisted

movements

Neural mobilisation

Seated hamstring

lengthening

QL release

Seated forward ball push

encourages sit-st and

even wb

Seated walk ball round

chair (rotation / weight

transfer


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Common postural deviations seen

on the ball Posterior cranial rotation, often in prone

positions

Chin poking in supine positions

Scapular elevation, medial rotation andadduction, especially on prone

Excessive lumbar extension (prone and supine)

Hip flexion in prone positions

Adduction and internal rotation of the femur insingle leg stance

Jaw clenching / lip or facial fixing

Foot fixing / gripping with toes


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So

Ensure dynamic stability not functional

rigidity

Elicit postures that are not physically andpsychologically taxing

Breathing should be natural and

uncontrived Effortless control


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Safety

Ensure correct size ball for patient

Use on flat surface, preferably on a non-slip mat

Bare feet or suitable footwear

Clear the area of sharp objects and furniture

Ensure patient is medically able to perform the exercise safely, e.g.blood pressure etc

Ensure patient has sufficient confidence and balance to perform theselected exercise. Never send a patient home to learn an exercise always ensure they have first performed it safely in your presence

Do not leave the ball unattended in areas where untrained

individuals may use it Do not over-inflate the ball

Do not keep the ball in extremes of heat or cold


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Progression

Base of support: narrow / wide

Plane of movement: saggital / coronal / transverse

: bilateral / unilateral

Increase / decrease lever arm

Increase / decrease level of mobility required

Apply an external force

Increase / decrease speed

Exercise in pairs to introduce unpredictability and ability

to respond to an external stimulus Exercise with eyes closed

Introduce another object to manipulate while performingexercise


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Phases of Rehabilitation

Relaxation phase

Dissociation phase

Activation and proprioception phase

Consolidation phase

Integration

Randomisation / diversification


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Relaxation phase(depending upon patient level)

Supported rocking

Supported thoracic mobilisation in sitting

Crook lying breathing patterns

Dissociation phase

Upper limb from trunk

Lower limb from trunk

Pelvis from lumbar spine


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Activation & Proprioception phase

Helium balloon

Standing arm raise

Kneeling press down

4 point

Oscillatory bounce

Seated forward translation


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Consolidation phase

Wall press and progressions

Seated work at appropriate level

Wall squat and progressions

Over the top

Superman

Floor bridge and progressions

Extended bridge and progressions Supine progressions e.g. crook lying with ball

under one heel, or ball in hands


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Integration

Standing and walking bounce work

Increase lateral weight shift demand

Functionally specific work

Randomisation / Diversification

Multimodal work (using distraction withother equipment such as throwing and

catching)


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Seated exercises

Control of neutral spine while moving

forwards/sideways / seated arm raises


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Seated exercises cont

Bouncing +/- arm movements


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Knee lift


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Follow hands exercise


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ROM for hips, with hands on table pushing

away


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Supine exercises

Crook lying moving ball in hands/ with rhythmic

stabilisations


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Supine exercises cont

Floor Bridge


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Extended bridge and progressions


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Walkout


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Prone exercises

Superman


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Prone exercises cont

OTT


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Titanic


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Body spin Around the world


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Ab burner Full body push-up


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Standing exercises

Wall press + progressions


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Standing exercises cont

Wall squat


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Advanced balance

Kneeling balance Standing balance


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Upper limb applications

Dynamic stabilisation

Joint position sensibility

Reactive neuro-muscular control

Functional motor patterns


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Rotator cuff facilitation

Prone over ball with hands on floor rock

fwd/back/side to load injured limb


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Rotator cuff facilitation cont

Basic wall press


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Superman Over the Top +/-

rhythmic stabilisations


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OTT with squat thrust

+/- twist


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Stage 2: Joint position sense

Open chain ball in

hand exercise

Eyes closed ball

bouncing


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Stage 3: reactive neuromuscular

control

Kneel on bed, hands

on ball. Keep balance

+/- rhythmic

stabilisations

Wall press: single leg,

eyes closed


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control cont

Ramp Standing ball bounce

hand to hand or to

another person


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Sway


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control cont

Lie on back throw

and catch ball

progress to extended

bridge position

Weight bearing

through elbows: ab

burner


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Stage 4: Functional motor patterns

Combined modalities:

weights, cliniband,

medicine balls

Activity specific

loading

Integration and

diversification of the

shoulder with whole

body movements,distraction, changing

balance demands


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Lower limb / trunk applications

Early mobility / weight transfer / joint

position sense

Higher load strengthening Reactive neuro-muscular control

Increased functional loading

Pair and group work


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Early mobility / weight transfer /

joint position sense

Supine knee

extension / flexion

with heel on ball

(eyes open / closed)

Seated bouncing


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Early mobility / weight transfer /

joint position sense cont

Seated anterolateral

lunge (VMO)

Superman


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Higher load strengthening

Floor bridge Extended bridge


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Higher load strengthening cont..

Wall squat Titanic


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Increase functional loading

Kneeling on ball


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Pair and group work

Press up Ramp


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Pair and group work cont

Foot follow me


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Pair and group work cont

Mirroring exercises


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References

Joanne Elphinston Get on the ball

course notes

T

he Core Workout Joanne Elphinston

Fit Ball Presentation 1

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