T9 - Functional Analysis

We made notes on this cat...i copied them up over xmas but forgot to e-mail them youu .. so there here :) ...

Amputee Transfer – Bed to wheelchair – Functional Analysis – Leading arm.
Starting position
Patient is sat on the edge of the bed with both arms on the edge of the bed ready to push off.
Shoulder slightly extended – Latissimus dorsi, teres major, pectoralis major, deltoid (posterior fibres), triceps (long head) – Sagittal plane
Shoulder internally rotated – Due to pronation of elbow – Transverse plane
Elbow fully extended – Triceps brachii, Anconeus - Sagittal plane
Elbow pronated – Pronator teres, pronator quadratus
Isometric muscle contractions
Wide BOS – Sat on bed; plus area underneath bed, feet on floor
COG – head to pelvis
LOG – through pelvis and bed
Friction is acting upon patient continuously; feet and floor, bum and bed, hands and bed

Phase 1
Patient’s leading arm reaches over to the chair arm of the wheelchair.
Shoulder flexes - Pectoralis major, deltoid (anterior fibres), biceps brachii (long head), and coracobrachialis - Sagittal plane
Shoulder abducts - Supraspinatus, deltoid (middle fibres) – Coronal axis
Shoulder still internally rotated - Transverse plane
Elbow extends – Triceps brachii, Anconeus - Sagittal plane
Elbow still pronated – Pronator teres, pronator quadratus
All CONCENTRIC muscle contractions.
Patients moves out of LOG + COG (not within body), therefore slightly less stable, but compensated for by the larger BOS; achieved by using the chair as extra BOS.
Friction continuously acting on the patient through the feet and the floor, bed and bum, hand and bed, hand and wheelchair arm

Phase 2
Patient pushes of the bed with opposite arm and leading arm takes the weight on the wheelchair arm.
Shoulder; slight extension – Latissimus dorsi, teres major, pectoralis major, deltoid (posterior fibres), triceps (long head) - Sagittal plane – Eccentric muscles contraction
Elbow flexes – Biceps brachii, brachialis, brachioradialis, pronator teres - Sagittal plane – Eccentric muscle contraction
Elbow pronates more – Pronator teres, pronator quadratus
Shoulder still abducted, but adducts slightly - Coracobrachialis, pectoralis major, Latissimus dorsi, teres major - Coronal axis – Eccentric muscle contraction
BOS – Feet on the floor and hand on the chair.
LOG – within the body but not through the centre
COG – within the body
Friction is continuously acting on the patient; feet and floor and the hand and the wheelchair arm.

Phase 3
Patient pivot turns around ready to sit down in the chair.
Shoulder extends – Latissimus dorsi, teres major, pectoralis major, deltoid (posterior fibres), triceps (long head) - Sagittal plane
Shoulder adducts more – Coracobrachialis, pectoralis major, latissimus dorsi, teres major - Coronal axis
Shoulder internally rotates – due to pronation of elbow - Transverse plane
Elbow flexes – Biceps brachii, brachialis, brachioradialis, pronator teres - Sagittal plane
Elbow pronates – Pronator teres, pronator quadratus
All ECCENTRIC muscle contractions
BOS - the floor and hand on the chair, although slightly wider and more stable as the patient is much closer to the larger BOS; the chair.
LOG + COG within body
Friction is continuously acting upon the patient; floor and feet and the hand and the wheelchair arm, although more friction between the hand and the wheelchair arm as there is more weight put through the hand at this point than in phase 3.

Phase 4 – Finishing position
Patient sits back into wheelchair and relaxes.
Shoulder flexes – Pectoralis major, deltoid (anterior fibres), biceps brachii (long head), coracobrachialis - Sagittal plane
Shoulder internally rotates – due to pronation of elbow - Transverse plane
Shoulder adducts fully back to side of body - Coracobrachialis, pectoralis major, latissimus dorsi, teres major - Coronal axis
Elbow flexes – Biceps brachii, brachialis, brachioradialis, pronator teres - Sagittal plane
Elbow pronates – Pronator teres, pronator quadratus
All ECCENTRIC muscle contractions
BOS – Chair and feet
COG – within the body
LOG – through the centre of the body
Friction is acting upon the patient a lot at this point as there is friction between the feet and the floor, bum and the chair seat, the patient’s arms and the wheelchair arms and the back rest and the patients back.

Hope this is good for everyone :) ... some bits are in bold and some italics so they stand out better like the plane and what type of movement it is .. if you'd prefer this one let me know an i'll email it :D
Steph X