Presentation contains detailed knowledge about Functional Re-education Training in rehabilitation to re-educate and restore motor impairments after any pathological condition. - Functional – related to day-to-day functions - Re-education – re-training (educating something, which is already known by an individual). - Functional re-education techniques are those which are used in re-education of lost functions. - Re-education means educating something, which is already known by an individual.

1. By – Anumeha Sharma
MPT (Neurology)

2.  Functional – related to day-to-day functions
 Re-education – re-training (educating
something, which is already known by an
individual).
 Functional re-education techniques are those
which are used in re-education of lost
functions.
 Re-education means educating something,
which is already known by an individual.

3.  Depending on the condition, the sequence
can be planned and the multiple posture may
overlapped during that program.
 Individuality – patient specific.
 Team work
 Modified movements
 “Making the patient independent” is the main
goal.

4.  Improve the coordination and balance.
 Increase the strength endurance of the
muscle.
 Increase the pelvic stability.
 Increase the dynamic and static stability.
 Enhance the proprioception function.
 Improve the postural instability.
 Improve the ambulatory skill.

5.  Functional re-education training consist of
the pre ambulatory mat activities and
ambulatory training.
 Rolling
 Supine to side lying
 Side lying to prone lying
 Prone lying with forearm support
 Prone on hands

6.  Quadruped position
 Kneeling
 Half kneeling
 Standing
 Walking

7.  Walking is a complex activity which requires
the co-operation and control of the whole
body.
 Useless unless the patient has first learnt to
get up and stand.
 Walking is a logical progression from the
activities previously learnt.
 Careful preparation and motivation.

8.  Patient should be –
I. Suitably dressed
II. Comfortable outdoor-type walking shoes.

9.  The patient must learn the correct pattern of
walking from the start.
 Sufficient support and/or aids must be
provided to allow a correct pattern of walking
to be a practical possibility.
 The amount of support or aid must only be
withdrawn or modified when the patient can
demonstrate his ability satisfactorily with less
support or no aid.

13.  The body always does its best to achieve the
purpose of an activity.
 If it is prevented or impeded from using the
habitual pattern it substitutes another (so-
called ‘trick movement’) e.g. a limping gait.
 This new pattern soon becomes habitual it
often persists long after the need for it has
disappeared.

14.  Pain, neuro-muscular inefficiency or
limitation of joint range are common factors
for deviation.
 Adequate and efficient support, such as
crutches or splints can be use as
compensation.
 Skill of the therapist – to recognise the key
factor or factors.

15.  Walking with flexed hips
 This requires correction of the stance
positions.
 Lack of the normal range of lumbar and hip
extension, possibly due to prolonged
recumbancy or sitting slumped in a chair, can
be a predisposing factor.
 Merely asking the patient to stand erect often
results in the patient bending knees.

16.  One method to help the patient’s efforts is
for the therapist to give pressure in the
direction in which movement is required.
 If the range of movement is severely limited,
mobilization of relevant joints must be
attempted first.
 Flexed hip in combination with hyper-
extension of the weight bearing knee, may be
caused by lack of adequate dorsiflexion range
in the ankle joint.

17.  Lateral shift of the pelvis
 Occurs when one leg has been non weight
bearing for some time.
 Easily observable.
 The fault lies in the failure to transfer the
weight over the hip of affected leg; therefore
to preserve balance in phase 2 the trunk must
lean sideways.

18.  This type of gait can usually be corrected by
practice of the stance position until it is
established and secure, then it can be
integrated with the total pattern of walking.
 Or sideways walking, with support of a
handrail.
 Test of efficiency is to step up sideways on to
a shallow stair tread or a large book.

19.  The flat footed shuffle
 Walking with the feet held rigid in
dorsiflexion and possibly with knees & hip
flexed is often associated with painful
conditions such as arthritis.
 The protective tension which produces this
pattern increase the effort of walking and
may well produce or even increase pain by
reducing the normal shock absorbing
function of many joints of the lower limb.

20.  Mobilisation of the feet and lumbar region
with instruction in the use of all possible joint
movement by adopting a lifting gait often
helps to restore the “spring” into walking.

21.  To be a functional walker the patient must be
able to move freely and safely at home, them
later on, out and about.
 Practice in overcoming any particular
stumbling block may be necessary but
patient must be encouraged to face and solve
their own problems as soon as possible.

22.  A shallow step or slope is attempted first and
practice given to balancing with one leg on the
step ready for weight transference.
 Movement both up and down and the
management of crutches and sticks must be
included.
 It is advisable to use hand-rail, if there is one.
 Frequent repetition of the activity is needed to
build up endurance, increase speed and gain
confidence.

23.  Frequent repetition of the activity is needed
to build up endurance, increase speed and
gain confidence.