In the 15 years since publication of the first edition, Steps to Follow has gained a worldwide reputation among professionals as a unique practical guide to the treatment of neurologically impaired patients. This second, completely updated edition incorporates significant practical advances in early and later neurorehabilitation and in the understanding of the problems confronting both patients and those who work with them. The relevant therapeutic activities to improve functional ability and quality of life following a stroke are described in detail twith the help of 750 photos showing patients in action during treatment: - Practical ways in which patients can be helped to interact more normally with their environment and so regain their independence, in spite of the perceptual disorders often associated with hemiplegia - More detailed explanation of hand function and more in-depth analysis of normal walking - Revised chapters on the various therapeutic activities, including new means of stimulating selective movements in order to counteract increases in muscle tone - Deeper understanding of abdominal muscle activity, which is relevant to retraining balance reactions and sitting and standing - A new chapter demonstrating how David Butlers concept of the mobilisation of neural structures throughout the body can be of inestimable value - Examples of ways in which therapists, nurses and relatives can help very severely disabled patients to avoid the development of secondary complications or overcome existing difficulties - Ways in whicfh the patient can maintain mobility and continue to make progress even after cessation of treatment, by exercising at home and participating in sporting and other leisure activities.

Inhaltsangabe1 Problems That Cannot Be Seen Directly.- Problems Related to Disturbed Perception.- Some Common Problems Associated with Disturbed Perception.- Reciprocity of Perception and Learning.- Disturbed Perception and Learning.- Implications for Therapy.- Guided Movement Therapy (Guiding).- Therapeutic or Intensive Guiding.- Using Verbal Instructions.- How the Patient is Guided Therapeutically.- Choosing a Task.- Additional Considerations When Choosing a Task.- Guiding When Giving Assistance.- Guiding the Patient in a Standing Position.- Considerations.- 2 Normal Movement Sequences and Balance Reactions.- Analysis of Certain Everyday Movements.- Rolling Over from Supine to Prone.- Sitting, Leaning Forwards to Touch the Feet.- Standing from Sitting on a Chair.- Standing up from the Floor.- Going Up and Down Stairs.- Walking.- Balance, Righting and Equilibrium Reactions.- Lying on a Surface That Tilts Sideways.- Sitting on a Surface That Tilts Sideways.- Sitting, Being Drawn Sideways by Another Person.- Sitting with Both Legs Flexed and Turned to One Side.- Sitting, Reaching Out to Grasp an Object.- Standing, Tipped Backwards.- Standing, Tipped Forwards.- Standing, Tipped Sideways.- Standing on a Tilting Surface, Such as a Tilt-Board.- Automatic Steps to Maintain or Regain Balance.- Steps to Follow.- Balancing on One Leg.- Protective Extension of the Arms.- Task-orientated Arm and Hand Movements.- Considerations.- 3 Abnormal Movement Patterns in Hemiplegia.- Persistence of Primitive Mass Synergies.- The Synergies as They Appear in Association with Hemiplegia.- In the Upper Limb.- In the Lower Limb.- Abnormal Muscle Tone.- Typical Patterns of Spasticity or Hypertonicity.- Placing.- Reappearance of Tonic Reflex Activity.- Tonic Labyrinthine Reflex.- Symmetrical Tonic Neck Reflex.- Asymmetrical Tonic Neck Reflex.- Positive Supporting Reaction.- Crossed Extensor Reflex.- The Grasp Reflex.- Associated Reactions and Associated Movements.- Abnormal Tension in the Nervous System.- Disturbed Sensation.- Considerations.- 4 Practical Assessment - a Continuing Process.- The Aims of Assessment.- Recommendations for Accurate Assessment.- Specific Aspects of Assessment.- Recording the Assessment.- The Comprehensive Evaluation.- The Head.- The Trunk.- The Upper Limbs.- The Lower Limbs.- Sitting.- Standing.- Weight Transference and Balance Reactions.- Walking.- Comprehension.- The Face, Speaking and Eating.- Sensation.- Functional Abilities.- Leisure Activities and Hobbies.- Considerations.- 5 The Acute Phase - Positioning and Moving in Bed and in the Chair.- The Arrangement of the Patient's Room.- Positioning the Patient in Bed.- Lying on the Hemiplegic Side.- Lying on the Unaffected Side.- Lying Supine.- General Points to Note When Positioning the Patient.- Sitting in Bed.- Sitting in a Chair.- Re-adjusting the Patient's Position in the Wheelchair.- Learning to Propel the Wheelchair Independently.- Self-assisted Arm Activity with Clasped Hands.- Moving in Bed.- Moving Sideways.- Rolling Over Onto the Hemiplegic Side.- Rolling Over Onto the Unaffected Side.- Moving Forwards and Backwards While Sitting in Bed.- Sitting Up Over the Side of the Bed.- Lying Down from Sitting Over the Side of the Bed.- Transferring from Bed to Chair and Back Again.- The Passive Transfer.- The More Active Transfer.- The Active Transfer.- Incontinence.- Constipation.- Considerations.- 6 Normalising Postural Tone and Teaching the Patient to Move Selectively and Without Excessive Effort.- Important Activities for the Trunk and Lower Limbs in Lying.- Inhibiting Extensor Spasticity in the Leg.- Retraining Selective Abdominal Muscle Activity.- Control of the Leg Through Range.- Placing the Leg in Different Positions.- Inhibition of Knee Extension with the Hip in Extension.- Active Control at the Hip.- Selective Hip Extension (Bridging).- Isolated Knee Extension.- Stimulating Active Dorsiflexion of the Foot and Toes.- Rolling Over.- Activities in Sitting.- Correcting the Sitting P