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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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Seated exercises cont
Knee lift
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Seated exercises cont
Follow hands exercise
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Seated exercises cont
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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Supine exercises cont
Extended bridge and progressions
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Supine exercises cont
Walkout
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Prone exercises
Superman
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Prone exercises cont
OTT
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Prone exercises cont
Titanic
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Prone exercises cont
Body spin Around the world
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Prone exercises cont
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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Rotator cuff facilitation cont
Superman Over the Top +/-
rhythmic stabilisations
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Rotator cuff facilitation cont
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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Stage 3: reactive neuromuscular
control cont
Ramp Standing ball bounce
hand to hand or to
another person
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Sway
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Stage 3: reactive neuromuscular
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