Synactive Theory 2
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| What are the positional deformities common in premature infants? | Hypotonia, excessive extension, abduction, and ER. | |
| How does the positional deformity of high guard in the UE affect development? | Affects hand to mouth, propping on forearms in prone, delays shoulder stability. | |
| How do LE positional deformities like excessive hip abduction, ER, nee flexion, and ankle eversion affect development? | Problems with WB on foot, toe walking, out toeing, delayed walking due to problems with balance. | |
| What are the benefits of prone? | Promotes improved oxygenation, ventilation, and postural security. | |
| What are prone positioning recommendations? | Gel/water pillow, alternate head positions, prone roll placed under head, down chest to umbilicus, foot support for bracing. | |
| What is the rationale behind prone positioning? | Preventing excessive neck hyperextension and shoulder retraction, allowing LE and UE flexion and more adduction. | |
| What are the benefits of sidelying? | Allows therapist to swaddle infant with head in midline, most secure containment, decreases gravity’s influence on extension, facilitates hand to mouth (self-regulation). | |
| What are sidelying positioning recommendations? | Top hip/shoulder slightly forward of the bottom hip/shoulder secure with roll. | |
| What are the drawbacks to sidelying positioning? | May promote atelectasis of the lung on the down side. | |
| What are the benefits of supine? | Promotes ER, and abduction of all limbs. | |
| What are supine positioning recommendations? | Support head midline with secure ventilator tubing, gel or water pillow, tuck arms in with elbows flexed surrounded with boundaries, hips in partial flexion toward midline, knees in partial flexion inside boundaries. | |
| What are the drawbacks to supine positioning? | compromises circulation, does not allow foot bracing. | |
| Describe state level 1. | Deep sleep with regular respiration, no body or eye movements. | |
| Describe state level 2. | Light sleep, irregular respirations, some body movement, frequent eye movement. | |
| Describe state level 3. | Drowsy, transition state into sleep or alertness. | |
| Describe state level 4. | Quiet alert with eyes open, little body movement. | |
| Describe state level 5. | Active alert with eyes open, lots of body movement, may be fussy. | |
| Describe state level 6. | Crying, sustained (more than 15 sec). |
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