Table 2. Physical Therapy Intervention Techniques.

Technique	Description
Breathing Strategies26
Costophrenic assisted cough	Use of manual assistance over the lower ribs to assist with generation of force for a productive cough.
Pursed Lip Breathing	“Breathing in through the nose to a count of “1,2” and out via pursed lips to a count of “1,2,3,4”
Diaphragmatic Breathing	Have patient place one hand over umbilicus and one hand on upper chest (distal to clavicles). Instruct patient to increase excursion of hand over umbilicus with decreased movement of upper chest. Begin this task in a comfortable position; incorporate as appropriate while performing functional tasks.
Scoop Technique	Use tactile cues to facilitate diaphragmatic breathing. A “slow stretch up and under the anterior thorax” Then ask the patient to “breathe into my hand”.
Range of Motion Exercise	AAROM using PNF Diagonals23
Upper Extremity	PNF Diagonal 1 and 223 in both flexion and extension with manual contact over the agonist muscle groups performed in supine and sitting
Lower Extremity	PNF Diagonal 1 and 223 in supine with manual contact over the agonist muscle groups.
	In sitting: straight plane exercises of hip flexion, abduction and adduction, knee flexion/extension, and ankle dorsiflexion/plantarflexion.
	In standing, closed chain activities including squats, steps to the side, calf raises.
Patient Education	Education regarding safe mobility; home exercise program
Functional Mobility Training
Bed mobility	Rolling side to side with rails and verbal cues initially and decreasing use of both bed rails and cues as patient increased in strength and endurance.
	Sidelying to sit with incorporation of pacing breathing through the functional task.
Transfer Training	Once patient was able to maintain sitting balance at edge of bed with minimal A or less, sit to stand transfers were initiated from various bed heights. Transfers from bed to chair were also performed.
Gait	Once patient demonstrated 3+ LE strength and the ability to maintain postural control with minimal A or less gait training with the least restrictive device was implemented. Initial floor surfaces included uncarpeted surfaces.

AAROM= active assistive range of motion, PNF= proprioceptive neuromuscular facilitation, A= assistance, LE= lower extremity