What is the second layer from the bottom in the bottom-up rehab pyramid?

What is the second layer from the bottom in the bottom-up rehab pyramid?

• A. Range of motion / flexibility
• B. Neuromotor control / proprioception
• C. Function / performance
• D. Strength and endurance

Answer: (A)

The bottom-up rehab pyramid starts with foundational work on motion and tissue length, followed by progressive loading and control. After addressing the initial healing and pain factors, the next priority is restoring range of motion and flexibility. Adequate joint motion is needed to safely tolerate strengthening and functional training later; without sufficient ROM, you risk abnormal movement patterns, compensations, or tissue irritation as you load the limb. Once ROM and flexibility are regained, you can effectively move on to strengthening, then neuromotor control/proprioception, and finally functional performance. For example, regaining ankle dorsiflexion and calf/ankle flexibility creates the necessary window to progress to balance and gait retraining.

The bottom-up rehab pyramid starts with foundational work on motion and tissue length, followed by progressive loading and control. After addressing the initial healing and pain factors, the next priority is restoring range of motion and flexibility. Adequate joint motion is needed to safely tolerate strengthening and functional training later; without sufficient ROM, you risk abnormal movement patterns, compensations, or tissue irritation as you load the limb. Once ROM and flexibility are regained, you can effectively move on to strengthening, then neuromotor control/proprioception, and finally functional performance. For example, regaining ankle dorsiflexion and calf/ankle flexibility creates the necessary window to progress to balance and gait retraining.