C6-roll onto side (S8)

The person with complete C6 tetraplegia needs to be able to roll onto his/her side in order to move into long sitting. Practice is simplified initially using one or more of the following strategies:

1. Begin 1⁄4 off supine (part-practice)
2. Arm splints to maintain elbow extension
3. Wrist weights to increase momentum
4. Manual guidance – cross ankles and/or assist with movement of the hips

Note: pillows under the head are removed to encourage the patient to lift and turn the head

Equipment:

• Height-adjustable wide bed
• Arm splints
• Wrist weights
• Pillows

Key Points:

• Ensure patient is positioned so that they can roll without fear of falling off the bed
• Ensure patient lifts and turns head
• Ensure patient does not flex the shoulders excessively unless they have sufficient momentum to prevent the elbow from falling into flexion

Common Errors:

• Patient is initially positioned too close to the edge of the bed not leaving sufficient room to safely roll over
• Patient does not move arms back and forth quickly enough
• Patient flexes shoulders excessively

Progression and Variety:

• Remove manual guidance
• Remove wrist weights
• Remove splints
• Add bed clothes
• Use regular bed