AIM:
To train weight shift (rotation, lateral) in preparation for sitting (I)
Rationale:
An important component of sitting independently is being able to shift body weight without falling. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary. Two strategies are illustrated:
- Turning to look behind
- Lowering arm to pillow
Equipment:
- Adjustable height plinth
- Pillows x 3
Key Points:
- Patient is positioned in sitting with 100% thigh support, feet shoulder-width apart, knees directly over feet, ie, no hip external rotation and ankles plantargrade
- Therapist is positioned behind or to the side of the patient and provides manual guidance if necessary
1. Turning to look behind
- Patient turns the head and trunk to look over the shoulder
2. Lowering arm to pillow
- Patient’s arm is positioned in 90° elbow flexion with slight shoulder abduction
- Patient lowers the flexed arm to the pillow/s
- Ensure patient shifts weight sideways
Common Errors:
- Therapist is too far away from patient to ensure safety
- Therapist pulls on patient’s arm
- Patient holds stiffly and only moves head or eyes
- Patient shifts weight forwards (by flexing at the hips) instead of sideways
Progression and Variety:
- Decrease/remove manual guidance
- Reduce thigh support
- Increase amplitude of movement
- Reduce height of pillow support