AIM:
To train inclining the trunk forward in preparation for standing up
Rationale:
An important component of standing up is the ability to move the trunk and shoulders forwards, ie, hip flexion with trunk extension. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary and/or support from a table/plinth.
Equipment:
- Adjustable height plinth
- Table
- Targets, eg, tape
- Arm sling (if necessary)
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
- dorsiflexed
- Patient flexes at the hips with truck extended and brings the shoulders forwards
- Therapist is positioned in front or to the side of the patient and provides manual guidance at the shoulders if necessary
Common Errors:
- Therapist pulls on the affected arm
- Therapist stands too close to patient and blocks forward movement
- Patient flexes at neck and trunk (rather than at the hips)
Progression and Variety:
- Decrease/remove manual guidance
- Decrease/remove other forms of support
- Reduce thigh support
- Increase amplitude of movement
- Increase speed of movement