AIM:
To train lifting the upper trunk off the bed (supine to long sitting, complete C6 tetraplegia)
Rationale:
An important component of moving from lying to sitting is lifting the upper trunk off the bed once in side-lying. Training is set up so the patient can practise something similar but simpler, with manual guidance from the therapist if necessary.
Equipment:
- Wide bed
Key Points:
- Therapist positions the patient in sidelying with the bottom shoulder abducted to 90° and elbow flexed
- Therapist is positioned on the bed behind the patient’s shoulders
- Therapist places one arm under patient’s head and cups the hand over the patient’s bottom elbow
- Therapist applies manual guidance to lever the patient up onto their bottom elbow
- Encourage the patient to push down into the bed with the bottom elbow and lift the head
Common Errors:
- Patient is too close to the edge of the bed
- Therapist is too far away from patient to provide sufficient leverage, or does not move forward with the patient
Progression and Variety:
- Position pillows under the bottom shoulder so the patient is moving from 1⁄4 off supine
- Practise in reverse
- Decrease/remove manual guidance