AIM:
To train rolling onto the side (supine to long sitting, complete C6 tetraplegia)
Rationale:
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:
- Begin 1⁄4 off supine (part-practice)
- Arm splints to maintain elbow extension
- Wrist weights to increase momentum
- 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