Sitting skills

Sitting Skills

Dynamic Shoulder Control, Propped Back on One Hand - The patient:

Begins by assuming a therapist-assisted sitting position, propped back on one hand, and learning to use motions of the free arm and head to maintain balance, and then to move the shoulder forward and back through small arcs and then larger arcs, with assistance from the therapist at first. The patient then

Sits, propped on one extended arm, pivots the trunk on the supporting shoulder, and moves the supporting shoulder forward and back while maintaining balance, by pivoting the trunk in the direction opposite to the motion of the shoulder and using free arm and head motions

Abducts the scapula of the supporting shoulder, when the trunk is rotated to a position directly over the shoulder, to raise the trunk

Progresses to maintaining dynamic shoulder control when the supporting shoulder is in extreme hyperextension.

Throw Free Arm Back, Propped Back on One Hand - After achieving balance and shoulder control while sitting in this position, the patient:

Begins by moving the trunk and free arm passively with the help of the therapist, and then

Positions the shoulder of the free arm as high as possible, throws the free arm back forcefully, and simultaneously pivots the trunk on the supporting shoulder so the trunk falls toward the moving arm

Stabilizes the shoulder by externally rotating and hyerpextending it and adducting the scapula

Lands with the palm on the mat, medial to the shoulder and with the elbow extended, to accept the body's weight.

Weight Shift, Propped Back on Two Hands - After achieving an upright sitting position, the patient sits, propped back on both hands, and shifts the body's weight laterally, a short distance in one direction and with the therapist placing a hand on the patient's shoulder at first, and then in the opposite direction and at greater distances.

Walk Hands Forward, Propped Back on Two Hands - After achieving an upright sitting position and the ability to do weight shifts in this position, the patient:

Shifts the weight laterally, and then elevates and protracts the scapula to move the unweighted hand slightly in a straight forward direction, throwing the head forward and toward the supporting arm to add power, if needed

Shifts the weight in the opposite direction and moves the other hand

Repeats these steps until the hands are walked forward toward the buttock.

Throw Free Arm Back, With One Arm Through Overhead Loop - After achieving an upright sitting position, the patient:

Starts in a semi-reclined position, in which the trunk is stabilized by a forearm hooked through an overhead loop

Throws the free arm back forcefully in the direction of the shoulder horizontal abduction, and lands with the palm medial to the shoulder, the elbow extended, the shoulder externally rotated and hyperextended, and the scapula adducted.

Pull on Suspended Loop and Walk Supporting Hand Forward, While Propped Back on One Hand - After achieving an upright sitting position, the patient:

Sits in a semi-reclined position, with one forearm through a suspended loop, and the other arm locked behind the body supporting the trunk

Pulls forcefully on the loop and throws the head forward to unweight the supporting arm, while moving the supporting hand forward toward the buttocks

Repeats this step until the hand is walked as far as possible with the loop.

In Long-Sitting: After achieving an upright sitting position, the patient:

Moves Buttocks Forward and Back -

Starts in long-sitting, propped forward on both arms with elbows extended, pushes into the mat to lift or unweight the buttocks, and throws the head back forcefully to move the buttocks forward, or,

Starts in long-sitting, with arms behind and slightly lateral to the buttocks, pushes into the mat, and throws the head forward forcefully to move the buttocks back.

Props to the Side on One Extended Arm -

Learns to hold the elbow straight and support him/herself on the arm, with the help of the therapist at first

Practices balancing on the arm, by moving the head and free arm in the direction opposite to the direction the trunk falls

Progresses to maintaining balance while the therapist pushes against the shoulders in various directions.

Achieves Dynamic Stability and Moves Lower Extremity, While Propped to the Side on One Extended Arm - While long-sitting in this position, the patient:

Practices and achieves maintaining balance while rotating the trunk, shifting it laterally, and moving the head and free arm in various directions

Leans in the desired direction of the leg movement, pulls one leg, and then the other, with the free hand, while simultaneously moving the head and torso forcefully in the direction of the pull.