Chapter 7: Sitting Upright and Trunk Control

For the Instructor Guide and Worksheet Key please contact user services at userservices@mheducation.com

OUTLINE

Objectives:

The student will appropriately:

1. Demonstrate techniques to passively stretch and strengthen the trunk.

2. Demonstrate handling to assist and/or facilitate upright sitting, postural stability, and scooting in sitting with appropriate client kinematics.

3. Demonstrate task and environmental setup to effectively challenge and retrain trunk control, and provide sound rationale for your choices.

4. Modify the task and environmental setup to facilitate equal weight bearing, and to make the task easier or harder.

5. Demonstrate appropriate body mechanics with all skills practice.

Activity 1. Trunk Stretching Techniques: Station Work

Station 1: Trunk stretching for anterior pelvic tilt, lumbar and thoracic extension, cervical retraction and extension, spinal rotation and lateral flexion.

Station 2: Supine and sidelying exercises for scapular and pelvic muscles, and practice of handling in seated weight shift activities.

Station 3: Facilitation/handling techniques for trunk control in sitting.

Activity 2. Outcome Measures

Compare and contrast outcome measures with a trunk control component: Postural Assessment Scale for Stroke, Trunk Impairment Scale, and Function in Sitting Test.

Activity 3. Retraining Trunk Control: Task and Environment

Students are assigned a case. They practice writing goals, developing a treatment plan, identifying the associated area of the International Classification of Functioning, Disability, and Health (ICF) for each treatment idea, and practice the session with classmates.

WORKSHEET

Prelab

Using the Video 7-1 (from start to 00:22 and then 01:07 to 01:32) and Video 7-2 (from 00:12 to end) located on the McGraw Hill website for this text, analyze movement from supine to sitting in the following domains:

1. Activity (Was the goal accomplished? What level of assistance, devices, and environment were used?)

2. Movement strategy (What movement strategy was used to achieve the goal? Consider all body segments and the speed and direction of movement.)

3. Body structures/functions (What is the quality of the movement?). This can be viewed as analysis of the body structures/function level of the International Classification of Functioning, Disability, and Health (ICF) model domains. Hypothesize possible impairments, that is, neurologic, biomechanical, or behavioral factors (see Chapter 1: Movement Analysis for a more detailed description of this method of movement analysis).

Then analyze sitting posture and overall postural control. Describe what you see.