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1/10/2018

Rolling

1/10/2018 Rolling FUNCTIONAL REHABILITATION: MAT TECHNIQUES: ROLLING Exercise mats, which are firmer than most beds, areTraining Strategies section. ROLLING - The ability to roll is required to turn in bed and come to sitting, and for self-care activities, such as dressing. To be able to roll from supine to prone and from prone to supine requires the following: Physical and Skill Prerequisites 1. Rolling from supine to prone requires: Greater than normal strength in the anterior and posterior deltoids and in the biceps, brachialis, and/or brachioradialis, and some strength in the middle deltoids Greater range of motion for external rotation of the shoulder and extension of the elbow, and normal range for shoulder flexion, horizontal adduction and abduction, elbow extension, and forearm supination Ability to maintain elbow extension while flexing the shoulders, combine arm throw across the body and head swing, and roll toward prone using momentum or pulling on equipment with the arm 2. Rolling from prone to supine requires: Strength in the anterior, middle, and posterior deltoids, and normal range of motion for shoulder flexion, elbow extension, and forearm supination. Ability to roll from prone by pushing with the arm Functional Skills 1. Rolling from Supine to Prone Without Equipment - The patient: Throws the head and arms forcefully in the desired direction of the roll, if able , OR Builds enough momentum to roll, by swinging the head and arms to one side and then the other with enough force and frequency to cause the trunk to rock, at first, and then by coordinating the swings with the rocking of the trunk. Momentum is maximized by holding the elbows http://calder.med.miami.edu/providers/PHYSICAL/matroll.html 1/3 " id="pdf-obj-0-7" src="pdf-obj-0-7.jpg">

FUNCTIONAL REHABILITATION: MAT TECHNIQUES: ROLLING

Exercise mats, which are firmer than most beds, are good surfaces to learn skills required for independent mobility and dressing, such as rolling, coming to sit, moving around on the mat, unsupported sitting, and leg management. After the skills have been learned on a mat, they must be practiced and learned on a bed. Techniques to acquire the prerequisites for the following functional skills appear in the Training Strategies section.

ROLLING - The ability to roll is required to turn in bed and come to sitting, and for self-care activities, such as dressing. To be able to roll from supine to prone and from prone to supine requires the following:

Physical and Skill Prerequisites

1. Rolling from supine to prone requires:

  • Greater than normal strength in the anterior and posterior deltoids and in the biceps, brachialis, and/or brachioradialis, and some strength in the middle deltoids

  • Greater range of motion for external rotation of the shoulder and extension of the elbow, and normal range for shoulder flexion, horizontal adduction and abduction, elbow extension, and forearm supination

  • Ability to maintain elbow extension while flexing the shoulders, combine arm throw across the body and head swing, and roll toward prone using momentum or pulling on equipment with the arm

2. Rolling from prone to supine requires:

  • Strength in the anterior, middle, and posterior deltoids, and normal range of motion for shoulder flexion, elbow extension, and forearm supination.

  • Ability to roll from prone by pushing with the arm

Functional Skills

1. Rolling from Supine to Prone

  • Without Equipment - The patient:

    • Throws the head and arms forcefully in the desired direction of the roll, if able, OR

    • Builds enough momentum to roll, by swinging the head and arms to one side and then the other with enough force and frequency to cause the trunk to rock, at first, and then by coordinating the swings with the rocking of the trunk. Momentum is maximized by holding the elbows

1/10/2018

Rolling

in extension, protracting the scapula at the end of the swing, and throwing the arms in an arc that is either perpendicular to the mat, if the triceps are functional, or, at a 45 degree angle above the plane of the body, if the triceps are nonfunctional. Externally rotating the shoulder and supinating the forearm help hold the elbows in extension in a patient with nonfunctional triceps.

1/10/2018 Rolling in extension, protracting the scapula at the end of the swing, and throwing theView Rolling Proceedure With Equipment - If unable to roll without equipment, due to poor motivation, weakness, obesity, contractures, spasticity, etc., the patient stabilizes the hand or arm and pulls on a parked wheelchair next to the mat or on a bedrail, and simultaneously: Rolls the trunk toward the stabilized arm and adds momentum by swinging the head and free arm in the direction of the roll (at an arc about 45 degrees above the plane of the body if the triceps are nonfunctional) Completes the roll at the end of the free arm swing by either pulling on the chair or rail with the free arm, or, reaching or punching with the free arm while protracting the scapula to add momentum to the roll http://calder.med.miami.edu/providers/PHYSICAL/matroll.html 2/3 " id="pdf-obj-1-9" src="pdf-obj-1-9.jpg">
1/10/2018 Rolling in extension, protracting the scapula at the end of the swing, and throwing theView Rolling Proceedure With Equipment - If unable to roll without equipment, due to poor motivation, weakness, obesity, contractures, spasticity, etc., the patient stabilizes the hand or arm and pulls on a parked wheelchair next to the mat or on a bedrail, and simultaneously: Rolls the trunk toward the stabilized arm and adds momentum by swinging the head and free arm in the direction of the roll (at an arc about 45 degrees above the plane of the body if the triceps are nonfunctional) Completes the roll at the end of the free arm swing by either pulling on the chair or rail with the free arm, or, reaching or punching with the free arm while protracting the scapula to add momentum to the roll http://calder.med.miami.edu/providers/PHYSICAL/matroll.html 2/3 " id="pdf-obj-1-11" src="pdf-obj-1-11.jpg">
1/10/2018 Rolling in extension, protracting the scapula at the end of the swing, and throwing theView Rolling Proceedure With Equipment - If unable to roll without equipment, due to poor motivation, weakness, obesity, contractures, spasticity, etc., the patient stabilizes the hand or arm and pulls on a parked wheelchair next to the mat or on a bedrail, and simultaneously: Rolls the trunk toward the stabilized arm and adds momentum by swinging the head and free arm in the direction of the roll (at an arc about 45 degrees above the plane of the body if the triceps are nonfunctional) Completes the roll at the end of the free arm swing by either pulling on the chair or rail with the free arm, or, reaching or punching with the free arm while protracting the scapula to add momentum to the roll http://calder.med.miami.edu/providers/PHYSICAL/matroll.html 2/3 " id="pdf-obj-1-13" src="pdf-obj-1-13.jpg">
1/10/2018 Rolling in extension, protracting the scapula at the end of the swing, and throwing theView Rolling Proceedure With Equipment - If unable to roll without equipment, due to poor motivation, weakness, obesity, contractures, spasticity, etc., the patient stabilizes the hand or arm and pulls on a parked wheelchair next to the mat or on a bedrail, and simultaneously: Rolls the trunk toward the stabilized arm and adds momentum by swinging the head and free arm in the direction of the roll (at an arc about 45 degrees above the plane of the body if the triceps are nonfunctional) Completes the roll at the end of the free arm swing by either pulling on the chair or rail with the free arm, or, reaching or punching with the free arm while protracting the scapula to add momentum to the roll http://calder.med.miami.edu/providers/PHYSICAL/matroll.html 2/3 " id="pdf-obj-1-15" src="pdf-obj-1-15.jpg">
1/10/2018 Rolling in extension, protracting the scapula at the end of the swing, and throwing theView Rolling Proceedure With Equipment - If unable to roll without equipment, due to poor motivation, weakness, obesity, contractures, spasticity, etc., the patient stabilizes the hand or arm and pulls on a parked wheelchair next to the mat or on a bedrail, and simultaneously: Rolls the trunk toward the stabilized arm and adds momentum by swinging the head and free arm in the direction of the roll (at an arc about 45 degrees above the plane of the body if the triceps are nonfunctional) Completes the roll at the end of the free arm swing by either pulling on the chair or rail with the free arm, or, reaching or punching with the free arm while protracting the scapula to add momentum to the roll http://calder.med.miami.edu/providers/PHYSICAL/matroll.html 2/3 " id="pdf-obj-1-19" src="pdf-obj-1-19.jpg">

With Equipment - If unable to roll without equipment, due to poor motivation, weakness, obesity, contractures, spasticity, etc., the patient stabilizes the hand or arm and pulls on a parked wheelchair next to the mat or on a bedrail, and simultaneously:

  • Rolls the trunk toward the stabilized arm and adds momentum by swinging the head and free arm in the direction of the roll (at an arc about 45 degrees above the plane of the body if the triceps are nonfunctional)

  • Completes the roll at the end of the free arm swing by either pulling on the chair or rail with the free arm, or, reaching or punching with the free arm while protracting the scapula to add momentum to the roll

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Rolling

1/10/2018 Rolling 2. Rolling from Prone to Supine - The patient: Pushes on the mat or

2. Rolling from Prone to Supine - The patient:

  • Pushes on the mat or other supporting surface with the arm away from the direction of the desired roll, until the side-lying position is achieved

  • Throws the head and arm in the direction of the roll

The PoinTIS SCI Physical Therapy site of the SCI Manual for Providers is based on information in Spinal Cord Injury: Functional Rehabilitation, by M.F. Somers, Norwalk, CT, Appleton & Lange, 1992, and information in "Respiratory Rehabilitation of the Patient with a Spinal Cord Injury", by J.L. Wetzel, B.R. Lunsford, M.J. Peterson, and S.E. Alvarez, Chapter 28 in Cardiopulmonary Physical Therapy, S. Irwin and J.S. Tecklin, eds., St. Louis, Mosby, 1995, unless otherwise indicated.