Mat Activities

Mat activities are one of the most important parts of rehabilitation programme of
SCI patients. Mat exercises are included in the treatment programme as soon as
weight bearing to spine is permitted.

Mat activities are given to:

● Facilitate balance
● Promote stability
● Mobilize and strengthen the trunk and limb.
● Train for functional activities

To achieve the desired effect of the treatment programme, mat activities should be
sequenced from easier to difficult and progression through sequence should be
considered. The type of the mat activities, given to the patient is determined by the
therapist on the basis of level of lesion and medical status of patient. The limit to
which an activity can be performed and time taken to learn it depends on the ability
of the patient. But therapist should work hard to improve the timing and speed of the
patient.

Different mat activities taught to patient are:

a) Rolling

For rolling to be effective, patient is required to learn to move the head, neck, upper
limb, lower limb and trunk in a balance manner. Rolling is needed to improve bed
mobility and to change position independently. Initially, rolling is taught to patient in
mat but afterwards patient gets confidence to perform it over bed.

Action to role prone from supine position:

● 1) Patient lies in supine position.

● 2) Patient flexes his head, neck and right shoulder.
● 3) Right arm is moved towards left side to create momentum.
● 4) The momentum of arm is transferred to trunk and lower limb.
● 5) The lower half of body will be rolled to prone position. Flexion of hip and
knee will facilitate the roll.
● 6) Patient takes his right shoulder at the back side by putting weight on left
forearm and thus, weight is distributed on both upper limb.
● 7) Patient lies prone.

Rolling to prone can also be assisted by use of pillows under one side of pelvis or
scapula if needed. The number of pillows is decreased in progression.
b) Prone on elbow

This position on mat activities given to cervical lesion patient facilitates head and
neck control and strengthens serratus anterior and other scapular muscles. This
position is very important to train the patient to gain stability is quadruped and sitting
position. Prone on elbow position should be used carefully in lumbar injuries as this
increases lumbar lordosis.

Action of patient:

● 1) Patient lies prone and places his elbows close to trunk.

● 2) Elbows are pushed down while lifting head and upper trunk.
● 3) Now, patient brings the elbow to the level of shoulder and body weight is
shifted through elbows.

c) Prone on hands

This position is given to paraplegic patient because it requires strong pectoralis

major and deltoid muscles. However, this activity is not appropriate to all paraplegics
as excessive lordosis is produced. Prone on hand position is required to gain
postural alignment during standing, ambulation and standing from floor with use of
orthosis and crutches.

Position of hands in this position is same as standard push up position except that
arms are laterally rotated.

d) Supine on elbow

This position is an important strengthening exercise for shoulder extensors and

scapular adductors. The purpose of this position is to prepare patient for long sitting
position. This position is assumed according to the comfort and disability of patient.

This position is achieved either from side lying position or by pushing the elbow over
mat and lifting into this position. The later technique requires a strong abdominal
muscle.