Table 1

The protocol for promotion of postural and selective control of movements, supine and sidelying


Performer activity

Activity goals for the child

1. Increase strength, balance. Control of the anterior and posterior neck muscles.

1. Activating neck flexors, shoulder and abdominal muscles through intermittent caudal compression.

1. Maintain head in midline and head turning to both sides.

2. Increase strength and control of the anterior shoulder and chest muscles and balance between anterior and posterior shoulder and chest muscles.

2. Horizontal intermittent pressure through the shoulders. Assist the child to bring arms forward to the mouth or on chest.

2. Bringing hands forward, hands to mouth and hands on chest.

3. Increase strength and control of the abdominal muscles.

3. Through lifted pelvis and flexed legs, provide intermittent compression toward shoulder.

3. Antigravity pelvis and lower extremity lifting with hip and knee flexion

4. Affect alignment, righting reactions and antigravity muscle activity in the trunk in the sagital and frontal planes.

4. From the lifted pelvis and control at shoulders, shift the infant's weight in small increments from side to side. When possible allow the infant to control the head and arms without assistance.

4. Rolling from supine to side.

5. Affect alignment, righting reactions and balance and control between the anterior and posterior neck and trunk muscles.

5. Guide the child from supine through sidelying to upright sitting.

5. Maintaining head control in midline during the transition with minimal assist.

6. Increase strength of the anterior neck muscles lateral head righting and neck and cervical extensors when rolling into prone.

6. Guiding upper shoulder slightly backwards with small weight shifting movements while supporting the child with one hand under head.

6. Keep the chin tucked during movements from supine to prone and when in sidelying

7. Increase the strength of the anterior chest and shoulder muscles.

7. Horizontal intermittent compression through the shoulders. Assist the infant in bringing the hands to mouth or toward the midline.

7. Bring hands to mouth or bring hands forward to chest.

8. Elongation of thorax and lumbar muscles; increase strength, balance and control of abdominal and trunk muscle groups.

8. Lifting pelvis laterally upward to lengthen the weight-bearing side of trunk and activate lateral muscles of the trunk and head on the non-weight-bearing side. Facilitate rolling from supine to side. Head, neck, trunk and pelvis are in alignment.

8. Maintain the pelvis in a neutral position while flexing the hip and knee. Improved antigravity strength of the lateral neck and trunk muscles

1-5: The child is in supine. 6-8: The child is sidelying

Øberg et al. BMC Pediatrics 2012 12:15   doi:10.1186/1471-2431-12-15

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