Table 2

The protocol for promotion of postural and selective control of movements, prone and sitting

Objectives

Performer activity

Activity goals for the child


1. Increase strength, balance and control in the anterior and posterior neck and upper back muscles.

1. Intermittent compression through shoulders in caudal direction is used to activate the neck muscles, pectoralis muscles and upper back extensors.

1. Lifting the head from the surface and turning the head to right and left side.

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

2. Mild intermittent horizontal compression through shoulders to activate the anterior and posterior shoulder and scapular muscles.

2. Bring the hands to mouth.

3. Downward rotation and stabilization of the scapula.

3. Small weight shifts to one side to facilitate head turning by providing compression down the non-weight-bearing side and elongation of the weight-bearing side.

3. Strength and control of shoulder girdle to provide a stable base for head lifting and turning.

4. Increase activity and strength of the abdominal muscles.

4. Support and tactile input over the abdominal muscles to increase activation in the sagital and frontal planes.

4. Maintain the pelvis in neutral to provide stable base of support for trunk extension and sagital and frontal plane weight shifts.

5. Increase strength and control of neck muscles; elongation of cervical spine.

5. Intermittent compression through the shoulders in a caudal direction to facilitate balanced activation of the anterior and posterior neck, chest and abdominal muscles.

5. Maintain the head up and in midline.

6. Increase strength, balance and control of anterior and posterior neck muscles and downward rotation of the scapula.

6. Intermittent horizontal compression through shoulders and chest muscles to assist the infant to bring the hands together in midline or to the mouth.

6. Maintenance of scapular depression to assist in bringing hands to midline.

7. Integrate control of abdominal muscles and back extension muscles; increase the strength of abdominal muscles; improve balance of trunk flexor/extensor muscle activity.

7. Support the head and shoulders and tip the infant approximately 15 degrees backward to activate neck and abdominal muscles. From this position add very small lateral movements to activate trunk in the frontal plan, elongating the weight-bearing side of the body to promote lateral righting of the head and trunk.

7. Maintain capital flexion, chin toward the chest with hips and knees in neutral flexed position.


1-4: The child is in prone. 5-7: The child is in sitting

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

Open Data