Functional movements break down 1

Shifting in bed components

1. Bend at hip + knees to bring feet closer to hips 

2. Load through legs/ push through feet 

3. Lift hip up + shift to side 

4. Reposition trunk + feet to align w/ trunk

Muscles involved in shifting in bed components

Hip bridge preparation:

Concentric hamstrings + hips flexion

Hip bridging:

Concentric hip extensors ( glute max )

PFers conc

Shifting pelvis:

Concentric hip abductors ( side shifted to ) + eccentric hip abductors ( side shifted away )

Upper body preparation:

Chin tucked

Shoulder + elbow extension

Shifting:

Shoulder + elbow extension + ( elbow flexion )

Shoulder abduction + adduction

Rolling components

1. Rotation + flexion of neck to side rolling 

2. Flexion of contralateral hip + knee 

3. Flexion + horizontal adduction; protraction of contralateral shoulder 

4. Rotation in trunk 

5. Loading of contralateral leg for rotation into side lying

Sidelying to sitting on edge of bed components

1. Neck LF

2. Trunk LF + horizontal abduction of lower arm 

3. Horizontal add → elbow F → loading upper arm 

4. Elbow horizontal extension → extension of lower arm

5. Legs lifted + lowered 

6. Pushing through hand

Components of transport in reaching

Shoulder protraction + elevation  Shoulder external rotation  Shoulder flexion + abduction + extension ( dependent on direction)  Elbow extension

Components of pre-shaping in reaching

• Supination/ pronation to orientate hand to object 

• Wrist extension w/ radial deviation 

• Opening of hand 

→ Thumb abduction + rotation 

→ MCP extension 

→ IP flexion 

→ finger abduction

Common adaptive movements in reaching

1. Shoulder abduction + internal rotation 

2. Shoulder hitching 

w/ trunk E + LF → replacement of shoulder F

3. Increased elbow flexion + pronation 

4. Grasp + release of object w/ wrist in flexion 

5. Increased aperture bwt thumbs + fingers ( distance bwt thumbs + fingers increased → strength? contractures? )

6. Use of unaffected/ less affected arm

Components for grasping

• Extension of the wrist + fingers 

• MCP flexion 

• IP flexion/ ext based on object shape + size 

• Abduction + flexion ( conjunct rotation ) = opposition? of thumb + 4th + 5th fingers 

• Ability to match force to task

Common adaptive movements

Forearm pronation  Wrist flexion  Simultaneous finger flexion → X sequential finger flexion  Excessive force to grasp objects  Use of unaffected/ less affected arm

Components for manipulation

• Ability to stabilise the proximal upper limb 

• Isolated + independent finger movements 

• Ability to translate + shift + rotate object in hand 

→ multiple joint configurations 

→ factors: abundance of neural connections → widespread neural interaction → cooperation of large no. of muscles

Common adaptive movements for manipulation

• Moves all fingers as one 

• Use of unaffected/ less affected arm