POSITIONING
Position the affected side towards the entrance or main part of
the room
SUPINE LYING
Head/Neck
Neutral and symmetrical ;supported on pillow
Trunk
Aligned in midline
Affected UE (Resting on Pillow)
Shoulder – Protracted, Flexed
Elbow – Extended , Wrist – Neutral
Affected LE
Hip – Flexed (Pelvis – Protracted),
Knee – Slightly Flexed (Small towel roll under the Knee)
Foot – Nothing against the sole of foot
(Note: In case of persistent Plantar flexion , a splint can be used to
maintain foot and ankle in neutral)
SIDELYING ON THE NORMAL
SIDE
Head/Neck
Neutral and symmetrical ;supported
on pillow
Trunk
Aligned in midline
Affected UE (Resting on Pillow)
Shoulder – Protracted, Flexed
Affected LE
Hip and Knee flexed and Pillow is
kept in between.
SIDELYING ON THE HEMIPLEGIC SIDE
Head/Neck
Neutral and symmetrical ; supported
on pillow
Trunk
Aligned in midline
Affected UE
Shoulder – Protracted, Flexed
Elbow – Extended
Forearm – Supinated
Affected LE
Hip and Knee flexed and Pillow is
kept in between.
SITTING ON THE ARM CHAIR OR WHEEL CHAIR
Head/Neck
Neutral and symmetrical ;Head directly
above Pelvis
Trunk
Aligned in midline, equal weight bearing on
both buttocks
Affected UE (Resting on Pillow)
Shoulder – Protracted, Flexed
Elbow – Supported on a arm trough and lap
board,
Wrist – Neutral
Fingers – Extended , Thump – Abducted
BOTH LE
Both Hips flexed to 900 and neutral rotation
SPONTANEOUS
TO SPEECH
TO PAIN
NO RESPONSE
-4
-3
-2
-1
FOLLOWS MOTOR COMMANDS – 6
LOCALIZES (COMMANDS)
-5
WITHDRAWS (TO PAIN)
-4
ABNORMAL FLEXION
-3
EXTENSOR RESPONSE
-2
NO RESPONSE
-1
ORIENTED
-5
CONFUSED CONVERSATION – 4
INAPPROPRIATE WORDS
-3
INCOMPREHENSIVE SOUNDS – 2
NO RESPONSE
-1
 EYE OPENING
–4
 BEST MOTOR RESPONSE – 6
 VERBAL RESPONSE
-5
TOTAL SCORE - 15
 MILD HEAD INJURY
– 13 – 15
 MODERATE HEAD INJURY – 9 – 12
 SEVERE HEAD INJURY
– 8 OR LESS
 Finger – to - nose
 Finger – to - therapist’s finger
 Finger – to – finger
 Alternate nose – to – finger
 Finger opposition
 Mass grasp
 Pronation/supination
 Rebound test
 Tapping(hand & foot)
 Pointing and past pointing
 Alternate heel – to – knee; heel – to – toe
 Toe to examiner’s finger
 Heel on shin
 Drawing a circle (UE & LE)
 Fixation or position holding
 Standing – Normal, Narrow BOS, Tandom
 Unilateral Stance
 Arm position may be altered (at side, on waist, over
head)
 Perturbations
 Standing, Functional reach – forward
 Standing, laterally flex the trunk to each side
 Rhomberg and Tandom Rhomberg
 Static marching
 Tandom walking
 Walk sideways, Backward or Cross – stepping
 Alter the speed of ambulation- Normal, Fast and Slow
 Start and Stop abruptly on command
 Walk and Pivot on command (90,180 or 360)
 Walk in a circle, alternate directions
 Walk on heels or toes
 Step over or around obstacles
 Stair climbing with and without using handrail; one step
at – a – time, Step – over - step