Chopping and Lifting

These combination patterns use bilateral, asymmetrical, upper extremity patterns combined with neck patterns to exercise trunk muscles. The arms are resisted as a unit. Successful use of these combinations requires that at least one arm must be strong.

You may use any elbow motion with the shoulder patterns. We have used the straight arm patterns in these illustrations.

10.2.1 Chopping

Bilateral asymmetrical upper extremity extension with neck flexion is used for trunk flexion, as shown here. Other uses for the chopping pattern are:

— Facilitating functional motions such as rolling forward or coming to sitting. To facilitate rolling from a supine to a side-lying position, it is better to use the reversal of lifting (O Fig. 10.5).

— Exercising hip flexion when the muscles of trunk flexion are strong.

Chopping to the left is illustrated in O Fig. 10.1, and O Fig. 10.2. Its components are:

— Left arm (the lead arm): extension-abduction-internal rotation

— Right arm (the following arm): extension-adduction-internal rotation. The following (right) hand grips the lead (left) wrist

Patient Position

The patient is supine and close to the left side of the table.

Fig. 10.1a,b. Chopping to the left in supine

Fig. 10.2a,b. Chopping to the left in sitting

Fig. 10.2a,b. Chopping to the left in sitting

Fig. 10.1a,b. Chopping to the left in supine

Body Position and Mechanics

Stand in a stride position on the left side of the table facing toward the patient's hands. This is the same position used to resist the single arm pattern of extension-abduction-internal rotation. Let the patient's motion push your weight back. As the patient's arm nears the end of the range, turn your body so you face the patient's feet.

Grip

Distal Hand

Your left hand grips the patient's left hand (leading hand). Your left hand may be placed around the wrist, thus protecting the joint when you apply approximation through this arm with a restretch to facilitate trunk activity.

Proximal Hand

Place your right hand on the patient's forehead with your fingers pointing toward the crown.

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