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DIAGONAL WEIGHT SHIFTS: ROTATION WITH EXTENSION FACING AWAY FROM

THERAPIST
The goals of the facilitation are to increase the babys spinal, pelvic, hip and
lower-extremity mobility; to increase the baby`s active head /neck rotation; and
to increase the babys experience in, and tolerance to diagonal weight shifts in
the trunk, pelvis, and lower extremities.
Note: This is rotation of the entire spine, not rotation of the rib cage over the
pelvis.
Babys Position: the baby straddle-sits on your leg facing away from you (figure
8.6.1).
Therapists Position: Long-sit on the floor (figure 8.6.1), or sit on a bench or ball
(figure 8.6.4) with your hips flexed to 90 .
Therapists hands: place both of your hands on the babys trunk, firmly holding
the babys rib cage (figure 8.6.1). If the babys trunk is flexed, apply gentle
pressure with your thumbs to extend the babys spine. Subtly press the babys
rib cage into the pelvis while maintaining the extension, in order to connect the
ribs and pelvis.
Your guiding hand is the hand that rotates one side of the babys trunk forward
(figure 8.6.2, therapists let hand), and your assisting hand is the hand that
aligns the rib cage with the pelvis and rotates the other side of the babys trunk
backward (figure 8.6.2, therapists right hand). If the babys trunk needs
support, slide your assisting hand to the babys anterior rib cage to provide
that support (figure 8.6.3, therapists left hand). Your leg helps keep the babys
legs abducted and helps with lower-extremity dissociation as the pelvis rotates.
Movement: When you extended the babys trunk and aligned the rib cage and
pelvis, use your guiding hand to rotate the babys trunk (figure 8.6,2 and
8.6.4). Rotation of the spine must facilitate rotation of the pelvis over the faceside femur. Do not rotate the rib cage over a static pelvis. This will create
mobility and possibly hypermobility in the spine. If the baby tries to retract the
shoulder as the trunk rotates forward, use your index finger to hold the babys
arm forward (figure 8.6.4). Use youre assisting hand to guide the babys trunk
to rotate and to keep the bays rib cage aligned with the pelvis. Do not let the
babys rib cage rotate without the pelvis, and do not let it shift laterally over
the pelvis. Do not pull the babys rib cage backward with your assisting hand.
When you are long-sitting, raise your leg to provide anterior support to the
babys trunk (figure 8.6.2). When the babys rotates away from your leg, slide
your hand around to the babys anterior rib cage (figure 8.6.3) to provide
anterior support to the babys trunk. Take care to not hyperextend the babys
lumbar spine when you support the anterior rib cage.

Rotation of the pelvis results in a weight shift to the same side to which the
face turns. Rotation of the pelvis over the femur results in hip joint rotation. The
backward rotation of the pelvis on the babys face side causes the femur to
move toward external rotation (figure 8.6.3, babys left leg; figure 8.6.4, babys
right leg). The forward rotation of the pelvis on the babys skull side causes the
femur to move toward internal rotation (figure 8.6.5, babys right leg).
Option: you may sit on a ball to perform this technique (figure 8.6.4 and 8.6.5).
When you sit on the ball, you can use bouncing to increase the babys alertness
and trunk extension. Be careful to monitor the babys ongoing responses to the
bouncing. Stop bouncing if it upsets the baby.
Suggestion: Use games and / or singing that encourage the baby to turn from
side to side. For example, have the caregiver stand in front of the baby and
move a toy from side to side to encourage the baby to turn from side to side.
Precautions:

Do not push aggressively on the babys trunk.


Extend the thoracic spine and maintain the extension during the entire
facilitation.
Do not pull the babys rib cage backward with your assisting hand.
Do not rotate or shift the rib cage over a fixed pelvis. This dissociates
the rib cage from the pelvis and leads to rib cage shifting and
hypermobility between the thoracic and lumbar spines.
Do not shift the babys rib cage laterally over the pelvis.
Keep both of the babys shoulders parallel with the floor.
Take care to not hyperextend the babys lumbar spine when you
support the anterior rib cage.

Component Goals:

Sequential spinal rotation with extension.


Pelvic-femoral (hip joint) mobility.
Lower extremity dissociation.
Elongation of hip adductors.
Weight shift to the face side.

Functional Goals:

Increased
Increased
Increased
Increased

spinal rotation to improve respiration.


spinal rotation to improve all reaching patterns.
spinal mobility for all transitional movements.
hip joint mobility for all transitional movements.