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of Developmental Sequences
Physical therapists frequently evaluate and teach patients to roll from a supine to Randy R Richter
a prone position. The purposes of this study were 1) to describe the rolling Ann F VanSant
movements of adults and 2) to determine whether the movement patterns used to Roberta A Newton
roll might represent different developmental steps within three body regions.
Thirty-six healthy adult subjects were videotaped during 10 trials of rolling from a
supine to a prone position. Written descriptions of each subject's movements were
reduced to general categorical descriptions of movement patterns for three body
regions (upper extremities, lower extremities, and head and trunk). Stage theory
criteria were used in an attempt to order the movement patterns into
developmental sequences. The most common combination of movement patterns
was used to describe adults' rolling action. Although stage theory criteria were not
met, developmental sequences of movement patterns were proposed for the three
body regions. Subjects were quite variable in their rolling movements. The most
common form of rolling occurred in less than 12% of the subjects' trials. The
descriptions of adults' rolling action gathered in this study provide physical
therapists with a variety of movement patterns for teaching patients to roll. [Richter
RR, VanSant AF, Newton RA: Description of adult rolling movements and
hypothesis of developmental sequences. Phys Ther 69:63-71, 1989]
Physical therapy for patients with some standard or norm. To date no movements are valid representations of
neurologic dysfunction often includes reported research exists describing the healthy individuals' movements is
the evaluation and teaching of rolling movement patterns that adults use to unknown. The purposes of this study
movements.1-3 To determine the roll. Although specific rolling were 1) to describe movement patterns
"quality" of the rolling pattern, rolling movements have been recommended used by adults to roll from a supine to
movements must be evaluated against for use in treatment,3-5 whether these a prone position and 2) to determine
whether different movement patterns
seen in three regions of the body
might represent developmental steps
R Richter, MS, PT, is Instructor, Department of Physical Therapy, School of Allied Health Professions, St within this rolling task.
Louis University, 1504 S Grand Blvd, St Louis, MO 63104 (USA). He was a student in the master's
degree program, Department of Physical Therapy, School of Allied Health Professions, Medical College
of Virginia, Virginia Commonwealth University, Richmond, VA, when this study was conducted. Background
A VanSant, PhD, PT, is Associate Professor, Department of Physical Therapy, School of Allied Health
Professions, Medical College of Virginia, Virginia Commonwealth University, PO Box 224, MCV Station, Gesell and Amatruda defined motor
Richmond, VA 23298-0001. development as a continuous process
that proceeds stage by stage in a
R Newton, PhD, PT, is Associate Professor, Department of Physical Therapy, School of Allied Health
Professions, Medical College of Virginia, Virginia Commonwealth University. systematic order.6 McGraw used the
term "phase" to indicate observable,
This study was completed in partial fulfillment of Mr Richter's master's degree, Medical College of definable behaviors occurring during a
Virginia, Virginia Commonwealth University. The results of this study were presented in poster format
at the Sixty-Third Annual Conference of the American Physical Therapy Association, San Antonio, TX, specific period of time.7 More recently,
June 28-July 2, 1987, and were presented at the Fall Meeting of the Missouri Chapter of the American the term "stage" has been used as a
Physical Therapy Association, Springfield, MO, September 19-21, 1986. more formal theoretical construct in
8,9
This article was submitted August 3, 1987; was with the authors for revision for 26 weeks; and was motor-development literature. In this
accepted June 9, 1988.
Data Analysis
Results
Movement Pattern Categories
Upper Lower
1
Upper Extremity
Lift and Reach Below Shoulder Level
The right upper extremity (UE) is lifted off of the support surface and reaches across the body with the right hand at or below shoulder level.
The left arm stays at the side of the body, abducts, or may be lifted off of the mat. The left shoulder or UE contacts the support surface as the
subject rolls over the left shoulder or UE.
Lift and Reach Above Shoulder Level
The right UE is lifted off of the support surface. The right hand is brought above shoulder level. The left arm may stay at the side of the body. The
subject rolls over the left UE or shoulder.
Push and Reach
At the start of the movement, part of the right UE appears to push while in contact with the support surface. The right UE is lifted from the support
surface as the right shoulder flexes, reaching toward a position parallel to or in front of the body when the subject is side lying. The left arm may
stay at the side of the body, and the left shoulder or UE remains in contact with the surface as the subject rolls.
Push
The right UE maintains contact with the support surface as the right shoulder extends. The right arm remains behind the body until the subject
reaches side lying. The left arm may stay at the side of the body, abduct, or flex. The left shoulder or UE remains in contact with the support surface
as the subject rolls past side lying.
Lower Extremity
Bilateral Lift
Both of the lower extremities (LEs) are flexed and lifted off of the support surface with the right pelvis remaining on the support surface. The LEs may be
carried to the left and may not reach full extension.
Unilateral Lift
One or both LEs may flex and assume a position as if to push. One LE may be lifted off of the support surface. If the right LE is lifted off of the support
surface, this movement occurs before any part of the right pelvis loses contact with the support surface. Neither extremity, although contacting the support
surface, maintains a fixed point of contact against which to push.
Unilateral Push
The right LE is pulled up toward the chest, remaining partly in contact with the support surface. One foot maintains a fixed point of contact on the support
surface and appears to push.
Bilateral Push
Both LEs are pulled up toward the chest. Both feet simultaneously maintain a fixed point of contact with the support surface and appear to push. As the
subject rolls to side lying, the right leg or thigh may remain behind the left LE.
3 Stockmeyer SA: An interpretation of the 4 Knott M, Voss DE: Proprioceptive 5 Bobath B, Bobath K: Cerebral palsy. In
approach of Rood to the treatment of Neuromuscular Facilitation: Patterns and Pearson PH, Williams CE (eds): Physical Therapy
neuromuscular dysfunction. Am J Phys Med 46: Techniques, ed 2. Baltimore, MD, Williams & Services in the Developmental Disabilities.
900-961, 1967 Wilkins, 1968 Springfield, IL, Charles C Thomas, Publisher,
1972, pp 31-185