A patient with C5 ASIA A SCI is working on short sitting balance. The therapist positions the patient with hands posterior to the hips, elbows locked in extension using shoulder external rotation and anterior deltoid contraction, forming a triangular support base. Which sitting balance position does this describe?

A patient with C5 ASIA A SCI is working on short sitting balance. The therapist positions the patient with hands posterior to the hips, elbows locked in extension using shoulder external rotation and anterior deltoid contraction, forming a triangular support base. Which sitting balance position does this describe?

• A. Hands anterior to hips position
• B. Hands in line with hips position
• C. A-frame position with hands posterior to hips
• D. Unsupported sitting position

Answer: (C)

In this scenario, the key idea is how hand placement changes the base of support and the amount of stability available during sitting balance, especially for someone with high cervical SCI. Placing the hands behind the hips with elbows locked, using shoulder external rotation and anterior deltoid activation, creates a triangular or A-frame base of support behind the pelvis. This posterior anchor increases stability by spreading load through the arms and shoulder girdle and by giving something solid to brace against to prevent the trunk from tipping forward. For a patient with limited trunk control, this arrangement makes it easier to maintain an upright position during short sitting because it resists forward sway and provides a stable reference point for practicing balance. The other hand placements shift the base of support in ways that either reduce posterior stability or increase demand on trunk control, and unsupported sitting removes external support altogether. So the described posterior-hands A-frame position is the appropriate choice.

In this scenario, the key idea is how hand placement changes the base of support and the amount of stability available during sitting balance, especially for someone with high cervical SCI. Placing the hands behind the hips with elbows locked, using shoulder external rotation and anterior deltoid activation, creates a triangular or A-frame base of support behind the pelvis. This posterior anchor increases stability by spreading load through the arms and shoulder girdle and by giving something solid to brace against to prevent the trunk from tipping forward. For a patient with limited trunk control, this arrangement makes it easier to maintain an upright position during short sitting because it resists forward sway and provides a stable reference point for practicing balance.

The other hand placements shift the base of support in ways that either reduce posterior stability or increase demand on trunk control, and unsupported sitting removes external support altogether. So the described posterior-hands A-frame position is the appropriate choice.