2. 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)

3. 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.

4. 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.

5. 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 90 0 and neutral rotation

7. SPONTANEOUS - 4 TO SPEECH - 3 TO PAIN - 2 NO RESPONSE - 1

8. FOLLOWS MOTOR COMMANDS – 6 LOCALIZES (COMMANDS) - 5 WITHDRAWS (TO PAIN) - 4 ABNORMAL FLEXION - 3 EXTENSOR RESPONSE - 2 NO RESPONSE - 1

9. ORIENTED - 5 CONFUSED CONVERSATION – 4 INAPPROPRIATE WORDS - 3 INCOMPREHENSIVE SOUNDS – 2 NO RESPONSE - 1

10.  EYE OPENING – 4  BEST MOTOR RESPONSE – 6  VERBAL RESPONSE - 5 TOTAL SCORE - 15

11.  MILD HEAD INJURY – 13 – 15  MODERATE HEAD INJURY – 9 – 12  SEVERE HEAD INJURY – 8 OR LESS

13.  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

14.  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

15.  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