# PWR-032 — Transitions, crawling and climbing: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 11 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Common household or practice equipment — Heavy stable chair against a wall with no wheels; Firm padded floor area clear on all sides; Gait belt/transfer equipment and trained helper when indicated; Step picture card and assistance-level record; A transition sheet for surface, chair, sequence link, limb position, assistance and guarding, completion, time, symptoms, stopping point and unsuccessful attempts. Space: Room-scale practice space Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Transitions, crawling and climbing are distinct tasks that require their own assessment. This lesson teaches one bounded transition: getting from a supported side-sit on the floor to standing at a stable chair. The method uses backward chaining: first learn the last step from half-kneel to stand, then add hands-and-knees, side-sit and floor entry. The learner moves only on the provider's cue; the provider controls medical readiness, chair, guarding, assistance, step order and dose. Target outcome: The learner completes the declared floor-to-stand chain with the recorded chair and assistance level, and can stop safely at each intermediate position. ### Authority and setup conditions - Confirm with the provider that kneeling, weight-bearing through hands and floor transfers are appropriate. - Test that the chair cannot slide or tip when pushed from the front edge. - Agree on hands-on assistance, no-lift boundary and a safe rest position at each link. - Load-test the chair and position the mat, helper and usual aid before the learner goes to the floor. Rehearse the final supported half-kneel-to-stand link first and confirm the chair does not move. - Rehearse the final half-kneel-to-stand link and the hands-and-knees-to-half-kneel link with the prescribed support before joining them into a chain. ### Required or supplied materials - Heavy stable chair against a wall with no wheels - Firm padded floor area clear on all sides - Gait belt/transfer equipment and trained helper when indicated - Step picture card and assistance-level record - A transition sheet for surface, chair, sequence link, limb position, assistance and guarding, completion, time, symptoms, stopping point and unsuccessful attempts. ## 1. Learn the last link first Start in a provider-assisted half-kneel facing the chair, both hands on the seat; bring the rear foot under the body and stand using legs and the approved hand support. Why: Backward chaining makes the successful finish familiar first. Success check: The learner stands without the chair moving or the helper lifting. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner stands without the chair moving or the helper lifting.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Return to half-kneel With provider guidance, step one foot back, lower the knee to the pad and pause with both hands on the chair. Why: Controlled reversal teaches a safe checkpoint. Success check: The knee reaches the pad without a drop. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The knee reaches the pad without a drop.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Move between all-fours and half-kneel From hands-and-knees, bring the stronger or provider-selected foot forward between the hands, then place both hands on the chair. Why: Foot placement creates a base for standing. Success check: The whole foot is planted and the learner can pause. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The whole foot is planted and the learner can pause.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Move from side-sit to all-fours Turn toward the chair, place hands on the floor or approved support and bring knees under the hips without twisting through pain. Why: This link organises the body for the kneeling phase. Success check: The learner reaches a stable hands-and-knees position. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner reaches a stable hands-and-knees position.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Assemble the full chain From supported side-sit: turn to all-fours, bring one foot to half-kneel, place hands on the chair, bring the rear foot under and rise. Why: Linking occurs only after each part is controlled. Success check: The learner pauses at every checkpoint and uses the recorded help. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner pauses at every checkpoint and uses the recorded help.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Stand and orient before walking Once upright, keep hands on the chair until balance and symptoms are checked; step away only on the provider's cue. Why: Standing up is not the same as being ready to walk. Success check: The learner remains stable for the agreed time. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner remains stable for the agreed time.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Record assistance at each link Use the declared scale—independent, cue, steadying contact, partial lift or full help—for every step. Stop if the provider would need to improvise a lift. Why: A single completion label hides where support was needed. Success check: The record identifies the exact link and assistance. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The record identifies the exact link and assistance.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.