Anna Goldenberg

Pediatric Occupational Therapist

Using a Bolster to Facilitate Motor Development

A bolster is a soft yet supportive cylindrical piece of equipment that can be used to promote pre-crawling skills, proprioception, and weight bearing. 

Upper Body:

Weightbearing on hands is achieved when a child is placed in prone position (tummy down) on the bolster and uses their hands to push against the floor to support their upper body. Hands should be under the shoulders, muscles active, and scapula and upper neck and back muscles engaged. The benefits of weight-bearing are isometric co-contraction of the shoulder, upper back, and arm muscles, proprioceptive input to joints, development of muscles in the palms of the hands, wrist extension, and neck and head control muscle strength. 

Weight shifting is achieved when a child is rolled forward and backwards on the bolster while in weight bearing position. This allows opposite muscle groups such as flexors and extensors to learn to work together and adjust the amount of force each muscle needs. It also provides dynamic proprioceptive awareness to the joints. 

Another way to achieve weight shifting is by adding a toy and encouraging the child to transfer all their weight bearing to just one arm while reaching for the toy with another. This transfer of weight activates core and postural control muscles, also known as righting responses.

A progression would be to engage the child in weight bearing and weight shifting with legs on the bolster as if in a plank. 

Lower Body: 

While positioned on a bolster, a child is assisted in maintaining a quadruped position (on hands and knees), allowing weight-bearing with hip flexion, in preparation for crawling. Dynamic rolling on the bolster assists the child to push off with their feet to propel themselves forward and backward in preparation for crawling.

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