How to play the Assisted Arm Raise Cross Body Aim: This game combines an assisted shoulder flexion and extension with an assisted partial horizontal shoulder adduction. The composed music has four pitches linked to the four movements which make up this exercise.  The switch position can be moved to complete a full horizontal shoulder adduction where the arm would cross the midline to come into contact with the torso. ​ Objectives: This exercise will enable repetitions of 2 movements. The weight of the impaired arm is initially assisted by the unimpaired arm but the weight will begin to transfer over as the muscles strengthen.  ​​ Upper Limb Exercises: Assisted Arm Raise and Cross (Assisted Shoulder Flexion and Extension with Assisted Partial Horizontal Shoulder Adduction) ​​​ Overview This exercise supports shoulder mobility and strength. Movements are slow, controlled, and supported. and features a shoulder flexion, horizontal shoulder adduction, and shoulder extension. Each movement is paired with a pitch to guide each step of the exercise:​​​​​​​​​​​​​​​​​​  This gaming exercise is paired with a simple 4-beat musical phrase: 1. Movement/Beat 1: Start position (hands clasped, at rest) 2. Movement/Beat 2: Raise arms (shoulder flexion) 3. Movement/Beat 3: Cross arms (horizontal adduction – press switch if using adaptive tech) 4. Movement/Beat 4: Return to centre, ready to lower down ​ Preparation: Sit upright in a chair with your back supported. Relax your shoulders.* Clasp your hands together Note:  This may take time,  be patient, and stretch gently beforehand if there is spasticity.

 Exercise Method (Step-by-Step): Movement 1: Shoulder Flexion Arm Raise.  Seated, with hands clasped and elbows extended, slowly lift your arms forward and upward. Move in a straight line (sagittal plane), keeping the arms extended. Stop when your arms are raised to just below shoulder height.  Avoid leaning or compensating with your trunk.  Movement 2: Horizontal Shoulder Adduction – Cross From this raised position, keep your torso upright and stable. Move your clasped hands across your body to activate the switch (the switch can be moved to accommodate your own range of motion) Do not twist or move your trunk—this is about isolating shoulder movement. Once you've reached across, return your arms to the centre of your chest.  Movement 3: Horizontal Shoulder Abduction Return to Centre.  Reverse the cross-body movement, bringing your arms back to the centre.  Movement 4: Shoulder Extension – Lower to Starting Position From the centre position, lower your arms  back down to your lap. Maintain control to avoid letting your arms suddenly drop. ​ Tips for Best Results • Begin with the non-paretic arm supporting the weight of the paretic arm. • Over time, allow the paretic arm to contribute more as strength improves. • Focus on quality of movement over speed — move in time with the music cues. • Stop immediately if pain occurs — but know that mild fatigue is expected and will reduce with practice. ​ Clinical Application • Supports scapular mobilisation, shoulder flexion, and cross-midline re-patterning • Suitable for Neurologic Music Therapy (NMT) using Patterned Sensory Enhancement (PSE) • Could encourage progressive independence in bilateral tasks and activities of daily living like reaching and lifting.