Their attention to doing seated activities can be sustained for 30 to 45 minutes. At least three different hand-over-hand activities will probably be needed and frequent rest periods should be expected. With nothing to do, their attention drifts away and they slump down and start to slide out of their chairs in about 10 minutes.
Upper extremity range of motion (UE ROM) exercises are bilateral and require hand-over-hand assistance, as described above. One hand / arm may be exercised with hand-over-hand assistance and an attractive object.