Sit upright on a stable chair or wheelchair with your back supported and a table close in front at elbow height.
Ensure both feet are placed flat.
Place your elbows onto the table.
Place your palms and fingers firmly together, to make a pyramid with your forearms.
Ensure your wrists are as straight as possible
Keeping your palms firmly together, twist your hands so that the back of one hand faces you, then again so the back of the other hand faces you.
Move your elbows closer together to allow more movement.
Move only as far as is comfortable.
Do not force your wrists.
