Her body cast extends to just above the knee joints on both legs. There is a metal connecting rod that goes from each thigh section of the cast to the turning frame. The lower legs are free/not casted. Her arms are not casted either. The two metal hoops can spin around on top of the metal cart with the wheels. She can rotate herself and propel herself with her hands on the floor. The pants she has on have holes cut to allow the connector rods to pass through. The head is in a really thick cast, but most of that thickness is soft padding material to prevent pressure sores, acts like a pillow as she is stuck in this for months on end.