Bed Mobility & Sitting

Question 1

List the essential components of Rolling in bed.

Answer 1

• Flexion of hips and knees
• Flexion and protraction of shoulder
• Trunk rotation
• Neck flexion and rotation

Question 2

List the essential components of lying to sitting.

Answer 2

• Lateral flexion of the neck
• Lateral flexion of the trunk
• Legs lifted and lowered over side of bed
• Shoulder abduction
• Elbow extension

Question 3

There may be varying patterns in health individuals during lying to sitting to standing. True or False?

Answer 3

True. important to teach patients with neurological impairments to learn a variety of techniques to get out of bed.

Question 4

It is easier to sit up from lying position on the stronger side. True or False?

Answer 4

False. It easier to get up from the weaker side, the stronger arm can help to push up, together with stronger trunk lateral flexion on the stronger side. But it is easier to go down to lying on the stronger side.

Question 5

List the essential components for scooting bed.

Answer 5

• Flexion of hips and knees
• Dorsiflexion of ankle
• Extension of hips (to bridging)
• Abduction/adduction (to shift side-ways)

Question 6

Benefits of proper positioning outside therapy hours?

Answer 6

1. inhibit abnormal muscle tone (preventing spasticity/contracture)
2. help to prevent muscle tightness by maintaining muscle length
3. help patient to learn correct posture
4. Avoid prolonged bedrest complications (e.g. chest complications, bed sores and discomfort)

Question 7

List the essential components for sitting.

Answer 7

• 100% thigh support
• ankle plantargrade
• even weight distribution on both LL
• feet shoulder/hip width apart
• flexion of knee
• flexion of hips
• extension of trunk

Question 8

What is poor sitting associated with?

Answer 8

• muscle weakness
• poor coordination
• tendency to adapt behaviour to avoid threats to balance.

Question 9

What ensures that the pelvis is in neutral position during sitting?

Answer 9

• ASIS is level with PSIS or slowly lower. (no anterior/posterior tilt)
• both ASIS are level (not lateral tilt)
• equal weightbearing on both ischial tuberosity
• natural lumbar lordosis
• head and trunk vertical with chin-in.

Question 10

What are some of the common impairments in sitting?

Answer 10

• spine alignment (e.g. slump position)
• unequal weight bearing
• Extensors weakness
• pelvis position (e.g. excessive posterior/anterior tilting)

Question 11

Why is trunk control important?

Answer 11

• maintain upright posture
• perform weight shift in sitting and standing.
• dissociate upper and lower extemities in function.

Question 12

Which trunk muscles are the most affected in stroke patients in terms of strength?

Answer 12

Trunk rotators and lateral flexors.

Question 13

How to assess trunk control post-stroke?

Answer 13

Trunk Impairment Scale (TIS)

• 17 items
• includes static balance, dynamic sitting balance, coordination of upper and lower trunk.
• Max score 23.
• higher the score, better the trunk control
• 4-points increase in TIS (MCID)

Question 14

What are some of the common errors when doing bridging?

Answer 14

• breath holding

- elevating the hips higher than the head may be contraindicated for patients with uncontrolled hypertension.