Functional Mobility Flashcards
What is the task oriented approach?
Manipulation of TASKS (activities) is the primary mode of intervention: manipulate and practice task variable, patient centered functional goals
Skill acquisition vs. skill retention
What are things to consider with mobility tasks? What are the essential elements?
Provide assistance vs. retraining skill
Essential elements: progression, stability, adaptation
Potential adaptations for accomplishing task
What are elements of STS transfers? Possible abnormalities?
Progression: generate sufficient force to rise
Stability: move center of mass from wider BOS (chair+feet) to smaller BOS (feet)
Adaptation: chair height, softness, arm rests
Fall risk, asymmetry, dizziness, orthostatic hypotension
What are STS transfer strategies?
Momentum transfer strategy: Upper body flexes forward. Buttocks leave seat. Lift/extension of legs. Stabilization.
Zero momentum or force control strategy: nose over toes, use of arm rests
What are parts of mobility examination?
5 times STS
FIM
STREAM mobility subscale (0-3 scale): rolling supine to sidelying, bridging, supine to sit, sit to stand, other activities
What are aspects of transfer training?
Task specific training: no single correct strategy, patients need to explore possibilities
Address impairments: LE strength, ROM
what are the elements of bed mobility: supine to sit?
Progression: push up with arms, flex head and neck into partial sit, and roll. (alternative: supine to side lying, push to sit)
Stability: demands are less so may not see this
Adaptation: different surfaces may make it harder
What is training for bed mobility?
Task specific training: no single correct strategy, patients need to explore possibilities
Address impairments: LE strength, ROM, trunk strength
What are elements of stair climbing?
Progression: reciprocal, requires greater knee extensor strength and foot clearance than gait
Stability: railing, assist from second person
Adaptation: stair height, dimly lit stair case, steepness
What are alternative strategies for stair climbing? Abnormalities?
Alternatives: Slow down or use railing when available
Abnormal patterns: Reliance on railing, non reciprocal pattern
What are parts of stair training?
Task specific training: no single correct strategy, patients need to explore possibilities
Address impairments: LE strength
What are components of W/C mobility?
Propulsion: household, community
Management: brakes/leg rests
Various strategies
Think of life space mobility
