Levels of Assistance and Precautions Flashcards
Independent
(I)
Pt requires no assistance or supervision from PT or device & is safe & secure to ambulate &/or complete tasks
Staff effort: 0%
Pt effort: 100%
Modified Independence
(Mod I)
Pt completes task using assisted device (walker, cane, grab bar, bedside commode-BSC) &/or requires extra time to complete a task
Staff effort: 0%
Pt effort: 100%
Supervision
(S)
No physical contact from PT/assistant, d/t cognitive issues PT/assistant should provide verbal cues to complete activity or assist with task set up
Staff effort: 0%
Pt effort: 100%
Stand By Assist
(SBA)
No physical contact from PT/assistant, d/t fall risk PT/assistant should be close to pt to maximize safety to complete activity or assist with task set up
Staff effort: 0%
Pt effort: 100%
Contact Guard Assist
(CGA)
Pt requires light physical contact from PT/assistant (i.e. PT hand on pt back to steady pt w/o physical support, may be d/t occasional LOB)
Staff effort: <5%
Pt effort: >95%
Minimal Assistance
(Min A)
Pt requires 25% or less physical support or assistance to safely complete task/transfer/ambulation
Staff effort: <25%
Pt effort: 75%
Moderate Assistance
(Mod A)
Pt requires 50% assistance from PT/assistant to safely complete task/transfer/ambulation
Staff effort: 50%
Pt effort: 50%
Maximal Assistance
(Max A)
Pt requires 75% assistance or support from staff member to safely complete task/transfer/ambulation
Staff effort: 75%
Pt effort: 25%
Dependent Total Assistance
(D) or (Total A)
Pt requires 100% assistance or support from staff member to complete task/transfer/ambulation
Staff effort: 100%
Pt effort: 0%
Multiple Person Transfers
i.e. Max A x2 for supine to sit
FWB
Full weight bearing, full body through extremity
WBAT
Weight bearing as tolerated, as much body weight as pt can tolerate through extremity usually limited by pain or ability
PWB
Partial weight bearing, 50% of BW through extremity
TTWB
Toe touch weight bearing, only toes allowed to touch ground; primarily use limb to balance ab 25% of BW
HTWB
Heel touch weight bearing, only heel allowed to touch ground; primarily use heel for balance ab 25% of BW
NWB
Non weight bearing, no weight at all is allowed through extremity & must not allow extremity to touch support surface
TKA Precautions
*if there is a WB precaution: it is WBAT initially and moving toward FWB
*pt w/ recent TKA would be WBAT d/t pain following surgery and limited ROM in joint
THA Precautions
*if there is a WB restriction it would be WBAT initially and moving toward FWB
THA Anterior Approach
*minimally invasive approach
*no extension of hip past neutral
*no ER of hip
*no adduction of hip
(position chair away from sx side ++ have pt turn towards sx side)
THA Posterior Approach
*No IR of hip
*No hip flexion >90
*No adduction of hip past midline
(position chair next to sx side ++ have pt turn away from sx side)
ORIF Precautions
*almost always has WB precautions: NWB or PWB
*
Importance of WB Status
*precautions usually stated in chart or consult order
*helps PT know what pt’s assist level will be and DC plans
Traditional Sternal Precautions
*maintained for 4-6 weeks
*do not reach arms OH (shoulder flexion >90)
*no not reach arms behind back
*do not lift >5-8lbs
*do not push with arms
* beneficial for pt to hold pillow w/ arms during functional tasks (rolling, supine to sit, and STS)
* beneficial to hold onto a pillow during cough or sneeze
Spinal Precautions: Cervical
*no shoulder flexion >90
*no lifting >10lbs
*ASPEN collar in place at all times
*ROM restrictions per surgeon
Spinal Precautions: Lumbar
*primarily after spinal laminectomy, decompression surgery
*No twisting
*No forward bending >90
*minimize side bending
*utilize log roll technique (when moving from supine to sit or sit to supine)
TLSO or LSO
Thoracolumbar Sacral Orthosis or Lumbar Sacral Orthosis to be worn during movement
*majority of time orthosis can be worn during movement, majority of time orthosis can be taken off while sleeping depending on surgeon orders and type of surgery
