Positioning and Bed mobility

Question 1

What is the difference between Basic and instrumental ADLs?

Answer 1

Basic ADLs refer to self care such as eating, bathing, washing, transferring, toileting, dressing, personal grooming…

Instrumental ADLs allow a personal to live independently in a community, but are needed for fundamental functioning. E.g.
shopping, driving, cleaning the house, cooking, using a phone, doing a hobby…

Question 2

What are the 4 levels of the ICF?

Answer 2

Pathology, Impairment, Activity and Participation

Question 3

Which 2 factors can affect all the levels of ICF?

Answer 3

Environmental and personal factors

Question 4

What are the therapeutic considerations of ADL?

Answer 4

• Should be as economic and as normal as possible
• should be activities they do regularly to promote self responsibility
• reeducation should be task oriented
• should fit into the pt’s daily routine
• should focus on the pt’s highest level of function

Question 5

What are the reasons for correct positioning of a patient?

Answer 5

Attempt to inhibit the abnormal posture typical of hemiplegia

Sensory stimulation through weight bearing on the affected side

Stimulation of awareness of the affected side

Prevention of pressure sores

Prevention of soft tissue contractures

Maintenance of a clear airway and reduction of the risk of aspiration

To improve blood oxygen saturation when patients are sat up, their blood oxygen saturation is significantly higher than when lying flat

To increase cerebral perfusion when patients who are hypovolaemic are in sitting, they may have reduced cerebral perfusion and possibly increased cerebral
ischaemia these patients have to lie flat

To reduce cerebral oedema intracranial pressure is highly dependent on posture, being higher in patients who are lying flat and lower when sitting up

To prevent soft tissue damage which may occur due to overstretching when the limbs are not well supported

To provide patient comfort