SCI - Bed Mobility and Transfers Flashcards
What are the key components of the Physical Therapy Exam for SCI patients?
- mini-mental state examination (MMSE) - 23 or lower indicates dementia.
- motor exam
- spasticity assessment
- MMT
- ROM
- reflexes
- sensory exam
What mobility skills should be focused on during bed mobility for SCI patients?
- rolling
- transitioning supine to/from sitting
- lower extremity management
How is balance and gait assessed in SCI patients?
Explain the head-hips relationship and its importance in functional mobility.
Head moves in one direction to move hips in the opposite direction.
What is muscle substitution, and how is it applied in bed mobility for SCI patients?
- Using fixation of distal extremity- anterior deltoids with clavicular portion of pectoralisto extend the elbow
- Compensation for triceps using external rotators
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How can momentum be used effectively during rolling for SCI patients?
Using head and arms to generate momentum and assist with rolling.
What are the different techniques for transitioning from supine to long sitting?
- Roll and walk on elbows
- Roll and throw, coming straight up from supine.
How much hamstring flexibility is required for long sitting?
At least 90 degrees hamstring flexibility is required for long sitting.
How can a patient transition from long sitting to short sitting effectively?
Slide the wrist under the leg and extend the wrist to move the leg, or use leg loops.
What are the key considerations for sitting balance in SCI patients?
Balance is affected by lesion level, and patients with low cervical lesions may need trunk flexion for balance.
- Low cervical and high thoracic lesions maintain sitting balance by forward head displacement and trunk flexion.
- Low thoracic lesions can be expected to sit with a relatively erect trunk.
Describe the balance skills needed for short sitting in SCI patients.
ROM in the legs and trunk positioning; short sitting requires foot support and trunk flexion.
How are PNF techniques used to improve sitting stability in SCI patients?
Stabilizing reversals and rhythmic stabilization techniques can improve postural control.
Reaching during sitting improves?
Reaching for objects during sitting helps improve anticipatory balance reactions.
What are the phases of the sit-pivot transfer?
- Preparatory phase: During the preparatory phase, the trunk flexes forward, leans laterally, and rotates toward the trailing arm in order to lead with the hips
- Lift phase starts when the buttocks lift off the sitting surface and continues while the trunk is lifted halfway between the two surfaces
- Descent phase denotes the period when the trunk is lowered to the other seating surface, from the halfway point until the buttocks are on the other surface.
Explain the head-hips relationship during transfers and its importance.
Head moves opposite to hips to lift and shift the body laterally, avoiding sliding.
What are the key methods for transferring from the floor to a wheelchair?
Floor to Wheelchair transfers:
- forward
- sideways
- backward
What techniques are used for walking on elbows to achieve long sitting?
Use of walking on elbows technique from prone/supine to long sitting.
What safety considerations should be made to avoid friction and shearing during transfers?
Avoid friction and shearing by lifting during transfers instead of sliding.
How can patients learn their limits of stability during sitting balance training?
Limits of Stability:
- This can be accomplished by weight shifting until the point is reached where balance can no longer be maintained
- Close supervision/assistance is warranted
How can SCI patients practice and improve stability in prone on elbows?
Practice stability and controlled mobility interventions
- Rhythmic stabilization
- Weight shifts
- Walking on elbows to both sides, up and down
- Strengthening SA and other scapular muscle
