SCI Transfer and Bed Mobility Checkout Flashcards
In which patient populations is it important to maintain a tenodesis grasp?
C6 and C7 Tetraplegia
How do we get a patient’s hips forward in the WC during a dependent transfer?
Unweight them on one side by leaning them forward and bring the opposite hip forward
OR
Head-Hips Relationship (start with head down and bring it up as PT assists at the hips)
The pt is positioned at the front of the WC before transferring over to the mat or at EOM getting ready to go to their WC during a dependent transfer. How should you angle their legs?
Away from the side that you are transferring towards
During a dependent transfer, how can you get your pt seated EOM to supine?
Scoop under both legs and lower upper body at the shoulders
OR
Lower upper body (pt tucks chin) and lift one leg at a time on the mat before straightening out
What should you always keep in mind when assisting patients at their shoulders?
DO NOT GRAB GH JOINT
Grab at top of shoulder / posterior (scapula)
C5 Tetraplegia Limitations
Shoulder girdle will start very weak
Absent / extremely wrist extensors
Preservation of finger flexors (Tenodesis)
C5 Tetraplegia
Transfers and Bed Mobility Considerations
Maintain forward tripod position (best)
Cannot use hook method due to weak wrist extensors
Body Jacket (TLSO) Precautions
No hip flexion beyond 90 degrees
No uneven transfers (surfaces same height)
Log-rolling in and out of jacket (avoid twisting at the trunk and limit SB)
Scapular Precautions
No WC propulsion / pulling / pushing with UEs
Which arm positioning is optimal for a patient with paraplegia to maintain?
Backwards Tripod
T or F: Sitting balance in a patient with paraplegia is limited.
What are the implications of this?
T
Remove all WC parts at the feet before unbuckling seatbelt
How can you get a SB underneath a patient with paraplegia?
PT positions SB as pt goes into a WC push-up position
How do you instruct with a patient with paraplegia to begin making the transfer from their WC to the mat?
WC push-up and shift hips over without rotation at the back
Shift weight to opposite to move hands and utilize head movement (aim for firm surfaces for push-off)
Once seated at the EOM, how can a patient with paraplegia get their legs onto the mat?
Pt can push through their arms and bring hips backward
Doing so at an angle is optimal for eventually laying down
For a patient with tetraplegia, how can they go from long sitting to side-lying?
Ensure that their legs are crossed
Use arm momentum method at an angle (to engage Lats) - instruct pts to lift their head as they move onto their side
