Week 5. Functional Mobility Flashcards
Functional mobility definition
Moving from one position or place to another (during the performance of everyday activities) such as in bed mobility, wheelchair mobility, transfers (wheelchair, bed, car, tub, toilet, tub/shower, chair, floor). Performing functional ambulation and transporting objects.
Evaluation of functional mobility includes?
Client factors and performance skills
What are the functional mobility aids?
Orthotic Ambulation aids; crutches, walkers, canes. Wheelchairs Scooters UE aids (mobile arm support)
What are ambulation aids?
Crutches Straight cane Quad cane Forearm crutch Hemi-walker Walker/Rolling walker 3 Wheel Walker Rollator
What are weight bearing status?
NWB
TTWB
PWB
FWB
What is NWB?
Non-weight bearing- affected foot not touching floor
What is TTWB
Toe touch weight bearing - May lightly touch the floor for balance, no to weight bear through the leg (10%)
What is PWB
Partial weight bearing 30%-50% of body weight on affected side
What is FWB
Full weight bearing - Full body weight allowed.
What are some safety concerns during functional ambulation?
Know your patients (precautions, orthosis, status, fatigue, endurance) Use appropriate footwear Monitor physiologic responses Use gait belt Plan for unexpected Do no leave patient unattended Clear potential hazards Work closely with PT
True or False. One forth of people 65-79 and one half of those over 80 fall every year?
True
What hazards include both environmental and intrinsic factors are there when considering falls?
Throw rugs Poor lighting Inadequate bathroom grab bars Inadequate stair rails Electrical cords Items on the floor Medications Weakness Balance disorder Health
When considering Transfers what does therapist must know?
The patient status (physical, cognitive, perceptual, behavioral abilities and limitations)
Their own limitations
Correct techniques
What therapist should consider during transfers
Precautions
How many people are need to complete the transfers safely
How much times will it take
Does the patient understand what is happening
Hight and position of both transfer surface
Is the equipment in the correct place and everything else out of the way
Transfers belt or other equipment needed.
What are proper body mechanics during transfers?
Close to the patient position your body to face the patient Bend your knees Keep a neutral spine Keep a wide base of support Keep your heels down Ask for help if you need it dont combine movements
What equipment might be involved in the transfers?
Wheelchairs Walkers Grab bars Slide Board Trapeze Shower chair/tub bench Raised toilet seats Mechanical lifts
What are possible transfers surfaces?
Bed chair wheelchair toilet in/out of tub/shower care floor
How to prepare patient for transfer?
Educate patient on transfer process
Positioning of wheelchairs (0-30 degree angle)
Lock breaks on device
Place both the patients feet directly on the floor, hip width apart, knees over feet
Remove wheelchair armrest on the side you are transferring to
Make sure any lines or cords are out of the way
Stabilize the patients involved foot/knee with your foot/knee
Have the patient reach for surface you are transferring to or help push up with intact UE’s
What kinds/types of transfers are there?
Stand pivot Stand step Slide board bend pivot dependent mechanical lift
Transfers Levels what are they?
D - dependent - client not able to assist at all or <25% transfer is completed entirely by one or two other people, and /or with use of sliding board or mechanical lift.
Max (A) client performs 25%-49%
Moderate (A) - client performs 50%-74%
Minimum (A) - client performs >75%
CG - Contact Guard- client requires close physical presence of another.
Supervision - client requires close supervision, verbal cueing
Modified (I) - client completes transfer (i) w/assistance of equipment.
(I) - Independent: Client performs transfer safety w/out need for (A).
How could you remediate or modify a treatment to improve patient ?
strength ROM gains balance AE AT
How can we grade a transfers?
decreased assistance provided Decrease cueing reduce reliance on AE Very transfer surface Vary transfer approach (left/right) change environemnt Use of caregiver to assist
Home Evaluations ?
Often done prior discharge home Patient should have stabilized OT/PT to perform assessment together if possible Caregiver/family should be present Home safety checklist are available
In the home evaluation what report should identify ?
Environmental barriers
functional limitations
recommendations for adaptive equipment and assistive devices
Recommendations for home modifications and future goals.
What are common recommendations for home ?
Install ramps or railings at entrance Remove throw rugs, extra furniture 'clutter' Remove door thresholds and door jams Install grab bars around toilet and in tub/shower Rearrange furniture for wheelchair Rearrange kitchen storage Lower clothing rods in closets Tub transfer bench Shower chair Three in one commode.
Ramps set up ?
For every 1 in of rise you need 1 foot of run
OT and Driving
OT makes up the majority of professionals providing driver rehabilitation
Considered a specialty practice area
Need for specialist continues to grow
