Bed Mobility Flashcards
(28 cards)
Person
active participant
Task
meaningful
Environment
enriched
Cognitive motor learning
- (what to do)—rely heavily on visual input, minimize distractions
Associative Motor Learning
(how to do it)—shift to proprioceptive input, focus feedback on repeated errors
Autonomous Motor Learning
(how to do it well)—practice speed, accuracy, and variety
Initiating Mobility: The Person
Establish Rapport
- Listen with attention.
- Communicate clearly about goals.
- Maintain confidentiality.
- Minimize perceived power differences.
- Use a caring, respectful touch.
- Explain all procedures before beginning them.
Initiating Mobility: The Environment
- The less mobile the patient, the greater the influence of the Immediate environment on quality of life.
- Maintain privacy (e.g., knock before entering room, drape effectively, etc.)
- Respect the patient’s space; act as if you are a guest in the patient’s home.
- Create a supportive ambient environment (e.g. lighting, sound, temperature, surrounding activity, etc.).
Initiating Mobility: The Task
- Engage the patient in the task:
- Explain procedures; ask for questions.
- Have patient mentally rehearse.
- Establish baselines:
- Physical mobility
- Vital signs
Total asistance
clinician performs more than 75% of the work
Max assist
PT performs 75%
Moderate assistance
PT performs 50%
Minimal assistance
PT performs 25%
Contact guard assistance
clinician has 1 or 2 hands on the patients body to provide occasional steadying assistance for balance but is not lifting, moving, or otherwise expending effort to complete the mobility task
Bed Mobility Progressions
- Mobility in supine
- Supine <-> Sidelying
- Supine <-> Sitting
- Mobility in sitting
In Supine: Hooklying
- Hips and knees flexed
- A component of bridging and rolling
In supine: bridging
- Lift hips and low back
- Patient assists w/upper extremities (UEs), not pushing head into bed
- Clinician may stabilize at patient’s feet
- A component of scooting and some activities of daily living (ADLs)
In Supine: Scooting Up in Bed
- Head of bed (HoB) flat if tolerated
- Begin in hooklying
- Elbows out and back
- Push on elbows and feet, lift and shift hips up
In Supine: Scooting Sideways
- Begin as if scooting up
- Lift and shift hips laterally
- Lift upper body in same direction
- Repeat as needed
Rolling: Supine to Sidelying
- Important in prevention of pressure injuries
- Used for placement of drawsheets & lift slings
- Potential component of supine-to-sitting
- Typically initiated with trunk rotation
Rolling: Supine to Right Sidelying
- Scoot to the left in the supine position.
- Turn and look to the right.
- Abduct the right arm ~45°.
- Bend the left hip and knee (or cross left leg over right).
- Reach left arm over and push down with left foot.
- Bring trunk into full sidelying.
Rolling: Supine to Prone
- Proceed as in rolling into sidelying but without abducting the arm.
- Continue from sidelying into prone.
Supine to Short-Sitting
- Typically simultaneous upper- and lower-body movement, powered primarily by core musculature
- When mobility is impaired, motion is usually done segmentally through sidelying.
Supine to Sitting Through Sidelying on the Left
- Roll from supine to left sidelying.
- Lift or slide both lower extremities (LEs) off the edge of the bed.
- Push right hand down into the bed, extending the elbow.
- Abduct the left arm, using it to push upright.
