Tx Strategies to Improve Bed Mobility & Transfers: Exam 1

Question 1

Functional interventions

Answer 1

education + training in performance bed mobility and transfers

tx’s should also include acts that will assist pt in gaining greater degree of funct. indep.

progressions!!!

Question 2

Practice pds and layout:

Massed vs. Distributed

Answer 2

• Massed: Rest pd MUCH LESS than Practice time
  
  • ​fatigue==issue here
• Distributed: rest + practice are ===

Question 3

Practice pds and layout

Blocked vs Random Practice

Answer 3

• Blocked: one task performed repeatedly
  
  • ​”block out” time for that task
    
    • ​ex. sit to stand only
• Random: involves mult. tasks
  
  • ​ex. bed to/from WC, WC to/from toilet, etc..

Question 4

Part vs. Whole Training

Breaking task up into component parts

Answer 4

• Break task up into component parts
  
  • EX.
    
    • practice rolling 1/2 way PRIOR TO rolling full way
      
      • ​manual assist only for aspects of task pt req’s assist for
      • ​allow pt to falter a bit

Question 5

IDing underlying impairments

Answer 5

• consult problem list
  
  • ​address pt impairments
    
    • ex. if ROM is limiting factor–> incorporate some ROM PRIOR to rolling
    • mat/bed ther-ex to improve strength PRIOR to “scooting”

Question 6

Transitional Mobility —>

Answer 6

ability to move from one pos. to another

Question 7

Static Control

Answer 7

ability to maintain posture/stability

Question 8

Dynamic Postural Control

Answer 8

• Ability to perform tasks in a controlled fashion “dynamic”
  
  • ​STATIC CONTROL NEEDED FIRST in order to progress
    
    • ex. need first to be able to maint. static standing before ambulation

Question 9

Working w/ pts

try to ID what?

Answer 9

• Which comp. of the task is LIMTD
  
  • ID critical elements of the task the pt is struggling w/

Question 10

Rx Tips:

Transitional Movement

Answer 10

• Mvmt b/w positions
  
  • hands on facilitation
  • hand place and guided mvmt practice

Question 11

Transitional mvmt: Moving b/w pos’s

Guided mvmt practice or hands on assist

Answer 11

• helps learner gain understanding of task req’s

Question 12

Transitional mvmt: Moving b/w pos’s

early assisted practice

Answer 12

• PT can
  
  • provie stability
  • control unwanted/compensatory mvmts
  • move pt thru CORRECT mvmt pattern
    
    • ​manual assist, PROM, strength limits.

Question 13

Rx: Postural Control/Stability

Answer 13

• promote control in static cond’s
  
  • promote against resist.
  • alter BOS
    
    • EX. remove UE support from balance task

Question 14

Rx: Dynamic Control

Answer 14

• Promotion of balance/stability w/ mvmt
  
  • ​change BOS
  • challenge limits of stability
  • provide/vary amt of resist thru mvmt
  • active but controlled wt. shifting

Question 15

Task specific interventions:

Hook Lying

Answer 15

• Transitional mvmt:
  
  • ​heel slides (assisted)
• Static Control:
  
  • ​iso. knee squeeze, DEC BOS, alternating iso’s
• Dynamic control
  
  • ​bridging, resistd knee flex t/o ROM, theraball knee-chest

Question 16

Task specific intervents

Bridging

Answer 16

• Transitional mvmt:
  
  • ​pelvic tilts, march w/ pelvic tilt, help them into bridge, heel digs
• Static Control
  
  • ​glute bridge hold while pushing down, lat. iso forces
• Dynamic Control
  
  • ​bridge up n down against resist

Question 17

Bridging:

How do DEC lvl diff. weaker pt

Answer 17

tilt pelvis for them

elevate their butt to DEC lvl activation required (something underneath them )

Question 18

Bridging:

how to INC lvl diff. stronger pt

Answer 18

bridge on theraball or uneven surface

Question 19

Task Specific

Rolling

Answer 19

• Transitional mvmt
  
  • ​reach across body
  • rhythmic initiation @ arms have them look to side (body follows eyes/head)
• Static Control
  
  • ​in SL an alt. iso’s to trunk an LEs
• Dynamic Control
  
  • ​provide resist. t/o ROM

Question 20

Task Specific

Supine/SL to Sit

break into parts if needed***

Answer 20

• Transitional mvmt:
  
  • ​press up off elbows
  • sliding legs off bed
• Static Control:
  
  • ​SUPINE
    
    • chin tucks and hold
  • SEMI PUSH-UP
    
    • alt. iso’s–> one push towards Flex,other pushing towardsExt.
• Dynamic Control:
  
  • ​SUPINE
    
    • resisted trunk Flex
  • resist. t/o ROM

Question 21

Task Specific

Sitting

Answer 21

• Transitional mvmt:
  
  • ​help them thru chin tuck and up
• Static Control:
  
  • ​sitting EOB–reach arm out and hold wt.
  • iso force @ trunk (erectors)/pelvis (Trans Abd.) while siting
• Dynamic Control
  
  • ​reach for water & move somewhere else
  • sitting toe touches
  • sit on ball

Question 22

W/ Sitting

what tasks are dynamic postural control for???

Answer 22

food to mouth

cutting food

toileting

Question 23

Strategies to improve Transfers

Answer 23

• Depends on TYPE of transfer
• Address underlying impairs IF POSSIBLE

Question 24

Strategies to Improve Transfers:

Address underlying impairs IF POSSIBLE

Answer 24

• EX.
  
  • indiv w/ paraplegia will NOT gain strength in LEs to be able to stand HOWEVER UE strength can inc as a means of compensation
    
    • ​WC pushups will pot. transfer skill to un-wt’ing of buttocks during transfers!!!

YOU FUCKING GOT THIS SHIT!!!!