Week 7 - Tailoring intervention grab rails Flashcards
Consequence of not tailoring the selection and installation of grab rails
- Non-use or removal
- Safety concerns
- Waste of money
Grab rail definition
A rail used to give a steadying and stabilising assistance to a person engaged in a particular function
Who do grab rails suit?
- Children
- Elderly
- People with difficulties with sit-stand transfers
Where are grab rails placed?
- Toilets/bathrooms/ showers
- Hallways
Tailoring interventions to the person
- Goals/preferences
- Specific impairments and performance difficulties
- Reach range
- Shoulder, elbow, wrist flexion/extension
- Grip size and strength
- Push or pull
Phases of sit to stand transfers
- Phase 1: flexion
- Phase 2: lift-off
- Phase 3: extension
- Phase 4: stabilisation
Tailoring interventions to the task
- Activities completed
- Alternative ways of doing activities
- Assistance received
- Equipment (current or future)
Tailoring interventions to the environment
- Space and clearance to and through the door and within the room
- Location of fittings and fixtures
- Materials and finishes
- Condition of the environment
How to check location of studs?
Timber frame:
- Tap
- Look for line of nails or a strip cover on a seam
- Stud finder
- Nail
- Drill
Steel frame:
- Magnet
Considerations when installing a grab rail
- Positioning: comfortable reach
- Length: resting forearm
- Location of centre line of toilet
- Diameter: hand size and grip strength
- Surface: environmental considerations (soap, body fat, powder, wet vs. dry conditions)
- Fixings: load capacity
Alignment considerations of a hand rail
- Vertical: stage 1 & 4
- pull up action
- reduces total ROM at hip and knees
- reduces perceived pain levels
- higher rails reduce biomechanical load
- Angled: stages 1 & 4
- allows flexible hand placement
- Horizontal: push up action
- assists with weight bearing
- supports forearm
- if too high or too low, will not assist momentum and stability
- requires larger forces
Considerations of unilateral grab rails
- Stages 2 & 3
- Suits people with lower limb weakness and asymmetrical conditions
- Place ipsilateral with hip and ankle conditions or contralateral for knee joint problems
Considerations of Bilateral grab rails
- Kyphosis, lordosis, back pain
- Symmetry of body position: centre of mass (COM) & centre of pressure (COP)
- Allows alternating of hands and bilateral hand use
Palmar contact & grip
- Diameter = circumference divided by Pi
e. g. 100mm divided by 3.14 = 30mm
Features of hand rails
- Surfaces
- Diameter
- Length
- Holes
- Flanges
Materials of hand rails
- Stainless steel
- Brass
- Plastic
- Timber
- Gold
- Galvanised steel
Measurement of rails
Grab rails
- Horizontal: to the top
- Vertical: to the edge
Handrails
- From the nosing to the top of the handrail
