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Safety

is the most important above all

Safety considerations before you start....

1. wash your hands


2. arrange the room to minimize hazards and maximize space


3. plan your activity


4. Ensure everything is lock and pt. anti-slip sock or shoes is on.


5. check pt. eval, for transfer and weight bearing status.


6. lower the bed to proper height


7. adjust the bed flat or head up if needed


8. apply gait belt


9. tell pt. your plan



how many weeks it takes the bones to heel?

6-8 weeks

types of weight bearing

1. NWB- non weight bearing (none)


2. PWB- partial weight bearing (some)


TTWB- toe-touch weight bearing


3. FWB- full weight bearing ( all)


WBAT- weight bearing as tolerated

ADA review to ensure persons with disabilities is protected by

1. reasonable accommodation


( toilet, WC width bathroom stalls, desk height adjustments)


2. Access to public buildings


( ramps, elevator, wide doors)


3. Access to recreation


(parks, etc)

Work and home modification PT can help with

1. safety assessment


2. bathroom modification


3. job site eval


4. redesign suggestion using universal design process

Modifications for visual or hearing loss

text phones, tv ears, visual alarms, voice commands devices, tactile controls on appliances


adequate lighting, removal of throw rugs

general design considerations

hall width - 32 inches


walk ways- 36


toilet - 18


counter tops- 30-34


ramps- 36 / 1:12

What is transfer?

act of moving from from surface to another


( pt. may need assistance)



Dependence

How much assistance can patient provide.


FOCUS on this concept!!!!

what are the types of transfer

NDMAL accronym


1. number of person needed for transfers


2. Description of transfer ( standing, sitting, recumbent, sliding board)


3. Manual or mechanical ( gurney, hoyer lift, sliding board)


4. amount of assistance pt. can provide


4. location of transfers (bed, gurney, mat, WC, etc)

Code for amount of assistance pt. provide during transfer

IMS3MT means


1. Independent- no physical assistance needed


Modified independent- no physical assistance needed just need equipment/ increased time


Standby assistance/ supervision - no physical assistance needed just verbal/ tactile cues/ or safety instruction


2. Minimal Assistance- once you touch the patient, 75% given by the pt. just need a bit of assistance


3. Moderate Assistance- 50-75% given by the pt.


4. Maximum assistance- 25-50% given by the pt.


5. Total assistance- 0 given, needs two or more person to complete transfers

Key for transfer is

what the patient can do NOT YOU.

other names for minimal assistance

guarding or contact guard assist

Movement and Therex needed for


supine- sidelying

rolling; head and trunk control


core reaching, cervical ROM. trunk ROM



Movement and Therex needed for


side lying to sit

weight bearing UE; head and trunk control


core obliques UE closed chain/ lat/ wrist/ hand ROM

Movement and therex needed for


sit- pivot (stand) to sit

hean and trunk control " squat"


Core, hip flexion, ankle DF knee flexion hip and knee extensor closed chain

Movement and therex for


sit to stand

head and trunk control; squat to stand


core, hip and knee flexion, ankle DF, hip and knee extensor, closed chain, (power LE) back extensor endurance

stand to sit

head and trunk control; stand to squat


core, hip flexion/ext, ankle DF, knee flexion, hip and knee extensor ECCENTRIC (power LE) back extensor endurance

sit to sit


with transfer board

lateral scooting


core obliques, back extensors, lats, triceps, wrist ext ROM, elbow ext. shoulder closed chain