On Bed Mobility: Biomechanics Blog Post Seven

Mobility is something most people take for granted. We think nothing of walking across the room to pick up an object or even getting out of bed without additional devices or help. However these abilities are not available to everyone whether it be due to a disability since birth, degenerative diseases, age, or an acquired injury.

Knowing the aforementioned information, it is helpful to know that there is also a "Hierarchy of Mobility Skills" that scale mobility from bed mobility to to community to mobility and driving. I personally had not taken the time to think of mobility in a specific order before learning of this BUT now that I do know I think it makes perfect sense. When learning or relearning mobility skills it is critical to build on the skills. Starting with bed mobility and moving to mat transfers, wheelchair transfers, bed transfers, mechanical ambulation for ADLs, toileting and tub transfers, car transfers, functional ambulation, and finally community mobility and driving is the technical chronological order.

I do think it is important to note that the order of learning these skills can overlap and should overlap. A person should find their just right challenge and use self reflection to find their level of comfort in moving from one skill to the next. I also think it is important to note that learning proper mobility takes practice and can be adapted slightly per person. In lecture we were shown a video of an individual with a spinal cord injury getting in and out of bed. He has learned this skill and adapted it to his personal preference while still following safety precautions. In simulation lab we as class learned that doing this the first time can be awkward however we found that practice is key and I believe it will be the same when working with clients.

I agree with the hierarchy of mobility skills as a blueprint for adaptations of movement and ADLs. I look forward to applying the knowledge in practice in the future!

Assistive Devices: Biomechanics Blog Post Six

Assessing proper fitting for: Canes, Axillary crutches, Lofstrand crutches, Platform walkers, and Rolling walkers

Why is important to fit an individual for an assistive device? For one, no two people are made the same therefore to properly fit an assistive device an individuals height, stability and comfortability must be taken into account as well as their needs. For example does this person fatigue easily? Should they be fitted for a device that includes a seat? Or does this person need supplemental oxygen? Should they be fitted for a device that includes space for an O2 tank?

How exactly does one fit for these five different devices?

Image retrieved from google images

Canes: Have the client stand with arms relaxed at their side. The cane handle should be in line with the wrist crease, ulnar styloid, or greater trocanter. When holding the cane the elbow should be fleced approximately 20-30 degrees.

Axillary Crutches: Estimate the length of the crutches based on the individuals height, the arm rest should be 2 to 3 finger lengths from the axilla and hand grips should be in line with the greater trochanter. Have the client stand with arms relaxed at sides and adjust height of crutches accordingly.

Lofstrand Crutches: Hand grips should be facing forward and at the height of the clients greater trochanter. The arm band should be positioned 2/3 of the way up the forearm, proximal to the elbow.

Platform and Rolling Walkers:  Estimate the appropriate height of the walker based on the clients height, adjust the hand grips so they are in line with the greater trochanter, ulnar styloid or wrist crease. Elbows should be flexed to approximately 20-30 degrees. *Platform walkers should have the platform positioned to allow the elbow to be flexed to 90 degrees, the proximal ulna should be positioned 1 to 2 inches off the platform surface. The handle of the platform need to be position medially for the clients grip comfort.

Information retrieved from MOBI app.