hierachy of mobility skills

The order for restoring confidence in mobility is somewhat complicated to understand but after careful review it makes sense the order. The order goes as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. I understand why driving is the highest on the hierarchy because driving requires great attention span. When someone gets behind the wheel, their life is put at risk and the people around them. Also, it makes sense for bed mobility to be at the very bottom because it is the basis for doing everything else. The first thing a person does in the morning is getting out of bed. A person must get out of bed to operate a vehicle. I agree with this approach. I think it makes a lot of sense for the order it is in because each step builds on each other.

              The labs we have done where we are performing transfers have taught me a lot. It would be very stressful to not be able to move by myself and I am grateful the labs are teaching me to help people who cannot move by themselves. I think it is very cool the different types of transfers we have learned. Before lab, I did not realize there were specific ways to transfer a client, especially when they have a spinal cord injury. I am looking forward to becoming an OT and I believe what I have learned so far about the transfers will help me be the best OT as I can be!

blog post 9

Assistive devices are very beneficial to clients because they aid in their mobility. It is important to properly fit a client for an assistive device for many reasons. If the assistive device does not properly fit, then it could hurt the person to use. Also, if the assistive device is not properly fitted to the specific person then it could affect their balance and posture. For example, if a person is using a walker that is 4 inches too short then they would have to hunch over to use the device. In the long run, the walker would hurt the client more than it would be beneficial.

To properly fit a client for a cane the client should stand straight with their arms directly by their side. The handle needs to be in line with the wrist crease, ulnar styloid or the greater trochanter. For the axillary crutches and lofstrand crutches the hand grips need to be in line with the wrist crease, ulnar styloid or greater trochanter when the arms are at rest by the client’s side. The same goes for a platform walker, with the handgrips in line with the ulnar styloid, wrist crease or the greater trochanter when the arms are resting at the client’s side. The same goes for the rolling walker. When fitting for a cane or walker, the elbow needs to be relaxed, and flexed 20-30 degrees. To fit for crutches, the axillary will rest roughly 5 centimeters below the floor of the axilla. For each assistive device, it is important the client’s shoulders are relaxed and not elevated to get a proper fit. Loftstrand crutches are often used for people with long-term disables, whereas platform crutches are often used right after an injury.