Skip to Main Content

++

CHAPTER OBJECTIVES

++

At the completion of this chapter, the reader will be able to:

++

  1. Understand the importance of bed mobility to prevent secondary complications

  2. Describe some of the precautions when positioning a patient

  3. Discuss the biomechanical principles behind correct body mechanics

  4. Describe some of the challenges facing a clinician while moving a patient or heavy object

  5. Describe some of the mechanical devices that can be used during bed mobility tasks

  6. List the 12 principles of good body mechanics

  7. Discuss the biomechanical principles and the integral elements of the motor control progression that can be implemented during a bed mobility tasks

  8. Demonstrate how to provide bed mobility to a dependent patient

  9. Demonstrate how to instruct a patient in bed mobility

  10. Describe the importance and the principles behind patient positioning

  11. Describe the importance and the principles behind patient draping

++

OVERVIEW

++

Bed mobility activities are designed to adjust the body position of a recumbent patient to prevent the development of joint contractures or skin breakdown. In contrast, depending on the patient's medical condition, such as after total joint replacement, there may be mobility restrictions or contraindications that affect bed mobility.

++

CLINICAL PEARL

A number of medical conditions can result in mobility and position restrictions or contraindications. These include:

  • Total hip arthroplasty (THA): the restrictions and contraindications following this surgical technique depends on the approach the surgeon used:

    • For the posterolateral approach, this involves avoidance of hip flexion of the hip beyond 60–90°, 0° hip adduction and 0° of hip internal rotation.

    • Following a lateral or anterolateral approach, the patient should avoid hip extension, external rotation, and adduction across midline.

This patient population is prescribed a positioning device, a triangular foam cushion, which is strapped between the legs to keep the hip in an abducted position. It is important to remember that these range-of-motion restrictions apply in relation to both hip and trunk motion. For example, both lifting the knee while sitting or leaning forward at the waist result in hip flexion beyond 90°. From a clinical perspective, extra care must be taken when the patient is moving from supine to sitting to prevent both excessive hip flexion and excessive hip adduction.

  • Hemiplegia: rolling from supine to sidelying on the hemiplegic side is relatively straightforward, but rolling to lie on the stronger side presents a greater challenge.

  • Spinal cord injury (SCI): the functional ability of the patient who is post SCI depends on the level and degree of injury (Table 10-1). With respect to bed mobility, an injury at the level of the sixth cervical vertebra (C6) will typically allow a patient to achieve independent performance of bed mobility.

++
Table Graphic Jump Location
TABLE 10-1   Functional Outcomes Related to Level of Spinal Cord Injury 

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.