Chapter 15: Spinal Cord Injury: Bed Mobility Laboratory

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OUTLINE

Objectives:

By the end of the lab, for the bed mobility tasks of rolling, supine to and from long sit, short sit to and from long sit, and scooting in long sitting, students will:

1. Demonstrate appropriate guarding techniques, verbal cueing, and manual assistance when teaching bed mobility skills.

2. Demonstrate the ability to adapt teaching of movement strategies based on the spinal cord injury (SCI) lesion level (tetraplegia, with and without triceps function, and paraplegia).

3. Demonstrate at least one variation to make the task easier and one variation to make the task more challenging.

4. Demonstrate the ability to break each of the tasks into component parts for practice.

5. Demonstrate at least one adaptation of the bed mobility tasks for each of the following populations: geriatric clients, clients with spinal precautions in thoracolumbar spinal orthoses (TLSOs) and cervical collars, and clients with musculoskeletal impairments.

6. Demonstrate ability to instruct at least four appropriate lower extremity (LE) self-ROM exercises and at least three strengthening exercises for a person with SCI.

Introduction

The instructor:

1. Reviews specific questions from prelab assignment.

2. Discusses treatment to promote recovery and compare/contrast this to the compensatory approach to treatment for clients with SCI.

3. Discusses the interdisciplinary team in rehabilitation of a client after SCI.

4. Discusses general rules for working with clients with SCI.

Activity 1. Bed Mobility: Rolling, Supine to/From Long Sit

The instructor demonstrates and students practice teaching rolling and transferring supine to/from sitting.

Activity 2. Bed Mobility: Short Sit to/From Long Sit, Scooting in Bed

The instructor demonstrates going short sit to/from long sit. Students practice teaching going short sit to/from long sit (contrasting clients with tetraplegia and paraplegia).

The instructor demonstrates scooting in long sitting. Students practice teaching scooting in long sitting (contrasting clients with tetraplegia and paraplegia).

Activity 3. LE ROM and Strengthening Exercises

Students teach each other LE self-ROM and strengthening exercises.

Wrap up: Instructor answers questions, gives general feedback from breakout and then discusses the main "take homes."

WORKSHEET

Prelab Assignment

Complete a table with expected movements, level of assistance and movement strategies that can be used for mobility skills, for clients with varied motor presentation after SCI (refer to Appendix 15-1).

Introduction

Clients with SCI are capable of neuroplastic change, and physical therapy should promote healing and recovery of the neurologic system to the extent possible. To promote neuroplastic healing therapy should include upright and weight-bearing postures and activities to challenge balance skill within these postures. In ...