Chapter 9: Bed Mobility, Positioning, and Range of Motion

For the Instructor Guide and Worksheet Key please contact user services at userservices@mheducation.com

Click here to view the Neurologic Lab Manual Video Hemi-Style Bed Mobility and Spinal Extension over a Wedge.

OUTLINE

Objectives:

The student will appropriately demonstrate:

1. Positioning the client to facilitate function, comfort, and pressure reduction to protect skin.

2. Accurate, effective, and supportive passive ROM for the client with flaccidity or spasticity.

3. At least one exercise and progression to do with a client who is functioning at a low level.

4. Verbal and physical cueing to train rolling, scooting, and sit to/from supine in bed.

5. Problem-solving to attain a safe position in sitting in the wheelchair.

Activity 1. Station Work

Students work in groups of three and rotate through four different stations:

1. positioning in bed

2. PROM

3. bed exercises

4. bed mobility training

Activity 2. Wheelchair Positioning

Students work in groups of four to come up with solutions to a wheelchair seating and/or positioning problem that a client is having. Student will demonstrate the solutions to the rest of the class.

WORKSHEET

Prelab:

Read the “Preparation for Function” handout and bring the two client cases (Al Crews and Linda Rosen).

Look at Video 7-1 and complete:

Movement Analysis:

1. Hypothesized impairments

2. Further questions (what else would you want to examine in this mobility activity?)

Activity 1. Station Work

Work in groups of three. One student is the PT, one is the client, and one is an observer. The observer provides peer review feedback throughout the activity. Treat Al and Linda at each station. Rotate roles at each station. Students move through the stations spending 15 minutes at each station.

Station 1A. POSITIONING IN BED: Determine the position that is optimal for mobility as well as skin protection for both client cases (Al and Linda):

1. Supine

2. Sidelying on unaffected

3. Sidelying on affected

Notes:

Station 1B. PROM: What are considerations for each client? Practice training a caregiver how to perform ROM.

1. Flaccidity and Spasticity (Al has flaccid hemiplegia and Linda has spastic hemiplegia.)

2. Self-ROM

Notes:

Station 1C. BED EXERCISES: Come up with a minimum of three exercises, and a progression for each.

Focus on muscle groups that are active during sitting/standing functional activities.

Notes:

Activity 2. Bed Mobility Training

Practice rolling, scooting, and supine to/from sit training with verbal/tactile cues, and consider task and environment.

Rolling: Typically, rolling to the stronger side is easier for ...