body mechanics & transfer techniques
DESCRIPTION
Body Mechanics & Transfer Techniques. Body Mechanics. Efficient use of body to produce motion that is safe, energy conserving, anatomically and physiologically efficient and leads to maintenance of a person’s body balance and control used to avoid injury to patient and therapist - PowerPoint PPT PresentationTRANSCRIPT
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Body Mechanics & Transfer Techniques
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Body Mechanics
Efficient use of body to produce motion that is safe, energy conserving, anatomically and physiologically efficient and leads to maintenance of a person’s body balance and control used to avoid injury to patient and therapist
Gravity & friction add resistance to activities i.e. lifting, reaching, pushing, pulling, and carrying objects
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Transfer Techniques Position patient close to you Position your COG as close to the patient’s COG as possible (S2) Increase your BOS (lower your COG and maintain
your vertical gravity line (VGL) within your BOS; BOS is dependent on position of your feet
Plan the activity and make room arrangements if necessary (obtain eq. Or assistance as needed)
Avoid trunk flexion and rotation
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Lifting Models Traditional model: lift any object that is below
the waist by squatting & avoid posterior tilt; keep lumbar and thoracic spine relatively straight
Lumbar Lordosis Model Deep squat lift: full squat, wide BOS with feet
straddling object; lumbar lordosis (ant tilt) Power lift: half squat (hips above knees); feet parallel
and behind object; lumbar lordosis Straight leg lift: knees only slightly bend; lumbar
lordosis
One leg stance (golfer’s lift) for light objects
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Pushing, Pulling, Reaching Pushing, Pulling, reaching, and
carrying:
lower COG (semi squat;
push or pull parallel to surface of object
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Transfers PT Goal
Safe & independent transfer PT POC
Transfer training to pt., caregiver
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Transfer Training Transfer from one surface to another Bed to chair Commode to wheelchair Commode to standing Car transfer Bed to gurney Bed to wheelchair *lots of types of transfers
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Transfers Safe movement of a person from one
surface to another or from one position to another Independently Verbal cues/instructions SBA Minimum Assistance Moderate assistance Maximum assistance of 1 Maximum assistance of 2 or 3 Or special equipment i.e. sliding board, hoyer lift
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Terminology Independent:
Pt can perform transfer w/o any type of asst. (verbal or manual)
Assisted: Pt requires asst from another person
(verbal or manual)
Dependent: Pt requires total physical asst from 1 or
more people to transfer
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Terminology Minimal Assistance
Pt performs 75% or more
Moderate Assistance Pt performs 50-75%
Maximal Assistance Pt performs 25-50%
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Terminology Stand by Asst
Pt requires verbal or tactile cues
Contact Guarding
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Organization of Patient Transfers Plan & organize transfer BEFORE
moving patient Instruct patient in technique/procedure Demonstrate technique/procedure Be alert to safety factors Review chart to determine amt of asst,
cognitive status, strength, type transfers already performed etc
Utilize safety belt NEVER leave pt. unattended
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Organization of Patient Transfers cont’d Proper shoes on patient Appropriate equipment Alert to IV lines, catheters, weight bearing
status etc Use proper body mechanics Position yourself to guard, protect and
assist Break transfer into component parts Only assist as needed at each component
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Types of Transfers All transfers start with bed mobility Types
Bend knees up, rolle to side, let legs off bed, push to sitting with UE’s
Raise up on arms, slide one leg out at a time while scooting bottom toward edge of bed used for THA (total hip arthroplasty) to avoid hip flexion greater than 90
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Pointers Avoid use of trapeze bar if performing
transfer training if at all possible Trapeze bar is useful for scooting in
bed but not for transfer Plus, pt won’t have trapeze at home
Train for homeUse good body mechanics &
mechanical advantage
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Types of transfers Pivot Sliding Board Hoyer Lift 2-3 person lift Floor to chair Bath tub with transfer chair Bath tub with transfer bench Car transfer
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Transfer training For all pivot transfers the pt should:
Scoot to edge of chair/bed/w/c Position feet Lean forward Pt should have on shoes that will provide traction NEVER transfer patient with patient just wearing socks
Therapist Always use gait belt Remove armrest on wheelchair if possible Lock brakes of wheelchair
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Pivot Transfer Standing Standing Pivot:
Partial stand if possible (keeps COG lower) Position w/c or chair parallel or at 45-60
degree angle Easier to transfer to strongest side Transfer training involves teaching the pt to
transfer to both sides Pt may push from w/c or hold around
therapist shoulder girdle Never let pt hold around therapist’s neck May choose to block stronger leg or weaker
leg
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Standing Pivot Transfer
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Sitting Pivot Transfer Position w/c close to plinth Pt scoots forward in chair Position feet Sliding board or pillow b/n plinth &
W/c Pt lifts & scoots their bottom by
pushing with UE’s (and LE’s as appropriate)
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Pivot Transfer Sitting
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Conditions Requiring Special PRECAUTIONS during TransfersTotal Hip Replacement
Low back trauma or LBP
SCI = spinal cord injury
Burns
Hemiplegia
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Total Hip Replacement transfer precautions Avoid hip flexion > 90
Avoid hip abduction
Avoid hip rotation
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Total Hip Replacement transfer precautions Utilize reclining wheelchair to transfer
pt or for sitting
Do NOT have pt sit in upright position
Do NOT have pt roll onto side to go from bed to sitting
DO educate pt regarding precautions & utilize precautions during transfers
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Low back pain or trauma Have pt log roll onto their side Allow feet to come off bed Have pt rise to sitting Avoid
Lumbar rotation Lumbar lateral flexion Lumbar flexion
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Burns Avoid shear forces across burn or
graft site Avoid sliding
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Hemiplegia Do NOT pull on affected UE or LE
Pulling on the affected UE or LE can dislocate the shoulder or overstretch the joint capsule
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Bed to Gurney transfers Insert draw sheet