Exam 3: Patient Skills - March 24th Lateral Transfers
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Talk through how a patient would independently transfer a patient from a bed to a chair with a sliding board
Have the patient shift to the side opposite of the transfer. Place the board under the lifted side and other end over the wheelchair seat. Place one hand out of the board on the chair, push down with both hands and lift, shift, and lower as needed
Talk through how a clinician would assist a patient in transferring with a sliding board
The clinical typically guards from the front and assist with hip movement centrally, directing distally as needed. Making several small movements may be needed
A pivot transfer’s primary action occurs at the ____ and requires ____ ____ on at least one LE
feet; weigh bearing
In regards to pivot transfers, the transfer should occurs towards the patients (stronger/weaker) side
stronger
Explain the ready position of the patient during an assisted pivot transfer
Feet back with inner foot slightly forward, trunk flexed, hands placed on armrests
Explain the ready position of the clinician during an assisted pivot transfer
In front of patient with hips and knees flexed, wide staggered stance. Inner foot slightly posterior, grip on gait belt
Blocking the knee during a pivot transfer creates ______ moment to counteract the flexion moment at the patient’s hips and knees
extension
During knee blocking, contact should be make at the patients (proximal/distal) tibia
proximal
What type of knee block can be used during an assisted pivot transfer
1: 1 2: 1 2: 2
What type of knee block should be used during a depended pivot transer
2:2
Describe the clinician’s position during a dependent pivot transfer
In front of the patient with hips and knees flexed. Inner foot slightly posterior with a grip on a gait belt
Describe how a patient with unilateral limited WB would perform a transfer from standing to sitting
slide affected LE forward before rising Hold NWB limb slightly off the ground during pivot pivot uninvolved side through small hops, extend knee of involved LE before sitting
Describe how a patient with THA posterior approach would transfer from one chair to another sitting platform
scoot forward without flexion the trunk beyond 60-90 extend knee on involved LE before standing while avoiding trunk flexion while pushing into standing also avoid IR during pivot and flexion while back to sitting
What are the different levels of transfers
Dependent, assisted, modified independent, and independent
Which type of level of transfer is minimal or no active participation by the patient
dependent
Which type of level of transfer involves some participation by the patient
assisted
Which type of level of transfer is when the patient performs the transfer independently with transfer devices
modified independent
Which type of level of transfer is fully completed by the patient without transfer devices
independent
What are the 6 levels of assitance
Stand by assistance/supervision Close Guarding Contact Guarding Minimal Assistance Moderate Assistance Maximum Assistance
Which level of assistance includes verbal cues
stand by assistance/supervision
Which level of assistance involves close proximity to provide physical assist if needed
close guarding
Which level of assistance involves contact providing occasional balance and physical assist
contact guarding
Which level of assistance involves the therapist providing up to 25% assist
minimal assistance
Which level of assistance involves the therapist providing up to 50% assist
Moderate assistance