Background

Mobility is crucial to independence. Loss of mobility can equate to a person losing the ability to participate in their occupation. In this section, we offer six videos for the occupational therapy (OT) practitioner to review that address the following: adaptive mobility devices (AMDs); training on how to size adaptive devices for clients; mobility training for ascending and descending stairs, which includes falling and lowering; controlled lowers that demonstrate how to safely assist your client to the floor in case of a fall; fall recovery, which demonstrates how to assist your client after they have fallen; and advanced transfer training for the caregiver or caregivers. We discuss how the OT practitioner can employ individual mobility equipment, the proper body mechanics to use when transferring clients, and the caregiver’s role as mobility assistants.

This section also builds upon the information you learned in the “Introduction to Transfers and Mobility” in Physical Dysfunction I and Modalities I.  As you go through this section and the associated lab, reflect on the clients you have seen and the conditions we have discussed. The skills in this lab are widely applicable across clients and settings.

Adaptive Devices

This video introduces you to various adaptive devices.

Adaptive Devices Video Transcript

Adaptive Device Training

This video describes how to fit and safely use an assisted device or mobility device.

Adaptive Device Training Video Transcript

Adaptive Mobility Device Fitting Tips

• Adjust the adaptive mobility device so that when the client is standing, the device’s handle is in line with the crease of the client’s wrist and until the handles rest on the crease of the wrists.

Adaptive Mobility Device Safety Tips

• Make sure that your client stands in the adaptive mobility device’s “box.”
• Make sure that your client does not hold on to other objects. Advise them to use a basket or bag, ask for help, or slide objects along the counter.
• Advise your client to not pull up on the walker to stand.

Stair Training

This video demonstrates how to train your client to go up and down stairs.

Stair Training Video Transcript

Ascending Stairs Tips

• Step up with the stronger leg.
• Bring the weaker leg up to the same step. Repeat.

Descending Stairs Tips

• Step down with the weaker leg.
• Bring the stronger leg down to the same step. Repeat.

Controlled lower

This video demonstrates how the OT practitioner can safely assist their client to the floor in case of a fall.

Controlled Lower Video Transcript

Controlled Lower Tips

• If a client loses their balance, use the gait belt to help correct, if possible.
• If a client begins to fall, it is best to lower them slowly to the ground with the goal of protecting them from injury.

Fall Recovery

This video demonstrates how the OT practitioner can assist their client after they have fallen.

Fall Recovery Video Transcript

Fall Recovery Tips

• If a client is on the ground, first confirm that the client is not injured, and obtain medical assistance if necessary.
• Once the client is able, have them crawl to a chair. Use the chair to help them into kneeling and then to pull themselves up to sit on the chair.
• If the client cannot do this, call 911 or for other assistance.

Two-Person Transfers

This video demonstrates how the OT practitioner can transfer a client with the assistance of another person.

Two-Person Transfer Video Transcript

Two-Person Transfer Tips

• Positioning
  • The lead practitioner positions themselves in front of the client.
  • The person assisting with the transfer positions themselves behind the client.
• Performing the Transfer
  • Both practitioners grasp the gait belt.
  • The lead practitioner uses the gait belt to pull the client forward.
  • The person assisting uses the gait belt to guide the person onto the chair.

Resources

• Proper Transfer Techniques: Tips for Safe Patient Transfers by
  Lauren Doss, OT
• Safe Patient Handling and Mobility (SPHM) by U.S. Department of Veteran’s Affairs