By Suzanne Maddison/Helen Morgan specialists physiotherapists.
We get asked by many patients what rehabilitation involves? What is the path I need to follow to be able to walk gain after prolonged bedrest/ illness or surgery? We have mapped out a series of functions that need to be achieved. It makes very interesting readings, as for some of us walking is taken for granted.
Self-care
- Feeding
- Grooming
- Washing
- Dressing upper body
- Dressing lower body
- Toileting
- Management of continence & products
Sitting
- Able to move from supine/lying to sitting
- Able to sit unsupported by person or chair for a period of time
- Able to then reach above head/across body/tough toes
- Able to reach out of base of support and grasp
- Able to multitask/divided attention whilst maintaining sitting
reactive responses and strategies/return to midline to loss of sitting balance
- Able to roll over
- Able to lie down/sit up
- Able to move body up the bed
- Able to bridge
Transfers
- Able to transfer in/out wheelchair on/off bed on/off shower chair on/off toilet/bath/commode/car
- Able to perform the action from sitting to standing consistently (and predictably)
controlled descent to sitting (thinking about tipping/backward leans where people’s pelvis’ shift off front of chairs etc when fast and backward/plank like lean) - Able to stand for appropriate time for transfer to be completed safely
Standing
- Able to stand for a period of time with support then without support – reliable acceptance of base of support and consistent orientation and awareness of midline
- Able to reach out or carry out a task
- Able to weight transfer, free leg for swing phase – laterally to offload free leg and establish contralateral stance &, anteriorly to transfer from rear foot stance to forward foot stance-
- Rotate within Base of support-
- Eyes open/eyes closed, head turns (vestibular aspects)
Narrow and wide base of supports - To be able to control step – and adequate foot clearance in swing-
- Be able to coordinate
- Steps with an aid/without an aid
- Be able to walk varying speeds/different surfaces/change direction, stop effectively, turn, shift gaze/negotiate obstacles
Requirements of efficient Movement
Postural control is the foundation for movement. Body parts needing to interact, segments join. For functional movement balance strategies, patterns of movement, speed accuracy, strength and endurance are needed. Other considerations:
- Problem solving
- Memory
- Orientation
- Attention
- Safety- able to judge own safety
- Good sleep hygiene
- Consider pain levels
If you need further information on rehabilitation and how we can help you regain function in your own home please contact us on 01245 377118
