Proper Patient Positioning and Handling is Essential

If there is one key point that I’ll take away from my neurology placement, that would be the importance of maintaining a high standard in our positioning of patients and the way in which we handle patients during transfers and therapy sessions.

First to the topic regarding the positioning of a patient who has suffered a stroke, whether in bed or a wheelchair. Over the past weeks, I’ve witnessed the effect poor positioning has on the level of upper/lower limb tone and the de-activation of postural tone. Having an upper limb positioned in a not so optimal position in bed on a repeated basis will increase the potential for a loss of ROM and function. This should be addressed with nursing staff and OT as soon as possible as the patient’s functional outcome is the priority.

Additional information that can be relayed to the nursing staff is the positioning in a wheelchair as many patients will be transferred when a therapist is not present. A great strategy that was pointed out to me was when working with a patient in a wheelchair, ensure that the patient has neutral pelvic tilt by having them lean forward and if their pelvis remains in contact with back of the chair then a good position has been achieved. Also ensuring that the pelvis is centered in the chair is a priority. As the patient will be spending a significant amount of time in the chair it’s important that they have every opportunity to increase their postural tone when not having physiotherapy.

To the topic of our handling of patients’ limbs and during transfers, I believe we must look at this from the patient’s perspective. I’ve had a couple of patients mention the difference when they’ve been handled by individuals who take a bit of care and those who don’t. Guess which way was better? I think patients will be much more receptive to our treatment sessions if they feel like they are being handle with care and respect, thus making our sessions that more effective.

Anyway I hope that everybody has enjoyed their placements and good luck this week.

Gareth