Easy Does It! Guidelines for Assisting Mobility-Impaired Clients to Move Safely.

This videotape was created by a physical therapist and a nurse to demonstrate how an interdisciplinary rehabilitation team uses ongoing assessment to provide mobility and safety training for both the client and the caregivers. The tape is divided into three segments: part 1 reviews cerebrovascular accidents (CVA) and introduces bedside assessment of the client; part 2 covers transfers; and part addresses mechanical lifts, seating, and ambulation.

Part 1 begins with a review of the changes that occur in an individual who has had a CVA, with an emphasis on how these changes determine the person's ability to move in his or her environment. The bedside assessment, completed as soon as possible after admission by a mobility team (nurse, physical therapist, and occupational therapist), determines bed mobility, transfer status, and seating requirements. Proper lifting techniques for the caregivers are demonstrated. Bed mobility techniques introduced include the use of lift and draw sheets, teaching the client to bridge, and how to protect affected extremities.

Part 2 reviews the principles used in safe transfers and illustrates the differences between supervised, minimal, and maximal assistance. Use of the transfer belt, board, sling, and disk is demonstrated for clients with hemiplegia and other neurological disorders.

The use of a mechanical lift to transfer clients is shown in part 3. Optimal seating guidelines are outlined, and the mobility team demonstrates how to safely position the person with quadriplegia in the chair. Lastly, the videotape shows aids used for ambulation, including straight and quad canes and standard and rolling walkers. The role of the physical therapist in determining the ambulation status of the client and communicating the information to the team is outlined.

This videotape presents basic principles concisely and illustrates them with actual clients and caregivers. More information on assistance and safety during activities of daily living, such as getting in and out of a car, using the bathroom, or going up and down stairs, would have been useful. The part on ambulation emphasizes the importance of reinforcing good walking habits, but only briefly mentions a few of the many alterations in gait that occur in clients with neurologic conditions.

Students in physical therapy, physical therapy assistant, nursing, nursing assistant, and occupational therapy programs could be introduced to principles and techniques of mobility assistance by viewing this videotape prior to practicing techniques in their laboratory classrooms. Directors of physical therapy and occupational therapy clinics might find this videotape useful to show to aides who receive on-the-job training. This tape would be useful in the libraries of schools and hospitals to refresh the memory of caregivers about safety for both clients and caregivers.