Mobility and Transfers in OT

    When discussing restoring confidence in mobility, clients want to be as independent as possible for their daily demands. So, the hierarchy of mobility skills helps to guide and give ideas of what level a client is at during treatment. Bed mobility is the lowest on the hierarchy of mobility skills because it has the biggest base of support. Ultimately, bed mobility is the ability for the body to perform activities in bed whether that be supine, prone, side lying, or sitting. These functional skills allow for the client to engage in ADL’s, sleep, and provide pressure relief to avoid pressure injuries. Bed mobility is the basic skill needed in preparation for transfers. These skills are needed in order to build on to one another to become more independent and more mobile. 

            The pyramid continues with mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, community mobility and driving. As a client progresses, they will continue to go up the pyramid and progress mobility. The body is easier to move when the base of support is smaller and the center of gravity is moving away from the center of base support. To include, the line of gravity is near the outer edge of the base of support, and extraneous joint motion is controlled. The base of support gets smaller as the client works their way up the pyramid, so the client must learn how to keep their body stable while performing their daily activities. I agree that this makes the most sense when discussing the hierarchy of mobility.

 

            In order for a client to perform any task, they must have awareness of their body position. Sensory inputs an important role in coordinating balance such as visual, vestibular, and proprioceptive input. Along with sensory input comes the motor output which applies to compensatory and anticipatory postural adjustments. These are all very important to roles when discussing mobility overall. 

 

I had little knowledge about the organization of mobility skills and their difficulty level before this class. Speaking as a former patient transporter in a hospital, I think this is scary that I was not required to learn this material. Transporters are constantly moving patients from bed to wheelchair, bed to bed, and many other positions throughout the day. I think knowing this information could have benefitted me by protecting myself and creating an environment that is safer for my client. This would have given me a better idea of how well a patient can move and noticing times to step in. Taking what I have learned in many of my classes, I can think of so many things that I did correctly in my job description. I can also remember so many things I did incorrectly, and I think knowing this material could have kept me from making so many mistakes. As for the future, I hope to ensure safety for my clients when transferring them. I am confident that I will continue to learn more about mobility skills and how to create the safest, most efficient way to help a client move for their activity demands. 

@amy_cole_studio