Ron, Most people I have worked with actually move their upper body first and then physically lift their legs and move them over. In other words, they press down and lift their bottom up and scoot over toward wher they are transferring. Depending on how far a distance it is, they may have to bring their legs over after each scoot or they may be able to complete the scooting and then move their legs at the end. If they move their legs first, it usually will make balance too "off". At least that has been my experience! Mary Alice On May 26, 2007, at 3:54 PM, Ron Carson wrote:
> Thanks Rob. > > Yes, she definately needs to address dynamic sitting balance. But > this > will improve quickly. She's been wearing her TLSO for many, many > months > and we just started weaning her off. > > Will you further explain the "press transfer". The patient has > NO LE > movement. I envision that she will need to physically place her > LE in > the direction of transfer and then push up her bottom and > swing her > torso over her legs. Is this technique the same as the "press > transfer". > > She has no bowel/bladder control so toilet transfers are not an issue. > > I already talked with her about hand controls. > > Keep the ideas coming. Also, I'm sure more questions will develop > with > time. > > Ron > > ----- Original Message ----- > From: Rob Koch <[EMAIL PROTECTED]> > Sent: Saturday, May 26, 2007 > To: [email protected] <[email protected]> > Subj: [OTlist] OTnow Colloboration With Spinal Cord Injury > > RK> Ron, > RK> I always start by considering what the person needs to > RK> do in daily life. > RK> At this level of injury the person should become > RK> completely independently from the wc. So the goal is > RK> to try to get the patient to buy into the idea that > RK> the goal is to be independent - not walk again! > RK> Unless of course she has an incomplete injury with leg > RK> movement. > > RK> So on to a purely occupational therapy session! > RK> Start with LE dressing in bed or first transfer > RK> intothe wc and then get dressed. > RK> She may be able to get dressed better in the chair. > RK> The goal should be to press transfer (without board) > RK> at her level. > RK> Next she can practice transfer to toilet and do > RK> toileting. > RK> Transfer to the tub transfer bench and do bathing > RK> Obviously all these functional tasks require sitting > RK> balance work. > RK> After self care is done time to make breakfast. > RK> Propelling chair into and around kitchen opening > RK> refrigerator, drawers, cabinets and using the stove, > RK> microwave. > RK> A big part is making sure everything is accessible > RK> from wc. > RK> Since she doesn't have to do lifting and self care > RK> activities with the child she can work on making > RK> breakfast for the family. > RK> If she is a homemaker it is on to homemaking > RK> activities from the chair > RK> Laundry, dishes, etc emphasizing accessiblity all the > RK> time and work simplification > RK> If she if off to work car transfers will be mandatory. > RK> She should be able to drive with hand controls. > RK> She should also experience life in the community - > RK> shopping, movie, buying gasoline, etc - how accessible > RK> is the world around her? > RK> Find out in OT! > RK> Many, many opportunities for good "occupation-based" > RK> therapy. > RK> Rob Koch > > > RK> I assume the woman has a complete injury - otherwise > RK> squat/stand pivot transfers > RK> --- Ron Carson <[EMAIL PROTECTED]> wrote: > >>> Here are some specifics: >>> >>> 1. There is no insurance >>> >>> 2. The patient is young, late 20's, mid 30's >>> >>> 3. She lives with her husband, sister and her >>> husband >>> >>> 4. She has a 4 y/o daughter >>> >>> 5. There is no primary care doctor; She typically >>> uses the ER >>> >>> 6. We have just starting weaning her off her TLSO >>> >>> 7. She has a donated power w/c (reclining captain's >>> back) >>> >>> 8. She has no pressure ulcers >>> >>> 9. She is able to sit without assistance and >>> without her TLSO. But she >>> has LOB with UE movement. But this will shortly >>> correct with practice >>> >>> 10. She is undergoing a sacral nerve stimulator >>> trial to hopefully d/c >>> cathing and suppository/digital stimulation. It >>> seems to be working OK >>> >>> 11. She has good UE strength >>> >>> 12. Initial goal is indpendent with transfers. >>> Currently uses a sliding >>> board with min - max assist depending on incline. >>> I envision that she >>> will be able to d/c sliding board and do her >>> transfers w/o assistance. >>> >>> 13. I also think a long term goal is for her to get >>> a ultralight-weight >>> w/c. >>> >>> 14. She has a weight issue but she is struggling to >>> find enough activity >>> to off-set her caloric intake. >>> >>> 15. They have no computer so on-line resources are >>> not possible at this >>> time. >>> >>> OK, hit me with some transfer ideas!!! And any other >>> suggestions. >>> >>> ----- Original Message ----- >>> From: Ron Carson <[EMAIL PROTECTED]> >>> Sent: Friday, May 25, 2007 >>> To: [email protected] <[email protected]> >>> Subj: [OTlist] OTnow Colloboration With Spinal Cord >>> Injury >>> >>> RC> Hello All: >>> >>> RC> I recently agreed to treat a patient who >>> suffered a T9-T10 SC injury >>> RC> late last year. She has just been d/c to her >>> home after several months >>> RC> of rehab. While I have worked with SC injury >>> patients, I do not consider >>> RC> it a speciality. There are SO many issues to >>> manage and address that it >>> RC> can be a bit overwhelming. Given that I >>> work alone, I don't have a >>> RC> 'team' to bounce off ideas, so I'm hoping that >>> OTnow members will be my >>> RC> surrogate team? <smile> >>> >>> RC> I would like to give and receive advice on >>> topics relating to this case. >>> RC> Do you think this will work? Will people >>> participate?? >>> >>> RC> Thanks, >>> >>> RC> Ron >>> >>> >>> >>> >>> -- >>> Options? >>> www.otnow.com/mailman/options/otlist_otnow.com >>> >>> Archive? >>> www.mail-archive.com/[email protected] >>> >>> > RK> > ********************************************************************** > **************** >>> Enroll in Boston University's post-professional >>> Master of Science for OTs Online. Gain the skills >>> and credentials to propel your career. >>> www.otdegree.com/otn >>> > RK> > ********************************************************************** > **************** >>> > > > RK> Need Functional Therapy Activities? > RK> http://hometown.aol.com/MrFunction > > > > > > > RK> > ______________________________________________________________________ > ______________Got a little couch potato? > RK> Check out fun summer activities for kids. > RK> http://search.yahoo.com/search?fr=oni_on_mail&p=summer > +activities+for+kids&cs=bz > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > ********************************************************************** > **************** > Enroll in Boston University's post-professional Master of Science > for OTs Online. Gain the skills and credentials to propel your career. > www.otdegree.com/otn > ********************************************************************** > **************** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
