Hello Susanne:

For some reason, I can't not successfully download the videos... aahh!

Your  suggestion about not moving sideways was very helpful. The patient
did agree that sideways movement was not an option.

I  think that single biggest problem hindering transfers is that she can
NOT  clear  her bottom unless she has a high placement for her UE's. The
suggestion to make the mattress edge firmer was MOST helpful!

The patient is able to move backwards while long sitting in the bed, but
her  pants end up around her ankles. She is unable to move forward while
long-sitting but she may learn using a "hip walking" strategy.

----- Original Message -----
From: susanne <[EMAIL PROTECTED]>
Sent: Wednesday, May 30, 2007
To:   [email protected] <[email protected]>
Subj: [OTlist] On-line Colloboration (5/29 Update)

s> Hi Ron - thanks for the update!

>> Just  got  back  from  an  appt. with the person w/ a 
>> T9-T10
>> spinal cord
>> injury. She confirmed that independent transfers and 
>> taking a
>> shower are
>> her two primary goals.
>>
>> The  pt. was able to indpendently go from supine to 
>> bedside
>> sitting.

s> Good!

s> She
>> is  able  to perform a slide board transfer from the bed 
>> to
>> her w/c with
>> min-mod  asst  (primarily  for  LE placement).

s> Did you check the "transfers" video links I sent you - some 
s> are done by quads. Look at Shaun and JGNI. Note how and at 
s> which points they move their legs.
s> Oh - and maybe try a different sliding board! And try 
s> sticking it under the seat cushion.

s> However, she is
>> UNABLE to
>> perform sitting bed mobility.

s> again if you look at those two guys, they never move 
s> sidewards while sitting on bedside. Their positioning in bed 
s> is done something like half sidelying (they also both 
s> demonstrate some active elbow extension, which is c7 
s> function, so I don't quite trust their SCI-levels - but sure 
s> they are quads).

>> She  is short and bottom-heavy. With her hands on the bed 
>> and
>> her elbows
>> fully extended, she still has too much weight on her 
>> bottom.

s> Both build and firmness of surface has a lot of influence. 
s> It's often more difficult for women. When she's able to turn 
s> in bed at night, maybe use a firm mattress. And if using a 
s> softer overlay, this should not extend all the way to the 
s> side of the bed. (We actually sleep on a futon, bf with an 
s> overlay - will find a link for that one later)

>> She tried a
>> push-up  block  but  it  "sunk"  into the mattress.

s> Are we talking bedside sitting here? And what is she trying 
s> to do - move sidewards? Oh - because it's a power chair, she 
s> can't just drag it closer - is that it?


s> They have
>> a mattress
>> overlay  that  they  are  going to try to see if this give 
>> a
>> comfortable
>> nights sleep while being firm enough to assist with 
>> transfers.


>>
>> She  has  difficulty moving her LE because of trunk
>> instability but this
>> should quickly improve.

s> Yeah - that and strong arms and shoulders will make the 
s> difference, I believe. Lifting weights is often recommended. 
s> Also working on the half-lying bed mobility (long-sitting 
s> etc).
>>
>> If  you  remember she was weaning herself off the TLSO. 
>> She
>> told me that
>> on  Saturday, she went all day without it and she did not 
>> wear
>> it during
>> today's therapy.

s> Good - now onto strengthen those trunk muscles, also so she 
s> don't hurt herself.

>> Next  week,  I  think  we  will  tackle  tub transfers.
>> Probably using a
>> standard tub transfer bench.
>>
>> So,  what  suggestions  can  you  give regarding bed 
>> mobility
>> and/or tub
>> transfers.

s> We don't have many tubs left in Denmark, so I guess I can 
s> only spell "roll in shower". Or, if there's a drain in the 
s> bathroom floor, then showering while on (a commode over) the 
s> toilet cuts down on both time and transfers. My bf does 
s> this. The hot water also helps relax and speed up the BM 
s> procedure. Got a long shower hose, with an on/off button on 
s> the shower head. (No - no private pics - LOL).

s> Warm greetings

s> susanne, denmark
s>  - girlfriend of a great guy with quadriplegia 




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