AIM:
To train lifting the legs onto the bed (wheelchair to bed legs down transfer, complete T4 paraplegia)
Rationale:
An important component of transferring from the wheelchair to bed is lifting the legs onto the bed. Training is set so the patient can practise something similar but simpler. Two strategies are illustrated:
1. Moving legs across the bed
2. Moving legs up and onto bed
Equipment:
- Wheelchair
- Height-adjustable wide bed
- Stools
- Wheelie stool
Key Points:
1. Moving legs across the bed
- Patient is positioned in long sitting on the bed
- Therapist is positioned behind patient on bed
- Ensure patient uses one hand to balance the trunk while the other hand reaches down as close as possible under the ankle to lift the leg and move the leg sideways
2. Moving legs up and onto bed
- Patient is positioned on the bed in long sitting with the feet supported on a stool
- Ensure patient uses one hand to balance the trunk while the other hand reaches down as close as possible under the ankle to lift leg up and move it onto the bed
- Patient repositions balancing hand between legs before lifting other leg up onto bed
Common Errors:
- Therapist is too far away from patient to ensure safety
- Patient does not lean sufficiently forwards and consequently falls backwards
- Patient fails to use balancing arm and falls forwards
Progression and Variety:
- Decrease height of stool
- Remove stool and lift legs from floor