The ability to move and position/re-position oneself is a critical life skill and dysfunction of this ability often results in significant health deficits and loss of functional independence and related components. Treatment to assess movement and positioning dysfunction and facilitation/restoration of functional movement is important to all therapies. Awareness and prevention of dysfunction/disease related to poor posture and its potential for negative outcomes will be covered. During this course, healthcare professionals will participate in two lab sessions and program development practice to ensure success in providing effective treatment. Participants are introduced to relevant assessment components related to positioning problems, multiple positioning interventions, realistic/functional goals for correction of positioning deficits and restoration of more normal/functional positioning. Additionally, awareness of pressure and issues related to positioning are presented, providing an opportunity to experience current preventative strategies and equipment in a meaningful/hands-on atmosphere.
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The Who, What, When, and Why of Positioning
- Identifying positioning needs
- Functional areas for positioning
- Age related positioning issues
- Effects of Poor Positioning Bed Positioning
- Why are Residents “Bed-bound”?
- Body alignment of “Non-risk” Residents
- Positioning for non “high risk” Residents
- Functional considerations in bed positioning
- Pressure concerns
- AHCPR guidelines/Definitions
- Tissue off-loading of immobile vs. semi-mobile Residents
- Handling and transfer techniques for “fragile” Residents
- Special conditions/ considerations
Bed mobility & Positioning Lab
- Assessing bed mobility
- Movement/handling techniques (mobile vs. immobile)
- Positioning for pressure relief
- Positioning for Pathological/Orthopedic/Neurological conditions
- Tone management
- Tissue/joint mobilization and ROM (from bed)
- Functional activity positioning
- Special conditions/considerations (restraint management, stomach emptying, respiratory function, etc)
- General screening procedure (rules of thumb)
- Optimal Wheelchair seating position
- Functional considerations
- Pressure Areas/issues in sitting
- Managing Pressure in Wheelchair
- Wheelchair Modifications
- Special conditions/ considerations
- Review of Chart w/emphasis on Medical condition
- Mat evaluation
- ROM (AROM/PROM)
- Posture (Trunk mobility, pelvic tilt & vert. curves)
- Strength (for wt. shift)
- Tone (low vs. high vs. abnormal)
- Overall endurance
- Propulsion style
- Functional/ADL considerations
- Cognitive status (fall risk)
Wheelchair Adaptations Lab
- Adjusting Axle/Castor position
- Cushion selection/ trial/”bottom-out test”
- Drop seat application
- Lateral supports (Carved foam & calf panel)
- Modifying foot rests (solid foot plate/calf panel)
- Extended Brakes
- Self-pressure relief exercise/education
Implementing Positioning in Your Facility
- Initial meeting
- Selecting team and identification of roles
- Initial Facility training
- Selection of initial trial Resident’s
- Initiating treatment
- Staff/family education
- Monitoring/Team Reassessment
- Developing a “Preventive” atmosphere
- Trunk mobility/strengthening
- Soft tissue mobilization/elongation
- Functional activities
- Strength Training/Self-pressure Relief
- Staff/Caregiver Education
- Case Study/Example Goals and Billing Issues
- Assessment/adjustment of Positioning plans
- Monitoring to assure plan/adaptation changes with Resident
- Case Study Example
- Billing Issues/How to bill for Positioning
- Sample goals
Course Goals & Objectives:
Participants will achieve an increased awareness/knowledge of positioning affects both in dynamic and static as well as bed and wheelchair positioning. They will be able to assess the fundamental/root cause for abnormal or non-functional positioning and make treatment decisions/plans to address functional limitations of those root causes by means of strengthening, stretching, adaptations use of appropriate compensatory techniques based on more complete knowledge of commercially available DME (durable medical equipment) or appropriate hands-on modifications. The clinicians will also be able to assess the effectiveness of established plans/treatments and modify as needed and appropriate.
- Identify Residents in need of positioning intervention (bed and/or wheelchair).
- Identify the risks of immobility and its interaction with health, functional activity participation and self-confidence.
- Identify physical barriers in need of assessment and how to correct to allow better positioning in bed/wheelchair.
- Recognize functional goals for correction of positioning deficits to allow increased independence and prevent negative outcomes such as pressure ulcerations, contracture, etc.
- Identify the use of several types of positioning/wheelchair accessories needed to promote functional posture.
- Identify anatomical structures related to maintenance of good posture in wheelchair sitting.
- Identify correct use of pressure management equipment for use in bed and in wheelchair systems to achieve effective relief of pressure.
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Contact Hours: 6 contact hours in length (check your state’s approval status in the state specific course catalog for your profession).
Target Audience: Physical Therapist, Physical Therapist Assistant, Occupational Therapist, Occupational Therapist Assistant
Instructional Level: Intermediate
Criteria for Completion: Criteria for Completion: A score of 70% or more is considered passing. Scores of less than 70% indicate a failure to understand the material and the test will need to be taken again until a passing score has been achieved
Financial – George Bryant is contracted with Rehab Synergies and receives a salary. He receives payment from HomeCEU for the presentation of this course.
Nonfinancial - no relevant nonfinancial relationship exists.
Content Disclosure: This course does not focus solely on any specific product or service
Cancellation Policy: For activity cancellation, returns, or complaint resolution, please contact Anne Osborn by email Anne@HomeCEU or by phone at 1.800.55.4CEUS (2387). We have a 100% satisfaction guarantee. Refunds will be issued for courses that have not been completed (exam not taken), or for any course that has been rejected by your board of approval. Webinar attendance must be canceled 24 hours before the scheduled start time.