This document provides information on functional re-education. It defines functional re-education as educating patients on activities or movements they already know but cannot properly perform due to injury or illness, with the goal of making them independent. The document discusses the benefits of and approaches to functional re-education, including bed mobility transfers, sitting transfers like sliding boards, and standing pivot transfers. It emphasizes safety, instructions, and body mechanics during transfers.
Posture - a perquisite for functional abilities in daily life. Posture is a combination of anatomy and physiology with inherent application of bio-mechanics and kinematics. Sitting, standing, walking are all functional activities depending on the ability of the body to support that posture to carry out each activity. Injuries and pathologies either postural or structural can massively change the bio-mechanics of posture and thus affect functional abilities.
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
Posture - a perquisite for functional abilities in daily life. Posture is a combination of anatomy and physiology with inherent application of bio-mechanics and kinematics. Sitting, standing, walking are all functional activities depending on the ability of the body to support that posture to carry out each activity. Injuries and pathologies either postural or structural can massively change the bio-mechanics of posture and thus affect functional abilities.
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
A chronicle on muscle strengthening:
MMT is a procedure for the evaluation of strength of individual
muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM.
content from
(proprioceptive neuromuscular fascilitation article of Marymount University Fall 2009),
DPT AMIR MEMON (pnf presentation)
DPT AARTI SAREEM (pnf presentation)
Gait training Physiotherapy perspective.pptxSusan Jose
do you know what is gait?
lets know more this presentation.
can physiotherapist help you with your walking abilities. click on the above slide to know more.
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
A chronicle on muscle strengthening:
MMT is a procedure for the evaluation of strength of individual
muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM.
content from
(proprioceptive neuromuscular fascilitation article of Marymount University Fall 2009),
DPT AMIR MEMON (pnf presentation)
DPT AARTI SAREEM (pnf presentation)
Gait training Physiotherapy perspective.pptxSusan Jose
do you know what is gait?
lets know more this presentation.
can physiotherapist help you with your walking abilities. click on the above slide to know more.
Moving, lifting, transferring of the patient
MOBILIZATION
FUNDAMENTAL OF NURSING
UNIT XII
DEFINITION: Moving and lifting the patient means transferring the patient from one place to another (or) changing the position of the patient.
PURPOSE: To prevent bed sores
Maintain good body mechanism
Perform procedures such as back care
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Objectives
After successful completion of this lesson the
students would be able:
Define functional re-education
Explain the benefit and types of functional re-
education
Explain the goal of Transfer Training
Identify Precautions with Transfers
Explain type and level of assistant
List type of transfers
Perform transfers
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3. Functional re-education
Education is the process of teaching and learning
Function- related to day to day activities/functions
Re education means educating something, which is
already known by an individual.
Functional reeducation
The patient knows the activity or movements that
has be performed but due to injury, ailments,
disease pathology pt. couldn't perform it properly.
“Making the patient independent” is the main
goals
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4. Functional ……
It is a sequence of progressions of position like
the development of the milestone of the child
from lying to standing.
Depends on the condition and level the
independence the program can be designed.
Depending on the positions, the sequence can
be planned and multiple postures may be
overlapped during that program
Individuality –patient specific, teamwork and
modified movements
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5. Principles of functional reeducation…
Proper and thorough assessment
Assessment of functional ability need special attention
Treatment should be tailor made
Commands
Treatment should be task specific
Never ever discourage the patient
Feedback should be taken from the pt. and relatives
Treatment should be effective (physical independence)
Reviews are needed to record
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6. Functional re-education helps to…
Improve coordination, balance & proprioceptive
Increase strength and endurance of muscle
Increase the dynamic and static stability
Enhance the Improve postural stability
Improve the ambulatory skills
Restore a natural mind body connection
Optimize joint biomechanics
Restore normal movements
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7. Functional re-education can be done on…
On mat
On re-education board
Using parallel bar
Using suspension therapy
Using hydrotherapy
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8. Medical Conditions that can Alter Mobility
Fractures/sprains
Neurological conditions – spinal cord injury,
head injury/TBI, stroke etc.
Degenerative neurological conditions –
Myasthenia gravis, Guilin barren syndrome
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9. Types of functional re education
1. Bed mobility
2. Transfer
3. Ambulation
4. Activities of daily living
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10. # Bed mobility
Lying(supine, prone, side),Rolling, coming to sit,
Sitting Balance, weight shift and Ability to achieve
pressure relief and preparation for stance if
indicated.
The progression of bed mobility should be based
on the main theme of normal development
sequence.
Supine prone prone kneeling half
kneeling standing (mat activity)
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11. Supine to sit
• To get patient from lying down to sitting at the side
of bed
Explain the procedure of what you will be doing
Use proper body Mechanics
Support the patients body and bring them from
supine to sitting at the edge of the bed
Avoid pain as much as possible
Sit with patient to ensure safety, then when
ready position them for comfort or prepare for
transfer
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12. Supine to sit
• Dependent patients:
Move patient by body segments; lower legs, hips,
shoulders, head, etc. to scoot them closer to edge
of bed
Support shoulders while legs are close to EOB (edge
of bed), use proper body mechanics and lift
shoulders as legs lower
Support patient in sitting
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13. Supine to sit
Patients who need min/mod assist:
Have patients move toward EOB by scooting
their legs
Have them do bridges to scoot hips and trunk,
and lift their neck and shoulders
Once close to EOB, support patients shoulders
and assist them to sit
Patients should use legs to dig into side of bed
to help pull to sitting
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14. Supine to sit: log roll
Patients who need supervision:
Have patient bend knee and reach arm
across body
As knee falls across body and arm
reaches patient will roll onto their side
Once in side lying, pt. will use arm and
opposite elbow to push themselves up as
their legs come off the side of the bed
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15. Sit to stand
Have patient scoot to edge of chair
Pull feet back toward them so ‘’knees are
over the toes’’
Patients will use arm rails/chair rails to push
up on
Use gait belt for better grasp/safety
Can use a count of 1-2-3, have patient lean
forward as they push up; “nose over toes”
ensure no dizziness
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16. 2. Transfers
A transfer is the safe movement of a person
from one surface/location/position to
another.
Planning and organization are required
before a patient attempts a transfer.
Relying on the mental and physical ability of
the patient transfers may be done by the
patient alone,
With assistance of another person or
by another person.
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17. Benefits of transfers
Maintains & improves joint motion
Increases strength
Promotes circulation
Relieves pressure on the skin
Improves urinary/respiratory function
Increases social activity
Increased mental stimulation
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18. Safety First
Safety must never be compromised
Never select method of transfer by ease of
PT
When in doubt always use an assistant
Always stabilize equipment (use wheel
locks)
Secure all lines when transferring
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19. BEFORE A TRANSFER or Lift
Know patients’ sensory, physical, cognitive,
and behavioral status.
Be aware of any medical precautions.
Know your own abilities and limitations
Use good body mechanics.
Recognize when and how much
mechanical or human assistance is needed
for a safe transfer.
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21. Independent Transfers
• No assistance of any type needed for any
aspect of the transfer.
• Patient can perform set up and transfer safely
without any assistance.
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22. Assisted Transfer
• Patient actively participates in transfer but
requires assistance
• Types of assisted transfers
– Two-person lift
– Sliding board transfer (SBT)
– Squat pivot transfer
– Standing pivot transfer
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24. Dependent Transfer
Patient does not or cannot actively
participate in transfer.
May be able to assist minimally.
Types of dependent transfers:
• Sliding transfer from cart to table (team transfer)
• Three person carry
• Hydraulic lift transfer
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25. Levels of Assistance for Transfers
Maximum Assistance
Moderate Assistance
Minimal Assistance
Contact Guard
Stand By/supervision
Independent
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26. Maximum Assistance (Max A)
PT provides assist for
about 75% of total
patient’s work
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27. Moderate Assistance (Mod A)
PT provides assist for
about 50% of total
patient’s work
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28. Minimal Assistance (Min A)
PT provides assist for
about 25% of total
patient’s work.
Requires assist for
balance, to move an
extremity or assistive
device.
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29. Contact Guard (CGA)
PT supervises patient’s
work by CONTINUOSLY
guiding or guarding
with touch/contact for
support/balance
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30. Close Guarding Assist
PT supervises patient’s
work by INTERMITTENTLY
guiding or guarding with
touch/contact
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31. Stand – By Assist
Patient can perform
activities without assist but
do not do it consistently
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32. Independent (I) Transfer
PT supervises the
patient without any
assist
Verbal cues may be
require
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33. Amount of Assistance
When more than one person is required to
transfer a patient safely the number of people
required to complete the transfer is
documented
Example – 2 people required to use moderate
assistance
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34. General Rules of Transferring
Proper body mechanics
Use Transfer belt
Instruction and verbal cue
Complete the transfer
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35. Body Mechanics
Proper attention to body
mechanics and the relationship
of center of mass and base of
support allow the therapist to
maintain the safest position
while working with a patient.
*the patient close to your BOS
to decrease stress on your back
and arms.
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36. USE A TRANSFER BELT
Transfer belts are used around
the patients waist to provide a
secure point of contact and
control for the therapist.
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37. Instructions and Verbal Cues
A patient should always be informed the transfer
to be performed and what they are expected to
do.
Instructions should be in a manner that can be
understood by the patient.
Instructions should be short and clear
If more than one person is transferring a patient,
communication is essential.
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38. Completing The Transfer
The transfer is NOT complete until the patient
is safely and securely in the new position.
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39. Types of Transfers
Bed Mobility Transfers
Independent
With assistance
Dependent (sliding transfer)
Sitting Transfers
Push up
Sliding board
Two person lift
Standing Transfers
standing Pivot
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40. Bed Mobility Transfers
Bed mobility transfers can be done independently or
with assist to move in bed.
Patients may need assist with bed mobility due to
weakness, obesity, Para or quadriplegia, amputation or
cognitive problems.
Bed mobility can help to prevent pressure ulcers/sores
and decrease joint contractures.
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41. Bed mobility- independent transfers
supine side lying
sitting on edge of
bed/table
Can also be taught to
avoid excessive strain on
LB.
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42. Bed Mobility- with Assistance
Assist from therapist
Assist from assistive
devices i.e. bed rails and
trapeze (should only be
used if necessary.
REMEMBER the goal is to
get patient independent if
possible
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43. Bed mobility- Sliding Transfer
Used to move
patient to/from cart
and treatment table.
3 or more
clinicians perform
the transfer using a
draw sheet.
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44. Sitting - up transfer
A push up transfer is
used when patient
Have enough
strength to lift
themselves from the
supporting surface
and sufficient sitting
balance to move
safely.
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45. Sitting assisted transfers - sliding board transfers
Can be done with assist
of PT or (I)
A sliding board is used
when a patient does not
have enough strength to
lift most of the weight of
the buttocks,
sufficient sitting balance
to move in a sitting
position safely but can
not perform push up
transfers.
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47. Sitting -Two Person Lift
The 2 person lift is an
assisted transfer with
max assist of 2 people.
This type of transfer is
often used to move a
pt. from WC to/from
floor or lower surface.
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48. Standing pivot transfer
Used when a patient, can sit,
stand, pivot, and bear some
weight on the LE, but have some
weakness, paresis, paralysis, or
loss of balance or sensation, which
necessitates assistance to transfer
safely.
Amount of assist will vary usually
moderate to minimal assist
Better to transfer leading with
stronger LE in MOST cases.
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49. Hydraulic Lift
A hydraulic lift is a
mechanical device that
allows one person to
transfer a dependent
patient.
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50. Time to Transfer
Introduce Self To Patient
Explain What Will Happen During Rx
Explain What Is Expected of Patient
Is Patient Ready? Does He Need Shoes Or Other
Clothing?
Assess Area For Safety
Use Gait Belt
Use Proper Body Mechanics
Make Sure Surfaces Are As Level As Possible
Give Clear, Concise Commands
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51. 3. Ambulation
Clients who have been immobile even for a
short time may require assistance
A client may require the use of an assistive
device to increase stability, to Support a weak
extremity and to reduce the load on weight
bearing structures
Use of a gait belt
Surfaces:
Even and Uneven
inclines/declines
change in surface (tile to carpet to grass)
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52. 4. Activities of daily living
Gait training with an appropriate assistive
device, like walker or cane
Walking in smooth surface.
Walking in rough surface and in obstacles,
Squatting, toileting , dressing, feeding
Stair climbing
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