As physical therapist who often handles patient with disabilities that limits their movements and functioning, it is very important for us to be able to position them properly since they stay on those positions in a long period of time. Our job is to increase their comfortability while not compromising the proper positioning of their body parts. This is also to prevent any other complications that may arise due to prolonged improper posture or improper bed positiong

1. Proper
Patient
Positioning
Technique of placing the
patient safely, comfortably
and effectively in
preparation for any
procedure

2. INTRODUCTION
Patient positioning must be considered before, during,
and at the conclusion of treatment and when a patient
is to be at rest for an extended period.
Patient positioning involves properly maintaining a patient's
neutral body alignment by preventing hyperextension and
extreme lateral rotation to prevent complications of immobility
and injury.

3. RATIONALE
Proper positioning is important for the following reasons:
• It prevents soft-tissue injury, pressure, and joint
contracture.
• It provides patient comfort.
• It provides support and stability for the trunk and
extremities.
• It provides access and exposure to areas to be treated.
• It promotes efficient function of patient’s body systems.
• It relieves excessive, prolonged pressure on soft tissue, bony
prominences, and circulatory and neurologic structures.

4. Pressure
Sores
Areas of unrelieved pressure
leading to ischemia and
damage to the underlying
tissue

5. Most Common Sites for
Pressure Sores

8. GUIDELINES
IN PROPER PT
POSITIONING
·When turning or
positioning a patient, the
patient must be lifted or
turned rather than dragged
·Wrinkles in the sheet,
blanket or personal
clothing should be avoided

9. WHEN and HOW
OFTEN do we need to
reposition our
patients?

10. • 5-10 MINUTES - patient skin tolerance to new position
• EVERY 2 HOURS - Patient repositioning when in
supine
• EVERY 10 MINUTES - Patient repositioning when in
sitting
Methods to relieve Pressure in sitting:
a. sitting pushups
b. leaning side to side
c. leaning forward

11. - Pillows, rolled towel or blanket are used to support body
parts and to avoid strain or pressure on ligaments, nerves
and muscles.
- “Bridging the gap”- a method which a sensitive area
must be relieved of all pressure by supporting the limb
segment just proximal or just distal to the sensitive area

12. Proper Positioning

13. 1. Supine
a. Provide a firm supportive
mattress. Use bedboard if the
bed is sagging.
b. Place a pillow under the
head, the neck and the upper
shoulder.
c. Place the arms slightly
abducted along side the body
with the forearms slightly
pronated and supported with
pillows.
d. Give the patient hand rolls
to grasp.

14. 1. Supine
e. place a small pad or pillow
under the lumbar curve
f. Extend and slightly abducted
the thighs and place sand bags
or trochanter rolls alongside
the lower extremity.
g. Place the feet apart about 3
in. and at right angle to the
legs with the use of a foot
board or support extending 3-
5 in. above the toes.

20. 2. Sidelying position
a. Place the patient on his side.
b. Support the head and the neck on a pillow, keeping them
straight with the spine.
c. Flex slightly abducted upper arm in front and support it with
a pillow.
d. Place a firm pillow against the back.
e. Flex the lower extremities at the hips and the knees with the
upper one more acutely flexed than the lower one.
f. Support the legs from the thigh to the foot with a pillow in
between the legs.

24. 3. Prone
a. Help the patent assume the horizontal recumbent position.
b. Assist him to turn over his abdomen.
c. Turn the head on one side.
d. Place the arms at the sides or flex or extended upwards.
e. Allow the feet to hang over the edge of the mattress.
f. Drape as in dorsal position.

27. 4. Fowlers
a. Place the patient in a horizontal recumbent position.
b. Elevate the head of the bed to approximately 45 deg angle.
c. Flex the knees slightly and support them with knee roll.
d. Drape as in dorsal horizontal.
5. Trendelenburg
a. assist the patient to a horizontal recumbent position.
b. Elevate the foot of the bed so that the lower trunk is higher
than the head and shoulder.
c. support the shoulder and knees.
d. Drape as in horizontal recumbent.

31. Preventative
Positions

32. TRANSFEMORAL AMPUTATION

34. TRANSTIBIAL AMPUTATION

35. HEMIPLEGIA
When the patient’s upper extremity is involved, the following
positions should be avoided: prolonged shoulder adduction
and internal rotation; elbow flexion; forearm supination or
pronation; wrist, finger, or thumb flexion; and finger and
thumb adduction
When a patient’s lower extremity is involved, prolonged hip
and knee flexion, hip external rotation, and ankle plantar
flexion and inversion should be avoided.

36. HEMIPLEGIA

37. HEMIPLEGIA

38. RHEUMATOID ARTHRITIS
Prolonged immobilization of the affected
extremity joints should be avoided, particularly if
the joint is maintained in flexion. Bony
prominences, especially the elbows and greater
trochanters, should be protected for the person
who is immobile in bed

39. SPLIT THICKNESS BURNS AND GRAFTED AREAS
It is important to avoid prolonged positioning of the
joints that have been affected by the burn or the graft
used to repair the wound. It is particularly important to
avoid positions of comfort. A position of comfort for
the patient with a burn is the position that does not
produce stress or tension to the wound or graft.
Prolonged flexion or adduction of most peripheral
joints should be avoided when the burn is located on
the flexor or adductor surface of a joint.

40. OTHER ORTHOPEDIC CONDITIONS
• TOTAL KNEE REPLACEMENT - keep the affected
knee in extension. Knee should be placed in full
extension (with no pillow) and in a neutral position
at the hips. A rolled towel or wedge can be used at
the hip or lower leg, if necessary, to maintain a
neutral position
• TOTAL HIP ARTHROPLASTY - motion of the affected
limb must be restricted to avoid excessive hip
adduction, rotation, and flexion. Prevention of hip
flexion beyond 90 degrees is most important