I. Residual disabilities that will impede the STG of performing a squat-pivot transfer with mod A include L unilateral neglect, decreased ROM on the left side, LUE flaccidity, LLE strength of 3-/5, orientation only X 2, only follows two-step directions and requires redirection to stay on task, and emotional lability.
Available function and strengths for STG achievement are intact and functional R side of his body, alertness, motivation, and the support of his family, co-workers and church friends. Prior to the CVA he was physically active with a healthy state of mind, which will both contribute to successful rehabilitation.
The COPM was administered to Mr. Chu to establish his priorities and focus his goals. Mr. Chu would like to increase …show more content…
Techniques used before the activity include verbal instruction and explanation of the steps involved along with implementing safety precautions. Client will view a video demonstration of a squat-pivot transfer to enhance his cognitive ability to understand the technique of a successful transfer. The OTA will pause the video at crucial moments for further explanation and safety precautions. While the client is supine in the bed, make sure Mr. Chu is in proper body alignment to facilitate turning him onto his affected side. The OTA will help the client move closer to the EOB by alternately moving his hips and shoulders. The OTA will then position the client’s knees in a bent position and his left scapula will be protracted so he does not roll onto his humeral head. Client will be instructed to reach for the side rail with his right arm as the OTA rolls the client onto his left side. The OTA will place his/her hands on Mr. Chu’s knees and around his right shoulder to assist him during the roll. The OTA will instruct Mr. Chu to place his right foot under his left ankle so that he can use his right foot to help push his left foot off the bed. The OTA will position one hand under the client’s left shoulder and the other hand behind his knees as the OTA brings the client to a seated position on EOB, making sure he is stable. The OTA will remind the client of steps of the squat-pivot transfer incorporating safety provisions. For example, to safeguard against injury explain to the client to keep his trunk in midline, his feet flat on the floor, his “nose over his toes,” the proper placement of his flaccid LUE, locking the wheelchair and positioning the casters, removing the foot plates and the armrest. Prior to starting the transfer, the OTA will assist the client in placing his LUE in his lap and positioning his feet properly if necessary. Due to his inability to follow more than two-step instructions and stay on task, the OTA will use continuous verbal cues