Restoring Confidence in Mobility
In order for a client to become confident in their mobility, it is important for an occupational therapist to educate the client on how they should control their instabilities. Tips for becoming more mobile could include having a small base of support, a line of gravity which is on the outer edge of the base of support (near the limit of stability), having a moving center of gravity, and having controlled extraneous joint motion.
Based on increasing activity demands, the hierarchy for restoring confidence in mobility begins with bed mobility, as it continues up to mat, wheelchair, and bed transfer. With more skill and function comes mobility including functional ambulation for activities of daily living, toilet and tub transfers, and vehicle transfers as we go up the pyramid. Near the top of the hierarchy, activities such as ambulation and driving for community mobility is seen.
The base of support is becoming smaller and smaller as you travel up the pyramid, so the order does make sense, as people are more mobile when a smaller base of support is present. I will say this is what I expected. I think it is interesting for me to see that there is a good amount of overlap that can occur in the hierarchy because so many of the activities are interrelated. I agree with the approach seen in the hierarchy because it is based on client cognition and it encourages the client's active participation. In past observations, I do think the hierarchy was followed, but I believe that it depended on the functional balance grade of the client, and of the approach used by the therapist.
Based on increasing activity demands, the hierarchy for restoring confidence in mobility begins with bed mobility, as it continues up to mat, wheelchair, and bed transfer. With more skill and function comes mobility including functional ambulation for activities of daily living, toilet and tub transfers, and vehicle transfers as we go up the pyramid. Near the top of the hierarchy, activities such as ambulation and driving for community mobility is seen.
The base of support is becoming smaller and smaller as you travel up the pyramid, so the order does make sense, as people are more mobile when a smaller base of support is present. I will say this is what I expected. I think it is interesting for me to see that there is a good amount of overlap that can occur in the hierarchy because so many of the activities are interrelated. I agree with the approach seen in the hierarchy because it is based on client cognition and it encourages the client's active participation. In past observations, I do think the hierarchy was followed, but I believe that it depended on the functional balance grade of the client, and of the approach used by the therapist.
Thanks for your thoughtful post!
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