Optimizing Positioning and Handling Techniques for Students with Movement Dysfunctions

1. SpEd 417/517 Course Objective: • Demonstrate a knowledge of positioning and handling students with movement dysfunction to facilitate normalized tone, postures, and movement, and to enhance optimal learning and functional abilities

2. Positioning & Handling Demonstration • Ryan - 21 years old • Spastic quadriplegia cerebral palsy • Cortical blindness

3. Westling & Fox Chapter 13 • Positioning and handling • Preparation to attain tone normalization and muscle lengthening for body alignment • Control of environmental and sensory influences • Inhibition of primitive reflexes • Facilitation of movement through space • Maintenance of body alignment and muscle length

4. Westling & Fox Chapter 13 • Body mechanics • Unsafe lifting and transferring can cause permanent damage to lifter and can compromise safety for student • Maintain erect trunk, bend knees, keep load close to body • Plan transfer, arrange environment, decide if assistance is needed

5. Westling & Fox Chapter 13 • Posture and movement • Key points of control - head, shoulders, trunk and pelvis • Positioning technique • side-lying for increased extensor tone • flexion and rotation for inhibition of extension • stimulate tone of low-toned child to elicit participation • use key points of control

6. Westling & Fox Chapter 13 • Positioning • Promote active participation • Prevent development or progression of deformities or skin breakdowns • Provide weight-bearing experiences • Facilitate circulatory, respiratory, and digestive functions • Allow mobility

7. Handling

8. Goals of handling • To elicit normal muscle tone • To facilitate upright positions with normal posture • To facilitate normal movement patterns

9. Normalizing tone • Health, emotional, and environmental factors • Posture and movement factors

11. Hypertonia

12. Hypotonia

14. Facilitating normal postures and movement • Normalize tone • Break-up atypical patterns • Use key points of control

15. Facilitating upright positions and normal posture • Dynamic positioning versus static positioning • Advantages and disadvantages of various • Facilitating automatic movement to maintain balance • Facilitating locomotion for independent mobility • Facilitating arm and hand movements for task performance • Facilitating oral movement for eating and speech.

17. Goals of positioning • To maintain tone • To maintain body alignment and prevent deformities • To maintain stabilization of body parts • Provide weight-bearing experiences • Facilitate circulatory, respiratory, and digestive functions • To promote active participation in meaningful activity • To allow mobility

23. Body Mechanics • Determine if student can assist in transfer • If you question your ability to lift/assist alone, ask for help • Assess student abilities and communicate what is happening • Assess the environment, decrease workload • Stay close to student - squat or kneel if necessary • Maintain wide, stable base of support http://www.rehab.on.ca/mobile/transfer/slides/slide1.html

24. Body Mechanics • Line yourself up with student, maintaining straight back throughout • Never twist trunk while lifting • Use leg muscles when lifting and lowering • Coordinate smooth lift with others - “one, two, three” • Ensure student feels secure throughout

26. Lifts and Transfers • One-person lift • Two-person lift • Standing pivot transfer • Two person side-to-side transfer • Two person top-bottom transfer • Other options

28. Mechanical lifts/assists

29. Positioning, Handling, and Body Mechanics Activity • Working in groups of three, each group will complete the previous lifting and transferring techniques • 40 points will be awarded according to the following criteria • Use of appropriate handling technique • Maintenance of proper body mechanics • Application of lifting/transferring technique • Awareness of mechanical aids • Use of safety precautions

30. 1. Body Posture and Body Mechanics

31. 2. Lifting

32. 3. Positioning

33. 4. Handling

34. 5. Transfers