Restoring Confidence!

Hey bloggers!

 Today I will be talking about functional and community mobility, in relation to the hierarchy for restoring bed mobility skills in clients as OTs.

 The hierarchy for restoring bed mobility skills (least to greatest confidence) is: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. The hierarchy of skill building for bed mobility is based on increasing activity demands of each task and illustrates the sequence for intervention planning. 

 Initially, I didn't really understand the order or sequence of the skills; or why they were placed in the hierarchy like they were. As I was reading about restoring functional and community mobility, it became more clear. We discussed in class that "mobility = controlled  instability". This means that a body is easier to move when the base of support (BoS) is small; the center of gravity (CoG) is moving; the line of gravity (LoG) is near the outer edge of the BoS near the limit of stability (LoS); and extraneous joint motion is controlled. 
At the base of the hierarchy, mobility is lesser, while stability is greater; and at the top of the hierarchy, mobility is greater, and stability is lesser. 

 Mobility skills addressed as basic activities of daily living (BADLs) are located towards the bottom or base of the hierarchy, followed by mobility skills addressed as instrumental activities of daily living (IADLs) that are located towards the top of the hierarchy. Accomplishment in each area builds a foundation of performance skills that are required for the activity demands of the next higher level of mobility.   

 Overall, I do agree with this is approach. Restoring competence in functional and community mobility is a building block toward the end goal of supporting health and participation in life through engagement in occupations.  

 Thank you, and stay natural!

 naturalOT 

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