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

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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

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Positioning Handling Demonstration

• Ryan - 21 years old
• Spastic quadriplegia cerebral palsy
• Cortical blindness

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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

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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

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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

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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

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Handling
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Goals of handling

• To elicit normal muscle tone
• To facilitate upright positions with normal
  posture
• To facilitate normal movement patterns

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Normalizing tone

• Health, emotional, and environmental factors
• Posture and movement factors

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Hypertonia
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Hypotonia
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Facilitating normal postures and movement

• Normalize tone
• Break-up atypical patterns
• Use key points of control

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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.

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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

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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/slid
e1.html
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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

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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

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Mechanical lifts/assists
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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

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1. Body Posture and Body Mechanics
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2. Lifting
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3. Positioning
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4. Handling
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5. Transfers