Mobility Skills

The order for restoring confidence in mobility skills based on increasing activity demands is a concept that therapists can use to determine where to start with a client who has decreased mobility. The base of the hierarchy is bed mobility, then mat transfers, wheelchair transfers, ADL bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and lastly community mobility and driving. The order of the sequence allows for the completion of one skill to be followed by a more difficult skill. As OT's we want to promote independence. This hierarchy sets the client up to achieve several goals on the road to recovery. 

I like this approach because it can be useful for any level of mobility skill. If a client's baseline is ADL bed transfer we assume that bed mobility, mat and wheelchair transfers (if needed) have already been accomplished. I did most of my observation hours in a pediatric outpatient clinic where most cases involved developmental delays. I haven't seen a lot of mobility issues to remember. However, from what I have gathered  in class and lab I think this approach is adequate. Our lab this week explained the importance of safe body mechanics when working on mobility skills with patients. We need to utilize the safety techniques for ourselves and for our patients. This is relevant to restoring confidence in mobility skills in that when we teach these skills to our patients they grow more confident in their own abilities and independence!