“Top 7 Postural Abnormalities: Effective Mobility Assessment & Assistive Devices Guide”

Discover the top 7 postural abnormalities. Learn how to effectively assess mobility. Find out the best assistive devices to enhance patient care and independence.

Postural Abnormalities

• Torticollis: Twisting of the neck, causing the head to rotate and tilt.
• Lordosis: Excessive inward curve of the lumbar spine; often called swayback.
• Kyphosis: Abnormally excessive convex curvature of the thoracic or sacral spine.
• Scoliosis: Abnormal lateral curve of the spine.
• Congenital Hip Dysplasia: Hip socket doesn’t fully support the ball of the joint.
• Knock-Knee (Genu Valgum): Knees tilt inward while ankles stay apart.
• Clubfoot: Foot turns inward or downward; a congenital condition.
• Foot Drop: Inability to lift the front part of the foot; caused by peroneal nerve injury.
• Pigeon Toes: Inward rotation of a child’s feet.

Contractures

• Stiffness or constriction in connective tissues, limiting movement and causing deformities.

Muscle Impairments

• Muscular Dystrophy: Muscle-wasting conditions leading to weakened skeletal muscles.
• Overuse Injuries: Result from repetitive demand on muscles, leading to conditions like tendinitis, strain, and bursitis.

Musculoskeletal Trauma

• Fractures, Sprains, Strains, Contusions: Result from direct trauma affecting bones, joints, and muscles.

Central Nervous System (CNS) Damage

• CNS and Mobility: CNS damage impairs muscle coordination, leading to mobility issues. Spinal cord injuries can cause partial or total paralysis.

Treatment Approaches

• Postural Abnormalities: Physical therapy, braces, surgery, and exercises.
• Contractures: Stretching, physical therapy, bracing, or surgery.
• Muscle Impairments: Physical therapy, rest, and sometimes surgery for overuse injuries.
• Musculoskeletal Trauma: Immobilization, physical therapy, and sometimes surgical intervention.
• CNS Damage: Rehabilitation, assistive devices, and in some cases, surgery.

Mobility and Independence Assessment

Importance of Mobility:

• Essential for maintaining independent living.
• Limited mobility can severely affect Activities of Daily Living (ADLs).
• Interventions aim to prevent immobility hazards, avoid dependent disabilities, and restore or keep mobility.

Assessment of Patient Mobility

• Functional Mobility Level:

• Level 1: Can walk indefinitely, slight breathlessness after one flight of stairs.
• Level 2: Walks one city block or 500 ft, climbs one flight slowly.
• Level 3: Walks no more than 50 ft, can’t climb a flight of stairs without stopping.
• Level 4: Experiences dyspnea and fatigue at rest.

• Activities of Daily Living (ADLs):

• 0: Completely independent.
• 1: Requires equipment or device.
• 2: Needs help from another person (assistance, supervision, or teaching).
• 3: Needs help from another person and equipment or device.
• 4: Fully dependent, does not join in activity.

• Impairments to Mobility:

• Pain, paralysis, muscle weakness, systemic disease, immobilizing devices.

• Gait Assessment:

• Evaluate walking pattern to decide mobility and fall risk.

• Range of Motion (ROM):

• Assess joint movement to find physical problems.

• Skin Integrity:

• Check for signs of pressure ulcers, especially over bony prominences.

• Pathological Conditions:

• Detect bone disorders, joint impairments, muscle development issues, postural abnormalities, trauma, and neurological damage.

• Use of Assistive Devices:

• Notice effective use of devices that support mobility, prevent deformities, and improve function.

• Physiologic Adaptation:

• Watch for orthostatic hypotension, pallor, diaphoresis, nausea, tachycardia, and fatigue.

• Neurovascular Status:
  • Check immobilized extremities initially every hour, then every 4 hours, to detect potential issues.

Assistive Devices: Enhancing Patient Mobility

Assistive devices are tools designed to help individuals with activities of daily living, particularly in improving mobility and independence. These devices can significantly enhance a person’s ability to move. They allow performing tasks and maintaining independence. This is especially true for those with physical limitations.

1. Wheelchairs

• Definition: A wheelchair is a device providing wheeled mobility and seating support for those who have difficulty walking or moving.
• Types: Manual (user-propelled or pushed by another) and electric-powered. There are also advanced versions like those controlled by neural impulses.
• Use: Suitable for individuals who can’t bear weight on their lower limbs. This product offers better support over long distances compared to walkers.

2. Crutches

• Function: Crutches increase the base of support, helping to transfer weight from the legs to the upper body.
• Types of Crutches:
• Axillary Crutches: Placed under the armpits with hand grips; typically used for short-term injuries.
• Forearm (Lofstrand) Crutches: Includes a cuff and handgrip, more suitable for long-term use.
• Gutter Crutches: Feature padded forearm supports, often used by those with partial weight-bearing restrictions like rheumatoid arthritis.

3. Walking Sticks/Canes

• Function: Canes offer support by transmitting weight from the legs to the upper body. They reduce pain. They improve balance. They enhance stability.
• Types:
• White Canes: Often used by visually impaired individuals.
• Quad Canes: Feature a wider base for extra stability.
• Forearm Canes: Give extra support with forearm bracing.

4. Walking Frames/Walkers

• Definition: Walkers are metal frameworks with four legs, providing a wider base of support than canes.
• Types: Include standard walkers, rollators (with wheels), knee walkers, and walker-cane hybrids.
• Use: Ideal for individuals with poor balance or limited arm strength, offering enhanced stability.

5. Gait Belt

• Definition: A gait belt is a 2-inch-wide belt used to secure a grip on unstable patients, providing stability during transfers.
• Use: Placed around the patient’s waist over clothing. It is used in one-person or two-person pivot transfers. It can also be used with a slider board.

6. Mechanical Lift

• Definition: A hydraulic lift is often ceiling-mounted. It is used for patients who can’t bear weight. It is also for those who are unpredictable or have medical conditions preventing them from assisting in movement.
• Use: Essential for moving patients safely from one position to another without strain.

7. Slider Boards

• Definition: A slider board (transfer board) assists in transferring an immobile patient from one surface to another while lying down.
• Use: Ideal for patients who can’t use their legs or when a standing transfer is unsafe.

Read more: “Top 7 Postural Abnormalities: Effective Mobility Assessment & Assistive Devices Guide”

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