The Safety Net

Physical Management

 

Introduction
Many people with developmental disabilities also have compromised motor functioning. For example, approximately 65% of persons diagnosed with cerebral palsy develop spasticity. Spasticity is a condition that causes stiff, tight, muscles, especially in arms and legs, and may result in the person having difficulty walking, controlling movement, and speech. Physical management is a term used to describe all the techniques that may be used to assist the development of movement and skills, minimize further loss of functioning and mitigate the development of secondary conditions such as skin breakdown and illness.

Therapeutic Positioning
Therapeutic positioning refers to the benefits of various positions. A physical or occupational therapist can evaluate individuals and determine optimal positions to address specific conditions. Examples of therapeutic positions are: supine (lying on one’s back), prone (lying on one’s stomach), side-lying, sitting or standing. Proper positioning will enhance comfort and function for the individual.

Importance of Positioning
The book, Positioning for Function by Bergen describes the following nine benefits for proper seating and positioning.

  1. Normalize or decrease abnormal neurological influence on the body. People who have experienced some neurological impairment may have conditions that will lead to contractures, dislocations, scoliosis and other deformities. Proper positioning can greatly lesson the influence of the condition.

  2. Maintain proper skeletal alignment. Proper positioning can counteract poor posture when the individual is unable to sit erect and may lean to one side or sit on the tailbone, for example.

  3. Manage pressure. Pressure sores can develop when the individual cannot or does not move frequently enough. Therapeutic seating, including proper cushioning, and a schedule for movement can mitigate the likelihood of developing pressure sores.

  4. Enhance freedom of movement through body stabilization. The more the upper body (trunk) is supported the more likely it will be for the person to participate in activities requiring purposeful arm movements.

  5. Increase personal comfort. Proper support can help the person feel more secure and, perhaps, more willing to try new activities.

  6. Enhance autonomic nervous system function. Proper seating positively affects breathing, cardiac function, digestion and eating.

  7. Decrease fatigue. When a person must use all her own muscle strength to stay upright, it can be extremely fatiguing. Supports can reduce the fatigue and allow the person more energy for other tasks.

  8. Facilitate normal movement patterns. Proper weight bearing, weight shifting and improved equilibrium are benefits of proper seating and positioning.

  9. Maximize functioning. The goal of proper positioning is achieved when the individual can participate with greater comfort and function.


 

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