Mais conteúdo relacionado



  2.  Donning: 1. Sit in wheelchair or on bed if balance is adequate in cross legged position with one ankle crossed over opposite knee. 2. Pull socks over foot with wrist extension grip and patting movts with palm of hand. 3. If trunk balance is inadequate and cross legged position cannot be maintained, prop foot on stool, chair.
  3. 4.Use stocking aid or sock cone to assist in putting socks while in this position. Powder socks cone ( to reduce friction) nd apply socks to it by using thumbs nd palms of hands to smooth sock out on cone. 5. Place cord loops of sock cone around the wrist or thumb nd throw cone beyond foot.
  4. 6. Maneuver cone over toes by pulling cords using elbow flexion. Insert foot as far as possible into cone. 7. To remove cone from socks after foot has been inserted, move heel forward off wheel chair footrest. Use wrist extension ( of hand not operating sock cone) behind knee nd continue pulling cords of cone until it is removed nd sock is in place on foot. Use palms to smooth sock with patting nd stocking motion.
  5. 8. Two loops can also be sown on either side of the top of the sock so that thumbs can be hooked into the loops nd socks pulled on.
  6. Removing:  While sitting in wheelchair or lying in bed, use dressing stick or long handled shoehorn to push sock down over heel. Cross legs if possible.  Use dressing stick with cup hook on end to pull sock off toes.
  7.  SHOES: Donning: 1. Use same position for donning socks as for putting on shoes. 2. Use extended handle dressing aid and insert in it tongue of shoe , nd dangle shoe on toes. 3. Using palm of hand on sole of shoe, pull shoe towards heel of foot. One hand is used to stablize leg while other pushes against sole of shoe to work shoe onto foot.Use thennar eminence nd sides of hand for this pushing motion.
  8. 4. With feet flat on floor or on wheelchair footrest nd knees flexed 90°, place a long handled shoehorn in heel of shoe nd press down on flexed knee. 5. Fasten shoes.
  9. Removing :  Sitting in wheelchair with legs crossed as described previously, unfasten shoes.  Use shoehorn or dressing stick to push on heel counter of shoe , dislodging it from heel ; then shoe will drop or can be pushed to floor with dressing stick.
  10. CRITERIA FOR DRESSING THE UPPER EXTREMITIES : 1. Fair to good msl strength in pectoralis major nd minor, Serratus anterior, Rhomboids major nd minor. 2. ROM of 0 to90° in shoulder flexion nd abduction 0 to80° in shoulder internal rotation 0 to 30° in external rotation 15 to 140° in elbow flexion.
  11. 3. Sitting balance in bed or wheelchair, which may be achieved with the assistance of bedrails, an electric hospital bed, or wheelchair safety belt. 4. Finger prehension achieved with adequate tenodesis grasp or wrist driven flexor-hinge splint.
  12. CONTRAINDICATIONS : Same as that of lower limb.
  13. PULL OVER GARMENTS : Pull over garments include, Blouses, Vests, Sweaters, nd Front opening dresses. Donning : 1. Garment is positioned across the thighs with back facing up nd neck towards knees. 2. Place both arms under back of garment nd in armholes.
  14. 3. Push sleeves up onto arms past elbows. 4. Using a wrist extension grip hook thumbs under garments back nd gather material up from neck. 5. To pass garment over head, adduct nd externally rotate shoulders nd flex elbows while flexing head forward.
  15. 6. When garment is overhead, relax shoulders nd wrists nd remove hands from back of garment. Most of material which is gathered up at neck, across shoulders nd under arms. 7. To work garment down over body, shrug shoulders forward.To hook wrists into sleeves nd pull material free from undera.rms or lean forwards, reach back nd slide hand against material to aid in pulling garment down.
  16. 8. Garment can be buttoned from bottom to top with aid of button hook nd wrist - driven flexor hinge splint, if hand function is inadequate.
  17. Removing :  Sit in wheelchair nd wear wrist - driven flexor hinge splints. Unfasten buttons ( if any) while wearing splints nd using buttonhook. Remove splints for remaining steps.  For pullover garments, hook thumb in back of neckline, extend wrist nd pull garment over head while turning head towards side of raised arm.
  18.  Hook thumb in opposide armhole nd push sleeve down arm. Elevation nd depression of shoulders with trunk rotation can be used to get garment to slip down arms as far as possible.  Hold one cuff with opposite thumb while elbow is flexed to pull arm out of sleeve.