Getting Stroke Patients Up And Moving

Getting a stroke patient out of bed requires a careful, practised technique. The patient's needs will vary depending on their symptoms, but they may need help with movement, eating, taking medication, and communicating. Physiotherapy can help to improve a patient's strength and mobility, but it is important to be aware of the correct techniques to avoid injury.

Sleeping on their left side, with their right side on the edge of the bed

To get a stroke patient out of bed, one recommended method is to have them sleep on their left side, with their right side on the edge of the bed. Here is a step-by-step guide for this technique:

• The patient should lie on their back and bend their right knee, with their foot on the bed.
• While pushing with the right foot to roll the right side of the pelvis over towards the left, the patient should reach with their right hand towards the side of the bed, effectively rolling onto their left side by pushing with their foot and pulling on the mattress with their hand.
• Holding the side of the mattress with their right hand at the level of their right shoulder, the patient should then move their legs to the side of the bed. If needed, the patient's left leg can be helped with the right leg, or they may require assistance sliding their legs forward to the edge of the bed.
• The patient should then lower their feet over the side of the bed while pushing with their right arm to get their upper body up off the mattress. Assistance may be needed with lifting the upper body and/or controlling the descent of the legs.

It is important to note that getting into bed is the reverse of the above process. The patient should sit, lie their upper body onto their left side, lift their legs in, and then roll onto their back. It is not recommended to just sit down and flop into bed, as this can lead to a loss of valuable transfer skills.

Rolling onto their left side, then pushing with their right foot to roll onto their right side

Rolling a stroke patient onto their side is a common technique used to help them get out of bed. Here is a step-by-step guide for this process, focusing on the instructions: "Rolling onto their left side, then pushing with their right foot to roll onto their right side."

Firstly, ensure the patient is lying on their back with their right side of the body closest to the edge of the bed. This positioning is important as it allows the patient to use their right side, which is typically stronger, to help with the movement.

Next, instruct the patient to roll onto their left side. They can do this by pushing with their right foot against the bed while simultaneously reaching with their right hand towards the side of the bed to steady themselves and provide additional support. This movement will help them roll onto their left side.

Once the patient is comfortably on their left side, they can begin the next stage of the transfer. They should continue to hold the side of the bed with their right hand, using it as leverage, while moving their legs towards the edge of the bed. If the patient has sufficient mobility, they can use their right leg to help guide their left leg towards the edge. If needed, a caregiver can provide assistance with this step.

At this point, the patient is ready to push themselves up into a sitting position. They should press down on the bed with their right forearm, gradually shifting their weight from their elbow to their wrist, and finally locking their elbow to straighten their arm. This action will help lift their upper body off the bed.

To complete the transfer, the patient can then slowly lower their feet to the floor and adjust their position as needed.

It is important to note that this technique may require practice and should be performed under the guidance of a physiotherapist or healthcare professional. Caregivers should also be mindful of their own body mechanics when assisting with transfers to avoid any injuries.

Moving their legs to the side of the bed, lowering their feet over the edge

Moving their legs to the side of the bed and lowering their feet over the edge is a crucial step in helping a stroke patient get out of bed. Here are some detailed instructions to ensure this process is safe and effective:

Firstly, ensure the patient is lying on their back with their stronger side facing the edge of the bed. For example, if their left side is affected, they should lie with their right side towards the edge. This positioning will enable them to use their stronger side to support the movement.

Next, ask the patient to bend their stronger knee, keeping their foot flat on the bed. They should then push with their foot to roll onto their stronger side, simultaneously reaching with their stronger arm to grip the side of the bed. This movement will help them roll onto their side and prepare for the next step.

Once they are comfortably on their side, guide them to move their legs towards the edge of the bed. If the patient is able, they can use their stronger leg to help move the weaker leg. If needed, you can provide assistance by gently sliding their legs forward to the edge of the bed.

Finally, the patient should lower their feet over the edge of the bed while pushing with their stronger arm to lift their upper body. You may need to provide support and control the descent of their legs. Ensure you protect your own back during this process by maintaining good body mechanics and avoiding any twisting movements.

By following these steps, you can effectively and safely help a stroke patient move their legs to the side of the bed and lower their feet over the edge, bringing them one step closer to getting out of bed. Remember to always seek professional medical advice and adapt these steps as needed to suit the patient's specific needs and capabilities.

Using mobility aids such as walkers or canes to help them balance

Mobility aids such as walkers and canes can be extremely beneficial to stroke patients. They can help them to move around more easily and improve their balance and stability.

There are several types of canes available, each with its own unique features and benefits. For instance, white canes are specifically designed for visually impaired individuals, as they are longer and thinner, enabling users to detect objects in their path. Quad canes, on the other hand, have four feet at the end, providing greater stability. Forearm canes offer extra forearm support and allow for better weight distribution from the wrist to the arm. Canes are generally useful for individuals who are at risk of falling or have problems with balance.

Walkers, also known as Zimmer frames, provide stability and support to the user. They consist of a metal framework with four legs. Basic walkers have a 3-sided frame that surrounds the user, who lifts and places it further in front of them before stepping forward to meet it. Some walkers have wheels or glides on the base of the legs, which can be helpful for individuals with limited arm strength as they can slide the walker instead of lifting it. Rollators, a common style of walker, include a frame with four wheels, handlebars, and a seat for resting.

It is important to note that the choice between a cane and a walker depends on the specific needs and mobility issues of the stroke patient. A physiotherapist or occupational therapist should ideally prescribe a walking aid after a thorough assessment of the individual's gait, balance, cognition, and relevant body systems. Additionally, the therapist should consider the patient's day-to-day mobility requirements, such as navigating thresholds, stairs, or public transport.

While mobility aids offer numerous benefits, it is essential to use them properly to avoid injuries. Individuals should receive training on how to use their mobility aid correctly and make adjustments as needed to ensure safety and effectiveness.

Practicing getting in and out of bed with assistance

Sleeping Position

It is important to ensure the patient sleeps with their right side towards the broad side of the bed. This positioning will enable them to use their right hand to catch the bed for support when turning onto their left side.

Turning and Sitting Up

From a lying position, the patient should turn onto their left side, placing their right hand in front to support themselves. They can then push themselves up into a sitting position using their right hand and arm.

Moving Legs

Once in a sitting position, the patient should move their legs to the side of the bed. If they are able, they can use their right leg to help their left, or they may need assistance sliding their legs forward.

Standing Up

The patient should then lower their feet over the side of the bed while pushing with their right arm to help their upper body rise. They may need assistance with controlling the movement of their legs and lifting their upper body.

Getting into Bed

To get into bed, the patient should reverse the above process. They should sit on the bed, lie onto their left side, lift their legs in, and then roll onto their back. It is important that they do not just sit down and flop into bed, as this can lead to a loss of valuable transfer skills.

Tips for Caregivers

Caregivers should be mindful of their own body mechanics when assisting the patient. Avoid bending over from the waist, and instead, bend your knees and keep your back straight. Move your body weight from one foot to the other when assisting the patient, and avoid twisting your body.

Practicing

Regular practice is key to mastering this skill. Break the process down into smaller steps and practice each one individually before putting them all together. For example, practice rolling from the back to the left side and back, then practice moving the legs to the side of the bed, and so on. Over time, add more steps to the practice routine until the patient can perform the entire transfer with assistance.

Remember, each patient's needs are unique, and it is important to consult with a medical professional for specific guidance.

Frequently asked questions