Mobility Hierarchy

 Mobility Hierarchy 🦽

Biomechanics Blog 6

           The order for restoring mobility for activity demands is the following: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. This order is a lot of what I expected it to be like because it starts off with activities that do not require much mobility and the requirements of body movements slightly increase to have more independence and movement as the hierarchy goes along.

 I think the hierarchy is in this particular sequence because when you are on a bed or a mat you have a larger base of support making it very stable. For example, you are more stable on these surfaces in comparison to a toilet transfer -which can be dangerous to a client that is not as skilled in mobility and the base of support is significantly smaller than a bed or mat. This makes this activity significantly more challenging. In the past, I worked at an outpatient therapy center as a tech. The hierarchy was not as prevalent to me as a tech. This is because the PT or OT would try to push their clients out of their comfort zone with balance and mobility often times. A lot of the exercises I observed were performed in parallel bars or near a chair which made me nervous at times for the client’s safety when working as a tech. I always felt like the client needed more time in a more stable environment before making such a big leap in mobility skills like standing up; however, they always made progress and did well in therapy interventions.

At first, I did not agree with what I observed at work, but my views of this have changed over time. I think in therapy interventions it is great to encourage more mobility outside of their comfort zone. This will increase the client’s confidence, they will achieve more mobility skills, eventually result in more ADL independence, and allow the client to gain more physical endurance. These interventions that are pushing the client outside of their mobility comfort zone are great and encouraged as long as you have a gait belt, and they are in parallel bars with a therapist, assistant or tech near for assistance depending on their level of assistance. This goes along what we have learned in lecture because we were told to always encourage movement and mobility within reason to our future client’s skill level and rehab potential level.