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May 2005
For Therapists
Using Functional Tasks to Improve Standing
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Consider the following to facilitate and improve your patient's ability to stand safely during functional tasks:
Provide a safe environment. Choose a task with a solid, stable surface in front of the patient. Position their wheelchair behind them and yourself on their weak side. Avoid standing in open spaces (middle of the gym) or near unstable surfaces (the bedside table).
If your patient has poor lower extremity control provide surface contact in front of their knees (such as the kitchen cabinets or the car).
Consider the height of the surface. Your patient's height and their key problem areas help determine the task and the location. For patients needing forward flexion, stand at a table (approx. 30"/76 cm high). For patients needing trunk extension, stand at the kitchen counter (approx 36"/92 cm high).
Offer a variety of heights to work from. As your patient progresses choose activities that encourage greater postural control.
Don't forget to watch for signs of fatigue. Offer your patients a chance to sit down before they become too tired.
For helpful hints on facilitating 'sit to stand', 'if the knee buckles', 'standing the low level patient' and more, order Teaching Independence: A Therapeutic Approach.
For more treatment ideas using function in standing order Functional Treatment Ideas & Strategies in Adult Hemiplegia.
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May 2005
For Families & Caregivers
Getting Out and About
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Stroke survivors do not need to be home bound. If you are a stroke survivor and unable to drive or use normal public transportation, and you don't have easy access to a car you can still get out and about using public services. Most communities offer transportation services for the disabled.
With this service, many stroke survivors can now enjoy getting out into the community and expand their horizons. You can use these services to go to your appointments, to the library or other destinations.
Contact your local transit authority and ask what services are offered in your community under the American Disabilities Act (ADA).
Each community has a different name for this service. It may be called "Dial-a-Ride", "Paratransit", or some other name. Also be sure to ask about the application process, how to schedule a ride and if there is any cost involved.
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