You have successfully transferred Mr McTavish to his chair and adapted it to enable him to maintain a good seating position. What other things should you now consider?
Positioning for People Affected by Stroke [PDF]
For more information on fatigue and fatigue management after stroke visit STARs AM 7: Physical rehabilitation, Case 1 Joan Poplar
Timing
Each person requires an individualised recommendation for how long they sit out of bed. Too long may result in altered position due to discomfort or being unable to reposition self when moved.
Recommendations:
Recommend the length of time Mr McTavish should sit for and adjust the recommendation as his ability changes. Reposition or return to bed.
Fatigue
Mr McTavish may only be able to tolerate a short period of time sitting initially. This may be apparent through change of alignment due to increasing compensation for muscle fatigue resulting in abnormal patterns of muscle tone.
Recommendations:
Develop a positioning programme to recommend how long he sits for e.g. ½ hr initially twice per day, gradually increasing as his tolerance improves.
Pain
Commonly this is due to pain of musculoskeletal origin (e.g. lower back pain, hip pain) and/or mechanical pain due to pressure.
Recommendations:
- Ensure adequate analgesia
- Ensure adequate upper limb support.
- Provide pressure relieving cushion.
- Realign position.
- Return to bed.
Implementation
Develop a positioning programme for each patient.
Recommendations:
Taking a picture of Mr McTavish – if he agrees – to help demonstrate his appropriate positioning and equipment needs. Document recommendations for all staff and carers to see. Review programme regularly.
Page last reviewed: 25 Feb 2021
