Assistive Technology for Positioning

Towels Towels are easy to obtain, easily washed to maintain good hygiene and can be folded for many purposes. May be used to provide support for a range of body parts to minimise strain on limbs. Pillows Pillows provide support, elevate body parts and splint incision areas, and reduce postoperative pain during activity, coughing, or deep breathing. They should be of the appropriate size for the body to be positioned. Cushions Cushions provide comfort, pressure relief and offloading, provide postural support to assist patient with optimal positioning and compensate for any deformations. There are a range of classification systems developed to describe cushions that provide useful information in relation to construction materials, different functions of the cushions and their ability to prevent pressure injuries. [24] Wedges Positioning wedges provides essential support to keep patients safe and comfortable in bed. They can provide back and side support, help to alleviate pressure and prevent slipping down the bed. In paediatrics wedges are frequently used to support prone positioning to help promote cervical extension and use their arms for play. Trochanter Roll Trochanter roll refers to a cylindrical prop such as a rolled-up towel, foam roll, cylindrical cushionpillow, or rolled-up blanket, which is used to prevent external rotation of the hips when a patient is in a supine position. Hand Rolls Hand rolls maintain the fingers in a slightly flexed and functional position and keep the thumb slightly adducted in opposition to the fingers to minimise the risk of flexion contractures and reduce skin breakdown. Hand rolls made from face cloths can be easily washed to maintain good hygiene. Splints A splint is a rigid support made from metal, plaster, or plastic. It's used to protect [25], support, or immobilize an injured or inflamed part of the body.[7] A splint can be a generic model or cutom fit to support a specific limb to maintain is optimal alignment Side Rails Side rails are bars along the sides of the length of the bed. They ensure patient safety and are useful for increased bed mobility. They can assist with rolling from side to side or sitting in bed. Trapeze A trapeze positioned above the patient near the head of the bed allows the patient to grasp and reposition themselves or to help with re-positioning. These can be fixed to the bed or free standing. They are contraindicated in some situations including new spinal cord injury, post abdominal surgery, and shoulder conditions. Slide Sheets Nylon sheets used under the patient to help reduce friction during patient repositioning. Abdominal Binder Abdominal binders are elasticated binders typically used when reintroducing patients to the vertical position and are associated with a significant reduction of orthostatic hypotension. Commonly used during tilt tabling the binder works by reducing splanchnic venous pooling under orthostatic stress. [26] Specialised Beds There are a wide range of specialised beds which can support patient positioning including profiling beds that allow the patient to be positioned in a wide range of position. The roto rest bed provides continuous, slow, side-to-side turning of the patient by rotating the bed frame. Keeping the patient in maximal rotation assists with prevention of skin breakdown and provides the most effective therapy for pulmonary indications. Sleep Systems Sleep systems are prescribed postural support systems used in lying that contain components, held in place using a base or sheet, forming part of a 24h posture management programmes, for children and adults with severe motor disorders and neurological conditions.[27] [28] Improved posture reduces the likelihood of secondary complications such as contractures, pain and poor sleep quality, thus improving quality of life. [29] Tilt Tables Tilt tables are commonly used in intensive care and rehabilitation settings as a technique to minimise the adverse effects of prolonged immobilisation such as orthostatic hypotension, reduced oxygen consumption, venous pooling, reduced lung volumes, impaired gas exchange, muscle atrophy, joint contractures, peripheral nerve injuries, and pressure areas[30][31][32] and to reintroduce patients to the vertical position. Benefits of tilting include increased ventilation, increased arousal, improved weight bearing of the lower limbs, and facilitation of antigravity exercise of the limbs.[31] Adaptive Seating Specialist seating is a tool which offers continuous posture management and enables a patient to receive a maximum quality of life. A commonly used intervention to enhance head and trunk stability for optimal positioning.[33][34] The use of adaptive seating can help develop motor skills, facilitate arm and hand mobility, self-feeding, visual scanning and tracking and reduce the need for assistance from caregivers.[34] Studies have shown that individuals using adaptive seating often have positive experiences, including increased performance of activities of daily living and social interaction.[35] Wheelchair A wheelchair provides both wheeled mobility and seating support for a person with difficulty in walking or moving about. The aim of wheelchair design is to provide appropriate seating and postural support without compromising strength, durability and safety.[36] Design features must be matched to the user`s functional ability and posture support needs, and also to the environmental and durability requirements. [37]