The Acute Phase — Positioning and Moving in Bed and in the Chair

Abstract

Successful rehabilitation depends not only on the various therapy sessions but also very much on what happens to the patient during the remaining hours of the day and night. Even the position in which he sleeps can make a remarkable difference to the end result. No matter how good the therapy, if during the rest of the time the patient moves with effort in abnormal patterns of movement, spasticity will increase and functional gains achieved during therapy will be lost and not carried over into his daily life. Likewise, if he lies and sits in grossly abnormal postures for prolonged periods, not only will tone increase; range of motion will almost certainly be lost as well. Rehabilitation should therefore be regarded as a 24-hour management or way of life for each and every patient.