 Show
In orthopaedics, weight bearing refers to how much weight a person puts through an injured body part. During single leg stance, an ambulatory person with no physical limitations will carry 100% of their body weight through each leg. Thus, grades of weight bearing are generally expressed as a percent or portion of this number. The concept of prescribing weight bearing restrictions applies to surgeries, joint dislocations, tendon or ligament tears/ruptures, and fractures affecting weight bearing structures of the upper and lower extremities. The surgeon or treating physician is responsible for prescribing an appropriate weight bearing status. Adherence to these restrictions is vital for optimal recovery, as premature weight bearing can delay healing.[1][2] Weight Bearing Grades[edit | edit source]Non Weight Bearing (NWB)[edit | edit source]NWB status means the patient is not to put any weight through the affected limb(s). Toe Touch Weight Bearing (TTWB)[edit | edit source]The definition of TTWB is poorly defined in the research literature.[3] In clinical practice, it is commonly described as having the ability to touch the foot or toes to the floor without supporting weight from the affected limb. The pressure should be light enough to avoid crushing a potato crisp underfoot. Partial Weight Bearing (PWB)[edit | edit source]PWB is a broad term and can range from anything greater than non-weight bearing to anything less than full weight bearing.[4] The status is usually accompanied by a percentage figure to further describe the extent of recommended weight bearing. Most of the definitions in the literature define partial weight bearing as being 30% to 50% of a patient’s body weight.[3] Full Weight Bearing (FWB)[edit | edit source]FWB means no restriction to weight bearing. In other words, 100% of a person's body weight can be transmitted through the designated limb. This term is somewhat interchangeable with the term 'weight bear as tolerated' (WBAT) which allows the patient to self-limit their weight bearing up to full body weight. Safe Mobility[edit | edit source]For the lower extremity, NWB, TTWB, and PWB require the use of a wheelchair or assistive device to maintain compliance during mobility. In the case of FWB or WBAT, an assistive device may be needed if other impairments (ex. pain, impaired balance, muscle weakness, abnormal tone) act as barriers to safe ambulation or contribute to significant gait deviations. The video clip below illustrates each type of weight bearing status and the assistive devices that may be needed to facilitate compliance. [5] Measures of Adherence[edit | edit source]There are a variety of ways to measure adherence to weight bearing restrictions. Clinically, adherence is commonly measured by observation, scales, placing a hand under the foot of an affected limb, and biofeedback.[6] Little research on been done on the accuracy and reliability of observation and manual assessment.[6] Particularly at lighter weights, the accuracy of scales can be difficult to replicate. They appear to most useful for assessing symmetry in static standing for patients who are WBAT. Although biofeedback is the most accurate measure of adherence, cost may pose a barrier to clinical use.[6] Physical Therapy Applications[edit | edit source]Physical therapists need to be aware of patients who have weight bearing restrictions. If restrictions are unclear, they should be clarified with the treating physician. In turn, this will influence the content of patient education, caregiver training, goals of treatment, and the types of devices that may be used for mobility. References[edit | edit source]
1. a bodily posture or attitude. 2. the relationship of a given point on the presenting part of the fetus to a designated point of the maternal pelvis; see accompanying table. See also presentation. Common examination positions. From Lammon et al., 1995. anatomical position that of the human body standing erect, palms facing forward; it is the position of reference in designating site or direction of structures of the body. The anatomical position for quadrupeds is standing with all four feet on the ground; the difference between animal and human anatomical position leads to confusion among terms indicating position and direction. The body in the anatomical poisition, showing regions of the body. From Applegate, 2000. batrachian position a lying position of infants in which the lower limbs are flexed, abducted, and resting on the bed on their outer aspects, resembling the legs of a frog. Bozeman's position the knee-elbow position with straps used for support. decubitus position that of the body lying on a horizontal surface, designated according to the aspect of the body touching the surface as dorsal decubitus (on the back), left or right lateral decubitus (on the left or right side), and ventral decubitus (on the anterior surface). In radiology, the patient is placed in either the right or left lateral decubitus position with the beam perpendicular to the long axis of the body. dorsal recumbent position position of patient on the back, with lower limbs flexed and rotated outward; used in vaginal examination, application of obstetrical forceps, and other procedures. See illustration. Fowler's position a position in which the head of the patient's bed is raised 30 to 90 degrees above the level, with the knees sometimes also elevated. See illustration. froglike position batrachian position. knee-chest position the patient rests on the knees and chest with head is turned to one side, arms extended on the bed, and elbows flexed and resting so that they partially bear the patient's weight; the abdomen remains unsupported, though a small pillow may be placed under the chest. See illustration. knee-elbow position the patient resting on the knees and elbows with the chest elevated. lateral position Sims' position. lithotomy position the patient lies on the back with the legs well separated, thighs acutely flexed on the abdomen, and legs on thighs; stirrups may be used to support the feet and legs. See illustration. orthopneic position a position assumed to relieve orthopnea (difficulty breathing except when in an upright position); the patient assumes an upright or semivertical position by using pillows to support the head and chest, or sits upright in a chair. prone position a position with the patient lying face down with arms bent comfortably at the elbow and padded with the armboards positioned forward. Prone position. From Lammon et al., 1995. reverse Trendelenburg position a supine position with the patient on a plane inclined with the head higher than the rest of the body and appropriate safety devices such as a footboard. Rose's position one intended to prevent aspiration or swallowing of blood, as from an injured lip: the patient is supine with head hanging over the end of the table in full extension so as to enable bleeding to be over the margins of the inverted upper incisors. semi-Fowler position a position similar to Fowler's position but with the head less elevated. Sims position the patient lies on the left side with the left thigh slightly flexed and the right thigh acutely flexed on the abdomen; the left arm is behind the body with the body inclined forward, and the right arm is positioned according to the patient's comfort. See illustration. Called also lateral position. Sims recumbent position a variant of the Sims position in which the patient lies on the left side in a modified left lateral position; the upper leg is flexed at hip and knees, the lower leg is straight, and the upper arm rests in a flexed position on the bed. Trendelenburg's position the patient is on the back on a table or bed whose upper section is inclined 45 degrees so that the head is lower than the rest of the body; the adjustable lower section of the table or bed is bent so that the patient's legs and knees are flexed. There is support to keep the patient from slipping. See illustration. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. a position to facilitate a vaginal examination, with the patient lying on her side with the lower arm behind the back, the thighs flexed, the upper one more than the lower. Farlex Partner Medical Dictionary © Farlex 2012 Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved. McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc. Placement to facilitate a vaginal examination, with the patient lying on her side with the lower arm behind the back, the thighs flexed, the upper one more than the lower. Medical Dictionary for the Health Professions and Nursing © Farlex 2012 Sims double-ended retractor Sims double-ended speculum Sims position - facilitates vaginal examination. Synonym(s): English position; lateral recumbent position; semiprone position Sims uterine sound - a slender flexible sound. Sims vaginal decompressor Medical Eponyms © Farlex 2012 Want to thank TFD for its existence? Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content. Link to this page: <a href="https://medical-dictionary.thefreedictionary.com/Sims+position">Sims position</a> |
A patient who can partially bear weight should have the head of his bed raised at 30 degrees
zusammenhängende Posts
Urheberrechte © © 2024 frojeostern Inc.
