Improving quality of life for the differently abled Children & Adults


By Tammy Groenwald, PT, DPT

Almost 1/3 of caregiver back injuries are due to lifting or repositioning patients with back and neck pain being the most prevalent musculoskeletal injuries.  Almost $25 billion is spent annually on direct and indirect costs associated with caregiver back injuries.  As a result, over ¾ of a million working days are lost annually.  There are 3 important factors a parent with a special needs child or caregiver needs to focus on to prevent sustaining an injury.

First and foremost is awareness of your body mechanics.  When transferring or positioning a child, one should always maintain a neutral spine and engage your core.  Always use your legs to lift and maintain a wide base of support.  Never bend at the waist, but rather bend at your knees.  Always keep the child as close to your body as possible and avoid twisting or awkward postures.

Secondly, always remember the rules of engagement for transferring or positioning a child.  Make sure you and the child are in a safe environment.  If any obstacles are in the way, be sure to remove them and make sure the surface the child is moving to does not move (i.e. lock the wheelchair).  Check with the child’s therapist if there are any precautions such as weight-bearing status or post-surgical contraindications.  Transfer the child the shortest distance possible and towards the child’s stronger side. Encourage the child to assist as much as possible to encourage independence.  Most importantly, always put your safety first! If you are unsure at all of your ability to transfer the child, ask for assistance or use a mechanical lift if available.

Lastly, use a gait belt to assist in transferring or positioning a child. A gait belt is a commonly used therapy device by therapists to transfer a child from one surface to another without holding onto his/her clothing or during ambulation with a child with poor balance. The proper fit of a gait belt is to make sure there is two fingers width between the belt and the child’s body. Gait belts are available to purchase online and vary by clasp style, fabric, and length.

If your child is a frequent dropper during ambulation, here are a few tips. Always use a light grasp around the wrist, NOT at the hand when walking. Therefore if the child drops to the ground, he/she is not pulling your hand and shoulder down with them.  By holding onto only the wrist, you will have your other hand free to control the child’s pelvis and shift their weight into your base of support if he/she chooses to drop.  If he/she drops to the ground often, let them but immediately prompt them to stand up. If the child has difficulty bearing weight through his/her legs, you can prompt through the gluts.

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