Restoring Confidence in Mobility

Restoring a client's confidence in mobility is incredibly important in the therapy process, especially for an occupational therapist.  By restoring their confidence in the ability to be mobile and move around, it gives them back the independence they lost when they first become immobile, whether due to an injury or something more severe, like a stroke.  For an OT working with a client who is trying to get back to independent mobility, there is a certain method for doing so, called the Hierarchy of Mobility Skills.  It's a sequence that works from the bottom up, starting with bed mobility and going all the way up to community mobility and driving.  From a body mechanics perspective, the higher up someone goes on the ladder, the smaller their base of support becomes.  The purpose of the hierarchy is to give back independence to a client. 

For the hierarchy of mobility skills, I wasn't sure what to expect.  I had never really heard of this before, so learning it was an entirely new experience for me.  However, based on the sequence, and what we have learned in our Biomechanics class, as well as what I saw during my observation hours in undergrad, I see that it makes sense.  Bed mobility, the first rung on the ladder, requires almost 100% assistance from the therapist, and it goes up from there to the very top with community mobility and driving, which is near complete, or complete, independence on the side of the client, as they can move around in society and interact with others in their community.  I do agree with the hierarchy, because the higher up a client goes, the more independence they can receive from achieving those points.  What we have learned in our Biomechanics labs has also been a really great way of seeing the hierarchy in action.  I think the wheelchair lab was very beneficial in showing this, because once a client is able to functionally use a wheelchair on their own, they gain a lot of independence back that they didn't have previously.  Or even the assistive walkers, once a client is able to get off of those (if they can), it's such a rewarding feeling, both for them, and for the occupational therapist working with them.