Wendy Barden is a Toronto-based Physiotherapist and owner of Stretchit Physiotherapy Services (SIPS). Wendy offers in-home physiotherapy to all age groups within the Greater Toronto Area.
Wendy completed the MelioGuide Building Better Bones Level 1 continuing education course for Physical Therapists several years ago. She keeps in contact by reading the blog articles I post. She periodically asks me questions related to client care. She recently asked me a question on how she should coach senior clients with low bone density on the safest way to complete an everyday task – putting on their shoes.
I provided my feedback to Wendy and am interested in any suggestions that you, the reader, may have. You can find my suggestions below. I encourage you to comment in the Comments box (either the Facebook of the standard comment area) below.
Minimizing Spinal Flexion While Putting on Shoes
Here is Wendy’s question. It includes the detail on the client.
Since taking the Building Better Bones course I am even more careful when prescribing exercises and helping my elderly clients modify their activities to minimize the risk of fractures.
I have an 86 year old who recently had a Bone Mineral Density (BMD) test. Her previous one was in April 2008. Since this time there has been a significant decrease in the average BMD in the Lumbar Spine (T score now -1.69,T score 2008 was -1.22) but no other significant changes from last study (left femoral neck T score now -3.11, April 2008 T score-3.24; left total hip T score now -2.78, April 2008 T score -2.61, perhaps no significant change but certainly osteoporotic!)
I was wondering if you have any suggestions regarding putting on shoes and tying the laces but minimizing spinal flexion during the task?
Here are several ideas I had for Wendy:
- Elevate the foot onto a stool and then hip hinge to safely reach for the laces.
- Instead of shoes with laces, wear shoes fastened with velcro and use long handle shoe horn.
- Again, instead of shoes with laces, wear slip-on shoes and use a long handle shoe horn.
- If she loves her laces, consider elastic laces combined with a long handle shoe horn.
Your Comments and Suggestions Welcome (and Encouraged!)
Modifying activities of daily living to accommodate client needs is part of the job for Physical Therapists and Occupational Therapists. Many times the client is unaware of the risks associated with the movement and we have to educate them and show them new ways to perform daily activities.
Do you have to deal with similar issues for your clients? What type of activities are you encountering and what are your suggestions?
What are your suggestions specifically for Wendy? Are there alternative ways to help this client safely tie her shoes?
Please let us know your thoughts and suggestions by commenting below!
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