From Supine to Sitting at the Edge of the Bed

If your patient is ready to attempt sitting at the edge of the bed (blood pressure, trunk control and endurance have all been assessed) here are a few practical tips to make it easier.

First, measure the length of the femur. This is important to determine the starting position and distance the patient should be from the edge of the bed.
Decrease extensor tone of the lower extremity by placing your hand along the ball of the involved foot. Bring the foot into dorsiflexion and eversion as both legs are brought into hip and knee flexion.
Have your patient roll onto the involved side and swing both legs over the edge of the bed. (Note the femur is fully supported.) Stand in front of your patient to prevent sliding or falling forward.
Carefully support the involved arm and cradle it next to your side. Place your hand along the scapula, taking care not to pull on the arm. Facilitate along the illac crest of the pelvis as you bring the patient into a sitting position.

For more tips and step-by-step handling skills related to bed mobility, see: Teaching Independence: A Therapeutic Approach to Stroke Rehabilitation (TI).

For therapists working in the ICU or acute care setting, see: Treatment Strategies in the Acute Care of Stroke Survivors (AC).