♪ Bob and Brad ♪
♪ The two most famous ♪
♪ physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist
- And together we are the most famous physical therapists
on the internet. - In our opinion.
- Very humble too. - Very much.
- By the way, Brad, today you wanted
to talk about how to use a sliding board safely
for transfers.
- Not only do I want to talk about it,
we're gonna demonstrate it.
- That's even better.
- Okay, so the slide board is something
that people who have weak legs for whatever reason
may need to do a slide board transfer,
in other words to get from the wheelchair
to the bed, to another chair, or into the car.
- To the commode, to the bathroom.
- Right, exactly.
You know I've seen people who use these a lot
use them -- how did that work?
The person -- from the car to their wheelchair
they were a paraplegic and that person was very good.
- Yeah, paralyzed from the waist down.
- From the waist down and he could get from his chair,
from the wheelchair, from the car and back,
(Brad snaps) just like that
but he made it look easy
but it's one of those things that takes practice,
it takes a lot of upper body strength,
arm strength and core strength.
We'll get into this a little bit more.
- To me, Brad, and I just wanna say this at the outset,
that this is to me one of the more dangerous transfers.
That's why I've worked with this a lot.
I worked on a rehab unit.
I mean, people really had to have good upper body strength
in order to do this,
because if it goes bad, and we'll show you,
I mean you end up on the floor,
and so it's not a good alternative.
- Right, I had one instance where we almost lost a woman
going forward on to the floor.
We had everything set up.
We were able to bring her back,
but if we weren't set up properly
it wouldn't have been good.
- Down she would've gone.
- Exactly.
- By the way, Brad, if you're new to our channel,
I know you aren't but these people out there might be,
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- Excellent, Bob
All right, so again arm strength: absolute necessity.
You need good arm strength, core strength.
Why would you need good core strength?
And you'll see as we get into this,
you need to be able to balance and scooch your trunk
because your legs are not doing the work,
so they're not only doing the work
of holding your balance for your trunk and arms,
but they're moving the weight along with.
Throws your balance off and takes more effort.
- And the core's kinda helping hold your lower body too.
- Right, I think first what we'll do
is we'll demonstrate how to do a slide board
and then after that we'll see if we got some time
to get into some exercises --
- To help prepare you for it.
- Exactly, excellent.
All right, so we're gonna go off --
this is a standard wheelchair
and you'll notice there's one arm rest here
and normally there's a second one here.
You need to have where the arm rest
either folds back or gets out of the way,
so we've already taken this one off,
cause if the arm rest is there
the slide board is not gonna make it.
- It'd be very difficult.
- It gets in the way. It's almost impossible.
The slide board, you know this is
a nice wooden slide board.
They make them out of plastic and they're equally as good.
It's kind of a personal choice.
I like a wooden one because they're slippery.
I just like the looks of them,
and I like the ones that have a taper on the end like here.
Some of them don't, they're just rounded
and they work, but I think the taper can be beneficial.
- A lot easier to slide in and get into the position.
I like the handles too, Brad,
cause some of them don't have it.
- Right, exactly,
and those handles come in handy as you'll see.
So if we're gonna go from this chair to this chair
the heigth of the chair
or the surface you're going to is important.
It's always easier to go downhill
versus trying to go up. - Right, very difficult.
- And we're smiling about it
cause we've both experienced this.
If you're going uphill it takes twice the strength
and everything else, so you can see this is
a little bit lower, a good place to start.
And here's one of the challenges that always come up
with a wheelchair, is the framework.
You have to get the slide board like this
and you have to get the person to lean over
and if they can't lift up their leg
you're gonna -- they have to grab their leg
and lift it up and scoot that underneath there.
Right, nice and tight so that it can stand there,
or sit there by itself.
- And you gotta have pants on
that aren't gonna kinda catch on --
I mean if you have really baggy pants
it starts to kinda catch the board.
- So I've got some tighter workout pants on
that are working really well.
One thing is if skin gets on the board, that's a problem.
If you get caught on the skin,
your skin on this slippery surface is not slippery,
it's actually sticky
particularly if there's a little perspiration involved.
- So if you're wearing a hospital gown,
like you're at the hospital it just doesn't work.
I mean you can't put it under the skin
and hope for this to work.
- So what I do then -- I don't know what you do, Bob,
I just take a towel.
Put the towel there and slide it in there
so that you're sliding across on the towel.
You can go as far as using some baby powder
to get it to slide across
and I'm gonna jump back one more time.
When you get a slide board inspected
to see if it's gonna be safe.
Now this one here is not a safe slide board.
It looks fine, it's good mechanically as far as --
I mean I'm sure I could put it across two surface
and jump on it and it would be fine,
but -- Ronny, can you get a little close up here?
I'm gonna show you a little thing
can cause big problems.
This board right here has a crack
and that crack goes all the way through the board.
This is a disadvantage of wooden --
cause they can crack, wooden slide boards
and you can hear it
and that's a skin pincher
and that can cause an injury
and get you to bleeding if you have someone diabetic
and you open their skin up,
then you get a whole other set of problems.
- And it could also splinter.
- Right, yup, exactly.
And we all know splinters are no fun to deal with.
We're working with enough all ready.
So I'm gonna put that on this end
and I'm just gonna take a chance that we'll be okay.
I would never do this with a patient,
this is gonna up in my fire.
(both laugh)
Yep, we're gonna burn it down in the fire pit,
well we can't do marshmallows on it
cause it's got a varnish.
So we get to here, Bob, and you can help me
if I'm forgetting anything,
and this is where this handle comes in handy.
You're gonna grab over here, one hand here --
- And again, that's where you gotta make sure
it's secured far enough on there
because sometimes as he starts to slide over
it starts to slide out and all of a sudden
if this happens where it goes too --
that far or if the board goes too far,
the board slides out. The board's gotta stay in place.
- So this initial, tuck it in there good.
- And that's why the handle really helps out some times too,
although you don't wanna squish the hand either.
- Right, if you're on a bed it's not going to.
If you're on a firmer chair it might,
and now the arm and the trunk and core strength right here
cause I'm moving my butt out across the slide board
right now as far as --
I always do this with at least two people.
One person behind standing, and a therapist in front
so that if I go backwards or I go forwards
we got good support.
- Especially initially.
- Yep, so two people. One in front, one in back.
And you just start to go and right here it's wobbly
because I'm on top of this wheelchair frame,
and I don't have the brake -- I do have the brake locked.
- Yeah, sometimes the brakes aren't tightening up enough
that they don't hold you.
- This one's just sliding on the floor, Bob.
Yep, just because I got all the weight
on the opposite wheel.
Sure enough, it's locked. - Oh yeah it is.
- That's why you need two people even more that first time.
Now I'm going downhill and now it's getting easy
as long as I got core strength and balancing
so I don't go forward or backwards
and my arms don't have to do a lot of work right now
but they still do when we slide right down to here,
and that's the fun part.
That's when it's like "whoa, things are going good!"
- As long as they don't slide right off the chair.
- But then you got the board here.
How're you gonna get that out of there?
Now if you have, you know, a therapist with you
they can just pull it out
but the whole idea is to independent with this
so we need to teach the patient how to get that out,
so again, they need to lean over --
- This is where it's worrisome where that crack is
cause you could get a little sliver.
- Yeah, I just might put a run in my nylons here.
There we go, and usually this makes a big difference
Wiggle it back and forth, pull it out
and then we're there.
So that's it in a nutshell.
To get back it's absolutely the opposite.
I'm gonna go through this a little quicker
just so you can see.
- Oh look at that. The chair's not holding.
- So these wheelchairs can be a bugger sometimes.
Gonna slide over.
- And that's kind of a little slice of real life,
isn't it, Brad?
I mean things don't go perfect all the time
and wheelchairs can move and that's what makes this
a very difficult transfer to perform.
Imagine going from wheelchair into a car, Brad,
where quite often it's like this.
I mean that's where you almost have to have a guy
that can do it without the board,
he's got such strength, or a girl.
- So if you see someone out doing one of these
and they do make it look so simple,
believe me, they put some time into it
and they've some strength and some talent.
- Yeah, show us some strengthening, Bob
- Okay, we're just gonna do some simple ones
but they're good basic cores exercises.
As far as for the arm strength,
you're in a wheelchair often times, simply --
- Wheelchair pushups - Wheelchair pushups.
Working those triceps, shoulders
and it's a very, very good exercise.
- Tons and tons of those.
- Yep, yeah you're gonna do lots of those.
For you core exercises
in the chair, depending on the person's problem
you may be able to do some knees to chest.
Maybe one at a time, both at a time if they're able to.
Those are pretty aggressive.
I usually start people in bed doing some core exercises
and again these are often times
led by the therapist instructor, so...
But it's a good idea so you have an idea of what,
what you may have if you're be gonna be working on this.
And we may do some trunk exercises here,
single knee to chest,
progress that to tummy tucks
along with posterior pelvic tilts.
I'm squishing in here and then I'm gonna lift both knees.
- [Bob] And obviously if you're paraplegic
you're not gonna be doing these.
This would be someone that maybe has weak legs.
- Right, or a below the knee amputation
and they're gonna do this.
So it all varies on the individual, okay?
Okay and we could work some oblique motion as well.
Elbow to opposite knee, elbow to opposite knee,
and then the other one, Bob.
If someone has a problem sitting on the edge of the bed
just because their balance is off but they're getting better
is -- come on over here -- perturbations.
- Sure.
- Yeah, so the therapist
or someone just kinda pushes you around
and challenges you.
- Yeah in unexpected positions.
You know, I'm going back, I'm going forward,
I'm going sideways. You know, I can go this way.
- Usually what I do as a therapist
is I sit right behind them so they can't see you
and then you work from --
and you know, then it gets them unexpectedly
which is more realistic.
So those are just some simple basic exercises
for this particular goal.
So overall I think you'll find out
it's something that needs some time.
In ten minutes we flew through this, Bob.
- Yeah, it's a difficult transfer,
but you know for some people
it's their really almost only option.
- Right, right, okay.
- Thanks for watching.